A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?
Apply cool compresses for 20 min every hour.
Encourage the child to take a 45-minute nap daily.
Allow the child to stay at home on days when her joints are painful.
Administer prednisone on an alternate-day schedule.
The Correct Answer is D
Choice A reason: wrong because applying cool compresses for 20 minutes every hour is not typically recommended. While cool compresses can help reduce joint swelling and pain, they are usually recommended to be applied for short periods and not as frequently as every hour
Choice B reason: wrong because while rest is important, there is no specific recommendation for a 45-minute nap daily. Adequate rest should be balanced with physical activity, which is essential for maintaining joint function and muscle strength
Choice C reason: wrong because allowing the child to stay at home on days when her joints are painful may lead to prolonged inactivity, which can worsen joint stiffness and reduce muscle strength. It’s important to encourage regular movement and activity as tolerated
Choice D reason: This is correct because prednisone is a corticosteroid used to reduce inflammation in conditions like juvenile idiopathic arthritis, and an alternate-day schedule can be effective in managing symptoms while minimizing side effects
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: Urinary incontinence is a condition of involuntary loss of urine control, which can be caused by various factors, such as nerve damage, bladder dysfunction, or medication side effects. It is not always caused by neuroblastoma, which is a type of cancer that arises from immature nerve cells.
Choice B: Blood-fed is not a term that describes a neuroblastoma. Neuroblastoma is a type of cancer that arises from immature nerve cells, which can form tumors in various parts of the body, such as the adrenal glands, abdomen, chest, or spine.
Choice C: Tiny is not a term that describes a neuroblastoma. Neuroblastoma can vary in size and shape depending on the location and stage of the tumor. Some neuroblastomas can be very large and cause compression of nearby organs or structures.
Choice D: Unfortunately, much of the time, by the time a diagnosis has been made, metastasis has already occurred. This statement describes a neuroblastoma accurately. Neuroblastoma is a type of cancer that arises from immature nerve cells, which can spread rapidly to other parts of the body, such as the bones, liver, lymph nodes, or skin.
Metastasis is the process of cancer cells breaking away from the original tumor and forming new tumors elsewhere. Neuroblastoma often has no specific symptoms until it has metastasized, making it difficult to diagnose early and treat effectively.
Correct Answer is A
Explanation
Choice A: An ostomy is a surgical opening in the abdomen that allows stool to pass out of the body. A child who has Hirschsprung disease, which is a condition that causes a blockage of the large intestine due to a lack of nerve cells, may need an ostomy to relieve the obstruction and prevent complications. The ostomy is usually temporary and can be reversed after the affected part of the intestine is removed or repaired. This statement indicates an understanding of the teaching, as the parent knows that the ostomy is not permanent.
Choice B: A urinary catheter is a tube that drains urine from the bladder. A child who has Hirschsprung disease does not need a urinary catheter, as their condition does not affect their urinary system. This statement indicates a lack of understanding of the teaching, as the parent is confused about the type of surgery or device that their child will have.
Choice C: A feeding tube is a tube that delivers nutrition directly into the stomach or small intestine. A child who has Hirschsprung disease may need a feeding tube if they have severe malnutrition, dehydration, or infection due to their condition. However, this is not always necessary and depends on the individual case and the surgeon's preference.
This statement indicates a lack of understanding of the teaching, as the parent assumes that their child will need a feeding tube without knowing the specific plan.
Choice D: A child who has Hirschsprung disease will not have normal bowel movements after the initial surgery, as they will still have an ostomy that bypasses their large intestine. They will need another surgery to reconnect their intestine and restore their bowel function. This statement indicates a lack of understanding of the teaching, as the parent has unrealistic expectations about the outcome of the surgery.
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