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: C

Rationale: Administering supplemental oxygen is the most appropriate nursing intervention to relieve tachycardia that may develop in a client with myocarditis from hypoxemia. Myocarditis can lead to decreased oxygen delivery to the tissues, which may result in tachycardia as the body tries to compensate for the lack of oxygen. Providing supplemental oxygen will help increase oxygen levels in the blood, improving tissue perfusion and thus reducing the tachycardia. This intervention aims to address the underlying cause of the tachycardia in this situation.

Correct Answer: C

Rationale: Osteomyelitis is an infection of the bone often caused by bacteria. When a client is diagnosed with Osteomyelitis, the nurse would expect to assess for positive wound cultures. This means that the wound site is likely to show growth of infectious organisms, confirming the presence of infection in the bone. A positive wound culture result helps guide appropriate antibiotic therapy to treat the infection effectively. Therefore, option C is the most appropriate assessment finding to expect in a client diagnosed with Osteomyelitis.

Correct Answer: C

Rationale: The Guthrie blood test, also known as the newborn screening test, is used to diagnose phenylketonuria (PKU) in newborns. PKU is an inherited metabolic disorder in which the body cannot properly process the amino acid phenylalanine. If left untreated, PKU can lead to intellectual disabilities and other serious health problems. The Guthrie blood test is a simple and effective way to detect PKU early so that treatment can begin promptly to prevent complications.

Correct Answer: D

Rationale: The presence of polyps in the colon is a significant risk factor for developing colorectal cancer. Polyps are abnormal growths in the inner lining of the colon or rectum that can potentially become cancerous over time if left untreated. Therefore, if a client has a history of polyps, the nurse may suspect the possibility of colorectal cancer and should closely monitor the client for any signs or symptoms. While the other conditions listed may sometimes be associated with colorectal cancer, having a history of polyps is the most concerning in this context.