Which of the following actions by the practitioner would be important in the prevention of rheumatic fever?

Correct Answer: C

Rationale: The correct action to prevent rheumatic fever is to refer children with sore throats for throat cultures (Choice C). Rheumatic fever is caused by an abnormal immune response to a bacterial infection with group A Streptococcus. By promptly diagnosing and treating streptococcal infections with antibiotics, the risk of developing rheumatic fever can be minimized. Conducting throat cultures for children with sore throats helps identify streptococcal infections and allows for appropriate antibiotic treatment, thereby preventing the progression to rheumatic fever. Encouraging routine hypertensive screenings (Choice A) and conducting routine occult blood screenings (Choice B) are not directly related to the prevention of rheumatic fever. Recommending salicylates instead for minor discomforts (Choice D) is contraindicated in cases of suspected or confirmed streptococcal infections due to the risk of worsening symptoms and potentially triggering rheumatic fever.

Correct Answer: B

Rationale: Acute glomerulonephritis is a condition characterized by inflammation of the glomeruli in the kidneys, leading to kidney dysfunction. Common laboratory findings consistent with acute glomerulonephritis include hematuria (blood in the urine), proteinuria (protein in the urine), and white cell casts (indicative of inflammation in the kidney tubules). Polyuria, which refers to excessive urination, is not a typical laboratory finding associated with acute glomerulonephritis. Instead, patients with acute glomerulonephritis often present with oliguria or reduced urine output due to impaired kidney function. Therefore, polyuria is not consistent with the typical laboratory findings of acute glomerulonephritis.

Correct Answer: B

Rationale: In a vaso-occlusive sickle cell crisis, it is crucial to focus on adequate hydration and pain management. Hydration is essential to prevent further sickling of red blood cells, which can exacerbate tissue damage and pain. Pain management is a key aspect of care as vaso-occlusive crises often cause severe pain that requires prompt and effective treatment. Administering heparin is not indicated in a vaso-occlusive sickle cell crisis as it is primarily used for conditions like deep vein thrombosis. Correcting acidosis and replacing factor VIII are also not typically part of the management of a vaso-occlusive sickle cell crisis.

Correct Answer: A

Rationale: Before administering digoxin, it is crucial for the nurse to check the patient's pulse rate. Digoxin is a medication commonly used to treat heart conditions such as atrial fibrillation and heart failure by increasing the strength and efficiency of the heart's contractions. However, digoxin can also cause adverse effects such as bradycardia (slow heart rate) or heart block. Therefore, it is important to assess the patient's pulse rate to ensure that it is within the safe range before administering digoxin.

Correct Answer: D

Rationale: Vernix caseosa is the grayish white, cheeselike substance that normally covers a newborn's skin at the time of birth. It is a natural substance produced by the baby's skin glands while in the womb. Vernix caseosa helps protect the baby's delicate skin from the amniotic fluid in the uterus and acts as a moisturizer as well. It also has antimicrobial properties, providing a barrier against infection. After birth, healthcare providers typically wipe off or gently wash the vernix from the baby's skin during the first bath.