Nurse Christine is planning a client education program for sickle cell disease (SCD) in children; which of the following interventions would be included in the care plan?

Correct Answer: A

Rationale: The most appropriate intervention to include in the client education program for sickle cell disease (SCD) in children is health teaching to help reduce sickling crises. Education plays a crucial role in managing SCD, and teaching children and their families about strategies to prevent sickling crises can significantly improve health outcomes. This may include advising on proper hydration, avoiding extreme temperatures, maintaining a healthy lifestyle, recognizing the early signs of a crisis, and seeking prompt medical attention when necessary. By providing education on ways to reduce sickling crises, Nurse Christine can empower the children and their families to better manage the condition and improve quality of life.

Correct Answer: D

Rationale: Nurse Cheryl should include in her teaching plan for Reggie's parents to avoid contact with people who have upper respiratory tract infections. Otitis media is often caused by upper respiratory infections, and exposure to individuals with such infections can increase the risk of exacerbating Reggie's condition or causing recurrent infections. Implementing measures to minimize exposure can help prevent further complications and promote faster recovery for Reggie. Placing the child in the supine position to bottle-feed may increase the likelihood of fluid entering the middle ear, worsening the otitis media. Giving amoxicillin on an empty stomach is not recommended as it can cause gastrointestinal upset and reduce absorption; instead, it should be given with food to enhance efficacy. Cleaning the inside of the ear canals with cotton swabs can be harmful and may cause damage or introduce infection, making it an inappropriate practice in managing otitis media.

Correct Answer: B

Rationale: Elevated levels of AFP (alpha-fetoprotein) in the amniotic fluid during an amniocentesis often indicate neural tube defects, such as spina bifida. Spina bifida is a condition where the spinal cord does not develop properly, leading to a range of possible issues depending on the severity of the defect. In this case, the elevated AFP levels point towards a higher likelihood of spina bifida rather than other conditions like CP (cerebral palsy), Down syndrome, or hydrocephalus.

Correct Answer: D

Rationale: When assessing a newborn and noticing a wide perineum and unequal gluteal and thigh folds, it may signal the possibility of developmental dysplasia of the hip (DDH), also known as hip dysplasia. DDH is a condition where the hip joint does not properly form in newborns, leading to instability and potential dislocation. The wide perineum and unequal gluteal and thigh folds are physical signs that can be indicative of hip dysplasia. It is essential to diagnose and treat hip dysplasia early to prevent long-term complications like difficulty walking and osteoarthritis. Regular screening of newborns for hip dysplasia risk factors and physical exam findings is crucial for early detection and intervention.

Correct Answer: C

Rationale: In Juvenile Rheumatoid Arthritis (JRA), which is now referred to as Juvenile Idiopathic Arthritis (JIA), the autoimmune reaction primarily occurs in the synovial tissue of the joints. The synovial tissue lines the inside of the joint capsule and produces synovial fluid, which helps to lubricate and nourish the joint. In JIA, the immune system mistakenly targets the synovial tissue, leading to inflammation, pain, and damage to the joints. This inflammatory process can result in swelling, warmth, stiffness, and eventual joint destruction if left untreated. Therefore, the synovial tissue is the primary site of the autoimmune reaction in JRA/JIA.