Achild has a chronic cough, no retractions but diffuse wheezing during the expiratory phase of respiration. This suggests which of the following?

Correct Answer: A

Rationale: The presence of a chronic cough, along with diffuse wheezing during the expiratory phase of respiration, suggests asthma. Asthma is a chronic condition characterized by inflammation and narrowing of the airways, causing symptoms such as coughing, wheezing, and difficulty breathing. The wheezing sound typically occurs during expiration due to air trapping in the narrowed airways. In this case, the absence of retractions (which could indicate increased work of breathing) and the nature of the wheezing pattern are more consistent with asthma rather than other conditions such as pneumonia, croup, or foreign body aspiration. While these other conditions may also present with respiratory symptoms, the specific combination of chronic cough and expiratory wheezing is most indicative of asthma in this scenario.

Correct Answer: C

Rationale: Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not develop normally. In infants, one of the signs of DDH is the presence of asymmetry of gluteal (buttock) and thigh folds. This is due to the dislocated or subluxed hip being positioned differently than the healthy hip. The nurse should look for this sign during the assessment of a 2-week-old infant to help identify potential hip joint problems early on. Excessive hip abduction, femoral lengthening of an affected leg, and pain when lying prone are not typical signs of DDH in a 2-week-old infant.

Correct Answer: B

Rationale: In a patient with diabetes insipidus (DI) who is on fluid restrictions, monitoring urine output is crucial to assess the effectiveness of the treatment regimen. DI is a condition characterized by excessive urination and thirst due to a deficiency of antidiuretic hormone (ADH). By monitoring urine output, the nurse can determine if the restrictions are achieving the goal of decreasing urine volume and preventing dehydration. Changes in urine output can also indicate the need for adjustments in the treatment plan. Monitoring oral intake, appearance of mucous membranes, and pulse and temperature are important aspects of pediatric care but are not as directly related to managing fluid restrictions in a patient with DI.

Correct Answer: D

Rationale: Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated streptococcal infections, especially streptococcal throat infections caused by group A streptococcus bacteria. The bacteria trigger an abnormal immune response in susceptible individuals, leading to the development of rheumatic fever. The other choices are not accurate. Glomerulonephritis is a separate condition associated with certain types of streptococcal infections but not with rheumatic fever. Symptoms of rheumatic fever can persist even after the fever has subsided, and it is important for children with rheumatic fever to follow proper treatment and rest guidelines as advised by healthcare providers. It is crucial for individuals with rheumatic fever to avoid activities that could strain the heart until the condition has been properly managed.

Correct Answer: C

Rationale: Ortolani's sign is a physical exam maneuver used to detect congenital hip dislocation in infants. When performing Ortolani's sign, the nurse gently abducts the hips and feels the femoral head slipping back into the acetabulum. This is considered a positive finding and suggests the presence of hip dysplasia. Barlow's test, on the other hand, involves gently adducting the hip to feel for instability and potential dislocation. Jackson's sign is a maneuver for detecting hip dislocation by observing leg length discrepancy. Trendelenburg's sign is a test for hip abductor weakness. Hematuria is the presence of blood in urine and is not related to hip exams or signs.