Parents tell the nurse that their child keeps scratching the areas where he has poison ivy. The nurse's response should be based on which knowledge?

Correct Answer: D

Rationale: Scratching the lesions caused by poison ivy may result in them becoming secondarily infected. It is important to advise against scratching the affected areas to prevent the introduction of bacteria from under the fingernails or through broken skin, which can lead to infection. This can complicate the initial skin irritation caused by the poison ivy rash. Encouraging the child to avoid scratching and keeping the affected areas clean can help prevent secondary infections and promote healing.

Correct Answer: D

Rationale: More than 2 exacerbations per year suggest suboptimal asthma control, requiring reassessment of management strategies.

Correct Answer: C

Rationale: The boy meets the Jones criteria with two major (carditis, polyarthritis) and two minor (CRP, ASOT) criteria, confirming rheumatic fever.

Correct Answer: C

Rationale: Atelectasis typically causes dullness to percussion due to lung collapse. It pulls the mediastinum toward the affected side and leads to decreased breath sounds.

Correct Answer: D

Rationale: Choanal atresia is a congenital nasal obstruction that causes cyanosis that worsens with feeding and improves with crying, since crying opens the mouth for breathing. Bilateral atresia requires urgent intervention.