A 3-year-old female patient woke up this morning feeling agitated and with a fever of 103.4° F (39.7° C). She was crying yesterday and reported back pain.

She has a history of asthma controlled by daily cetirizine and occasional albuterol.

She has had two urinary tract infections (UTIs) in the past 4 months.

Given the patient’s history and current condition, which condition is she most likely experiencing, what actions should the nurse take, and what parameters should the nurse monitor?

Administer the prescribed antipyretic

Obstructive uropathy

Albumin

V320

Answer and Explanation

The Correct Answer is A

Choice A rationale
The child’s symptoms of agitation, fever, and back pain, along with a history of asthma and recurrent urinary tract infections (UTIs), suggest that she may be experiencing another UTI1.
UTIs can cause fever and back pain, and the fever can lead to agitation in young children. Administering the prescribed antipyretic would help to reduce the child’s fever and alleviate some of her discomfort.
Choice B rationale
Obstructive uropathy is a condition where the flow of urine is blocked, which can cause pain and kidney damage. While this condition could potentially cause back pain, the child’s other symptoms such as fever and agitation are more indicative of an infection like a UTI1.
Choice C rationale
Albumin is a protein made by the liver that helps keep fluid in the bloodstream so it doesn’t leak into other tissues. It is not a condition but a substance in the body, and therefore would not be the correct answer to the question.
Choice D rationale
V320 is not a known medical condition or term, and therefore would not be the correct answer to the question.

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Correct Answer is A

Explanation

The correct answer is A. Praise the client for her actions and offer to discuss ways to decrease consumption even more.

Why? During pregnancy, any amount of alcohol poses a risk to the developing fetus, but abruptly shaming or forcing action may not be effective. The best approach is motivational interviewing, which involves acknowledging the client's reduction while encouraging further progress. A supportive conversation can help guide the client toward complete cessation of alcohol use.

Here’s why the other options are incorrect:

B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit – While alcohol cessation is the goal, forcing the client without a supportive approach can lead to resistance. Routine blood alcohol testing is not standard unless substance dependence is suspected.
C. Notify child protective services of the client’s illicit drug use and probable child endangerment – Alcohol is not classified as an illicit drug, and reporting at this stage would be premature unless clear evidence of abuse or harm to the fetus exists.
D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy – Disulfiram (Antabuse) is not recommended in pregnancy, as it may cause adverse effects. Instead, behavioral counseling and support groups are preferred interventions.

A. Administer the prescribed antipyretic B. Obstructive uropathy C. Albumin D. V320

Correct Answer is A

Explanation

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client at 9-weeks gestation informs the nurse that she has reduced her alcohol intake but still consumes at least one alcoholic drink every evening before bedtime. What action should the nurse take?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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