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: D

Rationale: In this situation, the nurse's priority is to provide a safe environment for the patient during the seizure. Inserting a padded tongue blade (Option A) is not recommended as it can cause more harm than good, such as dental injury. Restraint of the patient (Option B) during a seizure is also not recommended as it can lead to injury. Calling the operator to page for seizure assistance (Option C) may delay immediate intervention. The best course of action is for the nurse to clear the area of any objects that may injure the patient during the seizure and position the client safely. This will help prevent injury and ensure the patient's safety until the seizure subsides.

Correct Answer: B

Rationale: Following laryngectomy surgery, the larynx (voice box) is removed, making it impossible for the patient to produce sound for speech. The options listed are alternative communication methods for patients post-surgery, except for using a picture board. Placing a finger over the stoma can help redirect air for speech, using a special valve can help divert air for speech as well, and learning esophageal speech involves speaking by swallowing air into the esophagus and then releasing it to create sound. Picture boards are not a common method of communication for patients following laryngectomy surgery.

Correct Answer: A

Rationale: With a WBC count of 3,000/ul (indicating leukopenia or low white blood cell count), the priority nursing intervention should be preventing infection. Leukopenia puts the client at a higher risk of developing infections due to a compromised immune system. Nurses should focus on implementing strict infection control measures, such as hand hygiene, maintaining a sterile environment, and promoting vaccination compliance to reduce the risk of infection for the hospitalized client. This intervention is crucial for ensuring the client's safety and well-being during their hospital stay. Alleviating pain, controlling infection, and monitoring blood transfusion reactions are important aspects of care but in this scenario, preventing infection takes precedence due to the client's low WBC count.

Correct Answer: C

Rationale: The most appropriate nursing intervention in this situation is to resume orogastric feedings of breast milk. The newborn is showing signs of fatigue and weak sucking and swallowing reflexes during nipple feedings, indicating that they may not be ready to tolerate full oral feedings yet. By resuming orogastric feedings of breast milk, the newborn can continue to receive nutrition while building strength and coordination for oral feedings. It is important to progress gradually and monitor the newborn's tolerance for oral feedings before attempting nipple feedings again.

Correct Answer: C

Rationale: Corticosteroids, such as prednisone, are commonly used in the treatment of juvenile rheumatoid arthritis (JRA) to reduce inflammation and pain. However, one of the complications associated with corticosteroid use is immune suppression. Corticosteroids can suppress the immune system by reducing the activity and effectiveness of white blood cells, making individuals more susceptible to infections. It is important for healthcare providers, including nurses, to educate adolescents and their families about the risks and possible complications of corticosteroid therapy, including immune suppression.

Correct Answer: C

Rationale: When a neurologist asks a patient to smile, they are testing the function of the facial nerve, Cranial Nerve VII (CN VII). CN VII controls the muscles of facial expression, including the muscles required for smiling. If there is weakness or paralysis on one side of the face when the patient tries to smile, it may indicate a problem with CN VII function, such as Bell's palsy or a lesion affecting the facial nerve.

Correct Answer: C

Rationale: Tuberculosis is primarily spread through the air when an infected person coughs, sneezes, speaks, or sings, releasing bacteria-containing droplets into the air. Therefore, it is important for the individual with TB to cover their mouth and nose when coughing or sneezing to prevent the spread of the bacteria. By coughing into a disposable tissue or a handkerchief that can be washed in hot water, the risk of spreading the infection to others is significantly reduced. This measure helps minimize the transmission of the disease within the household and community.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.