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: C

Rationale: The essential assessment for a client undergoing urinary diversion is the client's knowledge about the effects of the surgery on his nervous control. Urinary diversion is a surgical procedure that involves redirecting urine flow from the bladder to a new exit point in the body due to bladder cancer, birth defects, or other medical conditions. Understanding the effects of the surgery on nervous control is crucial as it can impact the client's ability to control urination and bowel movements post-surgery. Educating the client about these effects will help in managing expectations and in planning for any necessary adjustments to their lifestyle and daily routine. It is important for the nurse to assess the client's level of understanding and provide appropriate education and support regarding nervous control changes that may result from the procedure.

Correct Answer: A

Rationale: The patient's symptoms of tingling in the fingers, positive Trousseau's and Chvostek's signs, and feeling depressed are suggestive of hypocalcemia, which is commonly associated with low serum calcium levels. In this case, the most likely serum calcium value would be below the normal range, which is around 8.5-10.5 mg/dl. Among the given choices, an extremely low calcium value of 5mg/dl (Choice D) would be more consistent with severe hypocalcemia presenting with tetany and other neuromuscular symptoms rather than depression and mild symptoms. On the other hand, a high calcium level of 11mg/dl (Choice A) would indicate hypercalcemia, which can lead to neuropsychiatric symptoms like depression, as seen in this patient's presentation. Therefore, Choice A (11mg/dl) is the most likely serum calcium value for

Correct Answer: C

Rationale: The dietary practice that will help a client reduce the dietary intake of sodium is avoiding the use of carbonated beverages. Carbonated beverages, such as sodas, contain high amounts of sodium that can contribute to increased sodium intake. By avoiding carbonated beverages, the client can effectively reduce their overall sodium consumption. Increasing the use of dairy products, using artificial sweeteners in coffee, and using catsup for cooking and flavoring food do not specifically address the reduction of sodium intake in the same way that avoiding carbonated beverages does.

Correct Answer: A

Rationale: Postural hypotension, also known as orthostatic hypotension, refers to a drop in blood pressure when a person stands up from a sitting or lying position. The usual criteria for diagnosing postural hypotension is a drop in systolic blood pressure of 20 mmHg or more or a drop in diastolic blood pressure of 10 mmHg or more within 3 minutes of standing up.