A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?

Correct Answer: B

Rationale: In pediatric nursing, understanding the relationship between elevated ASO titers and rheumatic fever is crucial. The correct answer is B) Painful, tender joints, and carditis. Rheumatic fever is a complication that can arise from untreated streptococcal infections. An elevated ASO titer indicates recent streptococcal infection, which can lead to autoimmune reactions causing rheumatic fever. Painful, tender joints (arthralgia) and carditis (inflammation of the heart) are classic symptoms of rheumatic fever. Option A) Subcutaneous nodules and fever are more indicative of rheumatic fever in advanced stages, but they are not the confirmatory symptoms. Option C) Erythema marginatum and arthralgia are also associated with rheumatic fever but are not confirmatory. Option D) Chorea (involuntary movements) and elevated sedimentation rate are symptoms found in Sydenham's chorea, another manifestation of rheumatic fever, but they do not confirm the diagnosis of rheumatic fever. Educationally, this question highlights the importance of recognizing the clinical manifestations of rheumatic fever in children with elevated ASO titers. It emphasizes the need for nurses to be able to differentiate between the various symptoms associated with rheumatic fever to provide timely and appropriate care to pediatric patients. Understanding these connections is vital in the assessment and management of pediatric cardiovascular conditions.

Correct Answer: C

Rationale: In this scenario, option C is the correct answer because it accurately conveys the significance of the blockages found during the cardiac catheterization. The statement that "Three main arteries have major blockages, with only 1 to 5% of blood flow getting through to the heart muscle" effectively communicates the severity of the situation to the client. This information is crucial for the client to understand the extent of the blockages and the potential implications for their heart health. Option A is incorrect because it only vaguely mentions lifestyle changes without providing specific details about the severity of the blockages. Option B is also incorrect as it focuses on past heart attacks rather than the current blockages identified. Option D is incorrect as it discusses the risk of heart failure and fluid retention without directly addressing the specific blockages identified in the client's case. Educationally, it's important for nurses to be able to clearly communicate complex medical information to patients in a way that is easy to understand yet conveys the seriousness of the situation. Understanding the implications of blockages in the coronary arteries is crucial for providing effective patient education and promoting patient engagement in their own healthcare management. By choosing option C, the nurse can empower the client to make informed decisions about their treatment and lifestyle modifications.

Correct Answer: C

Rationale: In the context of caring for a client with Amyotrophic Lateral Sclerosis (ALS), the assessment finding that warrants immediate intervention by the nurse is option C) Weakened cough effort. This is because weakened cough effort in a client with ALS can lead to an increased risk of aspiration and respiratory complications due to compromised airway clearance. Option A) Inappropriate laughter may be a symptom of pseudobulbar affect, which can occur in ALS, but it is not immediately life-threatening and would not require urgent intervention. Option B) Increasing anxiety is a common emotional response in patients with chronic illnesses like ALS, but it does not require immediate intervention unless it is severe and impacting the patient's immediate safety. Option D) Asymmetrical weakness is a common symptom in ALS due to its progressive nature, but it does not warrant immediate intervention unless it is acutely worsening and affecting the patient's ability to breathe or maintain their airway. Educationally, it is essential for nurses to prioritize and recognize critical assessment findings in clients with ALS to prevent complications and provide timely interventions. Understanding the unique manifestations of ALS and their implications on the client's health is crucial for delivering safe and effective care in pediatric nursing practice.

Correct Answer: B

Rationale: In the context of pediatric nursing and cardiovascular health, the correct answer, option B, to encourage the client with glomerulonephritis to restrict protein intake by limiting meats and other high-protein foods is crucial due to the impaired kidney function associated with glomerulonephritis. Excessive protein can lead to increased waste products that the compromised kidneys may struggle to filter, worsening the condition. Option A, increasing intake of high-fiber foods, is not directly related to managing glomerulonephritis. While fiber is important for overall health, it is not a specific dietary recommendation for this condition. Option C, limiting oral fluid intake to 500 ml per day, is incorrect as fluid restriction is generally not recommended for clients with glomerulonephritis unless they have severe edema or are in end-stage renal failure. Fluid management is typically individualized based on the client's condition and kidney function. Option D, increasing intake of potassium-rich foods, such as bananas or cantaloupe, is not recommended for clients with glomerulonephritis, especially if they have hyperkalemia, a common complication in such cases. Excessive potassium intake can further burden the kidneys and lead to electrolyte imbalances. Educationally, understanding the rationale behind dietary recommendations for clients with glomerulonephritis is crucial for nurses caring for pediatric patients with this condition. By grasping the importance of protein restriction to alleviate the kidneys' workload, nurses can help manage and improve the client's health outcomes effectively.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer that warrants notification of the healthcare provider before proceeding with the scheduled procedure. A blood pressure reading of 184/88 mm Hg indicates hypertension, which can increase the risk of intraoperative and postoperative complications, such as bleeding and cardiac events. Option A, light yellow coloring of the skin and eyes, could indicate jaundice, which may also be concerning but is not as immediately life-threatening as uncontrolled hypertension. Option C, vomiting clear yellowish fluid, may suggest bile reflux, but it is not as urgent or critical as uncontrolled hypertension. Option D, a red, swollen, and leaking IV insertion site, indicates a local infection or infiltration, which is important but can be addressed by the nursing staff without delaying the procedure. Educationally, this question highlights the importance of recognizing and prioritizing critical assessment findings in the preoperative setting, emphasizing the impact of vital signs on surgical outcomes in pediatric patients undergoing general anesthesia. Nurses must be vigilant in identifying potential risk factors to ensure patient safety and optimal surgical outcomes.