Molly, with suspected rheumatic fever, is admitted to the pediatric unit. When obtaining the child's history, the nurseconsiders which information to be most important?

Correct Answer: C

Rationale: A recent episode of pharyngitis is most important when obtaining the history of a child suspected of having rheumatic fever because rheumatic fever often develops as a complication of inadequately treated streptococcal pharyngitis. It is crucial to determine if there was a recent streptococcal infection to assess the likelihood of rheumatic fever developing. The other symptoms mentioned, such as fever, lack of interest in food, and vomiting, are important as well, but the connection with the recent episode of pharyngitis is more specifically related to the potential development of rheumatic fever in this case.

Correct Answer: B

Rationale: Primary enuresis refers to involuntary wetting during sleep in children who have never been consistently dry at night. The most likely underlying physiology of primary enuresis is delayed bladder maturation. This means that the child's bladder is not yet able to hold urine for the entire night, leading to bedwetting episodes. As children age, their bladder capacity increases and their ability to remain dry at night improves. In most cases, primary enuresis resolves on its own as the child's bladder matures. It is important for parents and caregivers to provide support and reassurance to the child during this time.

Correct Answer: A

Rationale: Short stature due to growth hormone deficiency commonly occurs as a result of anterior pituitary gland hypofunction. The anterior pituitary gland is responsible for releasing growth hormone, which is crucial for proper growth and development, especially during childhood. When there is a deficiency of growth hormone, children may experience slowed growth rates and ultimately result in short stature. Other gland dysfunctions mentioned in the choices, such as posterior pituitary gland hyperfunction, parathyroid gland hyperfunction, and thyroid gland hyperfunction, do not directly impact growth hormone production and are not associated with growth hormone deficiency-related short stature in children.

Correct Answer: A

Rationale: Deferoxamine is a chelating agent used to treat iron overload in patients such as those with thalassemia. One of the serious side effects of deferoxamine is ototoxicity, which can manifest as decreased hearing or ringing in the ears. Therefore, if a child with thalassemia who is taking deferoxamine experiences a decrease in hearing, the nurse should promptly notify the physician for further evaluation and possible adjustment of the treatment plan to prevent further hearing damage. Hypertension, red urine, and vomiting are possible side effects of deferoxamine, but decreased hearing is the most concerning side effect that requires immediate attention due to the risk of permanent damage.

Correct Answer: A

Rationale: The most appropriate instruction in a teaching plan focusing on initial prevention for Sheri, who is diagnosed with rheumatic fever, would be treating streptococcal throat infections with an antibiotic (Choice A). Rheumatic fever is often preceded by a group A streptococcal infection, such as strep throat. Prompt treatment of streptococcal infections with antibiotics can help prevent the development of rheumatic fever and its complications. Therefore, this instruction emphasizes the importance of treating the initial infection to prevent the occurrence of rheumatic fever in individuals like Sheri who are at risk. Choices B, C, and D are not specific to the initial prevention of rheumatic fever but may be more related to the management or treatment of established cases.