A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?

Choice A reason: This choice is correct because a child who has nephrotic syndrome is the most appropriate roommate for a child who has leukemia. Nephrotic syndrome is a kidney disorder that causes proteinuria, edema, hypoalbuminemia, and hyperlipidemia. It does not pose any risk of infection or injury to the child who has leukemia, and it does not require any isolation or special precautions. Therefore, placing these two children in the same room can help to conserve resources and promote socialization.

Choice B reason: This choice is incorrect because a child recovering from a ruptured appendix is not an appropriate roommate for a child who has leukemia. A ruptured appendix is a medical emergency that occurs when the appendix becomes inflamed and bursts, releasing bacteria and pus into the abdominal cavity. It may cause peritonitis, sepsis, or abscess formation, and it requires surgery and antibiotics. It may pose a risk of infection to a child who has leukemia, who has a weakened immune system due to chemotherapy or bone marrow suppression. Therefore, placing these two children in the same room can increase the chance of cross-contamination and complications.

Choice C reason: This choice is incorrect because a child who has rheumatic fever is not an appropriate roommate for a child who has leukemia. Rheumatic fever is an inflammatory disease that occurs as a complication of streptococcal infection, such as strep throat or scarlet fever. It may affect the heart, joints, skin, or nervous system, and it requires anti-inflammatory and antibiotic medications. It may pose a risk of infection to the child who has leukemia, who has a compromised immune system due to cancer or treatment. Therefore, placing these two children in the same room can increase the likelihood of transmission and infection.

Choice D reason: This choice is incorrect because a child who has cystic fibrosis is not an appropriate roommate for a child who has leukemia. Cystic fibrosis is a genetic disorder that affects the mucus glands of the lungs, pancreas, liver, intestines, and reproductive organs. It causes thick and sticky mucus to build up in the organs, leading to chronic lung infections, pancreatic insufficiency, malnutrition, and infertility. It requires respiratory therapy, enzyme supplements, nutritional support, and antibiotics. It may pose a risk of infection to the child who has leukemia, who has a reduced ability to fight germs due to malignancy or therapy. Therefore, placing these two children in the same room can increase the possibility of exposure and infection.

Choice A: Restraining the child's arms is not an appropriate action for a nurse to take when caring for a child who is experiencing a seizure, as this can cause injury to the child or the nurse. Restraining the child's arms can also increase the child's anxiety and agitation, which can worsen the seizure.

Choice B: Using a padded tongue blade is not an appropriate action for a nurse to take when caring for a child who is experiencing a seizure, as this can cause injury to the child's mouth, teeth, or tongue. Using a padded tongue blade can also increase the risk of choking or aspiration, which can compromise the child's airway.

Choice C: Attempting to stop the seizure is not an appropriate action for a nurse to take when caring for a child who is experiencing a seizure, as this can be ineffective or harmful. Attempting to stop the seizure can also interfere with the natural course of the seizure, which may be necessary for the brain to recover.

Choice D: Positioning the child laterally is an appropriate action for a nurse to take when caring for a child who is experiencing a seizure, as this can help maintain the child's airway and prevent aspiration. Positioning the child laterally means placing the child on their side with their head tilted slightly forward and their mouth open.