The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?

Correct Answer: B

Rationale: It is important to note that exercise should not be completely avoided for a child with asthma. Regular physical activity is beneficial for overall health and can help improve lung function in asthmatic individuals. Supervised and controlled exercise under the guidance of healthcare providers can be safe for children with asthma. Avoiding exercise altogether can lead to deconditioning and other health issues. It is important to educate the family on the proper management of asthma during exercise, such as using a rescue inhaler before engaging in physical activity. Therefore, this statement indicates a need for further home care teaching.

Correct Answer: B

Rationale: When scoliosis progresses to a greater than 40-degree curvature, it is often treated with spinal fusion surgery. This surgical procedure involves fusing together the vertebrae in the curved part of the spine to correct the curvature. Spinal fusion surgery is typically recommended for severe cases of scoliosis to halt the progression of the curve and prevent further complications such as lung and heart problems. Other treatment options like exercise, bracing, and casting may be more suitable for milder cases or as a preventative measure in certain situations.

Correct Answer: A

Rationale: Methotrexate, which is a disease-modifying antirheumatic drug (DMARD), is commonly used to treat juvenile arthritis by decreasing the inflammatory response in the joints. By suppressing the overactive immune response that causes inflammation in the joints, methotrexate helps reduce pain, swelling, and stiffness in children with juvenile arthritis. This ultimately helps to improve joint function and prevent joint damage. While methotrexate may indirectly contribute to improving functional ability and controlling febrile responses in some cases, its primary mechanism of action is to target and reduce inflammation in juvenile arthritis. The medication may also help in managing associated conditions like uveitis, but its main role lies in decreasing the inflammatory response in arthritis.

Correct Answer: C

Rationale: A febrile seizure is a convulsion in a young child triggered by a spike in body temperature, often from an infection. Febrile seizures typically occur early in the course of a high fever in children between the ages of 6 months to 5 years old. They are usually brief, lasting for less than five minutes. In about one-third of cases, febrile seizures may occur before the fever is noted by a caregiver. Therefore, the statement that febrile seizures usually occur late in the course of high fever is incorrect.

Correct Answer: D

Rationale: Coarctation of the aorta is a congenital heart defect characterized by a narrowing of the aorta, the main artery carrying blood from the heart to the body. The signs of coarctation of the aorta include higher blood pressure in the upper extremities (Choice A) due to the narrowing of the aorta causing increased pressure proximal to the constriction. Right ventricular hypertrophy (Choice B) occurs as the heart works harder to overcome the obstruction in the aorta. Legs being cooler than arms (Choice C) is a result of decreased blood flow to the lower body due to the aortic narrowing. Hemodilution (Choice E) can occur as a compensatory mechanism in response to the increased blood pressure in the upper body. Nosebleeds (Choice D) are not typically associated with coarctation of the aorta but may occur due to other factors unrelated to this condition.