The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?

Correct Answer: A

Rationale: Rheumatic fever is a systemic inflammatory condition that can develop as a complication of untreated or inadequately treated streptococcal infections, such as strep throat. One of the major clinical manifestations of rheumatic fever is polyarthritis, which is characterized by inflammation and pain in multiple joints. It typically involves large joints like the knees, ankles, elbows, and wrists. Polyarthritis in rheumatic fever is migratory in nature, meaning the joint pain shifts from one joint to another over a period of time. Other common clinical manifestations of rheumatic fever include carditis (inflammation of the heart), chorea (involuntary movements), subcutaneous nodules, and erythema marginatum (rash).

Correct Answer: B

Rationale: The nurse is testing the girl's cerebellar function by asking her to do the "finger-to-nose" test. The cerebellum is the part of the brain that plays a crucial role in coordinating movement, balance, and posture. In the finger-to-nose test, the child is asked to touch her own nose and then the nurse's finger repeatedly. A properly functioning cerebellum helps control and coordinate these precise movements. If there are issues with the cerebellar function, the child might have difficulty performing this task accurately, indicating a potential problem with motor coordination and balance.

Correct Answer: A

Rationale: In a female child with acute post-streptococcal glomerulonephritis, the earliest sign of improvement is often seen as an increase in urine output. This occurs as the kidneys start to recover and normal functioning is restored. Increased urine output indicates improved glomerular filtration and clearance of waste products from the body. It is an essential indicator of renal function and overall improvement in the condition of the child. Other signs such as increased appetite and energy levels may follow but increased urine output is typically the first noticeable sign of improvement in cases of glomerulonephritis.

Correct Answer: B

Rationale: The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first 6 months of a baby's life. Breast milk provides all the necessary nutrients and antibodies that a baby needs for healthy growth and development during this crucial period. Breastfeeding also offers long-term health benefits for both the baby and the mother. It is important for mothers to receive support and education to establish and maintain successful breastfeeding. After the first 6 months, the AAP recommends continuing breastfeeding while introducing appropriate solid foods until at least 12 months of age, or longer if both the mother and baby are willing and able.

Correct Answer: D

Rationale: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes characterized by hyperglycemia, ketosis, and metabolic acidosis. The initial treatment for DKA requires correcting dehydration and electrolyte imbalances. Normal saline infusion is the preferred choice for initial fluid resuscitation in patients with DKA to address dehydration and restore intravascular volume. It helps improve organ perfusion and correct electrolyte imbalances such as hyponatremia and dehydration commonly seen in DKA patients. Administering normal saline helps replace lost fluids and improve circulation, which is crucial in the management of DKA. Potassium infusion may be needed later to replete potassium levels once the patient's kidney function has been assessed. NPH insulin infusion is not the initial treatment for DKA, although insulin therapy is an essential component of DKA management. 5% dextrose infusion is contraindicated in the initial treatment