A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant?

Chickenpox.

Mumps.

Sore throat.

Influenza.

Answer and Explanation

The Correct Answer is C

A. Chickenpox is caused by the varicella-zoster virus and is not directly related to the development of acute rheumatic fever.

B. Mumps is caused by the mumps virus and is not directly related to the development of acute rheumatic fever.

C. Sore throat.

Acute rheumatic fever (ARF) is an inflammatory condition that can occur after an untreated or inadequately treated streptococcal throat infection, such as streptococcal pharyngitis (strep throat). It is caused by group A Streptococcus bacteria.

In ARF, the body's immune response to the streptococcal infection can lead to inflammation and damage to various parts of the body, including the heart, joints, skin, and central nervous system. One of the major criteria for diagnosing ARF is a history of a sore throat. Therefore, the most significant recent occurrence for the health history in this case would be a sore throat (option C).

D. Influenza is caused by the influenza virus and is not directly related to the development of acute rheumatic fever.

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Correct Answer is B

Explanation

A. Assessing for teeth clenching or grinding is not the most appropriate assessment in this situation. While teeth clenching or grinding may indicate discomfort or anxiety, it may not directly address the specific concern of post-operative bleeding after a tonsillectomy.

B Inspect the posterior oropharynx.

Observing a child who has had a tonsillectomy frequently swallowing may raise concerns about post-operative bleeding. Inspecting the posterior oropharynx is essential to assess for any signs of bleeding, such as fresh blood or bleeding sites.

C. Asking the child to speak to evaluate a change in voice tone is not the primary assessment needed in this scenario. The primary concern is to assess for any signs of bleeding, and this can be done by inspecting the posterior oropharynx.

D. Touching the tonsillar pillars to stimulate the gag reflex is not necessary and may not be well-tolerated by the child who has had a tonsillectomy. It's also not the primary assessment to address the concern of post-operative bleeding.

A. Evaluate infant for failure to thrive (FTT). B. Auscultate heart and lungs while infant is held. C. Stimulate the infant to cry to produce cyanosis. D. Obtain a 12-lead electrocardiogram.

Correct Answer is B

Explanation

A. Evaluating the infant for failure to thrive (FTT) is not the most appropriate initial intervention in this case. FTT is a long-term growth issue, and the immediate concern is the infant's current symptoms and cardiac status.

B. Auscultate heart and lungs while the infant is held.

Tetralogy of Fallot (TOF) is a congenital heart defect that includes four specific cardiac abnormalities, and it often requires surgical correction in infancy. When an infant with a history of TOF surgery presents with symptoms such as rapid breathing, feeding difficulties, and fatigue, it may raise concerns about potential cardiac issues or complications.

The most appropriate initial intervention is to auscultate the infant's heart and lungs while the infant is held to assess for any abnormal heart sounds or signs of respiratory distress. Auscultation can provide important information about the infant's cardiac and respiratory status. This assessment will help determine if there are any immediate concerns related to the infant's cardiac condition.

C. Stimulating the infant to cry to produce cyanosis is not a recommended or appropriate intervention. Cyanosis is a sign of inadequate oxygenation and should not be induced in a child.

D. Obtaining a 12-lead electrocardiogram may be indicated if there are significant concerns about the infant's cardiac status, but auscultation should be performed first to assess the immediate condition. An electrocardiogram is a diagnostic tool and would be ordered as a follow-up assessment if needed.

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A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is B

Explanation

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