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.

Answer and Explanation

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

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Correct Answer is B

Explanation

Choice A reason: This choice is incorrect because mumps is not the common name for pertussis. Mumps is a viral infection that causes inﬂammation of the salivary glands, especially the parotid glands. It may cause symptoms such as fever, headache, and swelling of the cheeks or jaw. It can be prevented by vaccination with the measles-mumps-rubella (MMR) vaccine.

Choice B reason: This choice is correct because whooping cough is the common name for pertussis. Pertussis is a bacterial infection that causes severe coughing spells, which may be followed by a high-pitched whoop sound or vomiting. It may cause complications such as pneumonia, seizures, or brain damage, especially in infants and young children. It can be prevented by vaccination with the diphtheria-tetanus-pertussis (DTaP) vaccine.

Choice C reason: This choice is incorrect because the fifth disease is not the common name for pertussis. The fifth disease is a viral infection that causes a rash on the face, trunk, and limbs, which may resemble a slapped cheek appearance. It may cause mild symptoms such as fever, runny nose, or joint pain. It usually affects children and is self-limiting.

Choice D reason: This choice is incorrect because chickenpox is not the common name for pertussis. Chickenpox is a viral infection that causes an itchy rash with ﬂuid-filled blisters all over the body. It may cause symptoms such as fever, headache, or loss of appetite. It can be prevented by vaccination with the varicella-zoster (VZV) vaccine.

A. Apply a eutectic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure. B. Keep the infant NPO for 6 hr prior to the procedure. C. Hold the infant's chin to his chest and knees to his abdomen during the procedure. D. Place the infant in an infant seat for 2 hr following the procedure.

Correct Answer is C

Explanation

The correct answer is: c. Hold the infant’s chin to his chest and knees to his abdomen during the procedure.

Choice A: Apply a eutectic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure.

Applying a eutectic mixture of lidocaine and prilocaine (EMLA) cream can help reduce pain during procedures like lumbar punctures. However, it typically needs to be applied 30 to 60 minutes before the procedure to be effective. Applying it only 15 minutes prior would not provide adequate analgesia.

Choice B: Keep the infant NPO for 6 hr prior to the procedure.

Keeping an infant NPO (nothing by mouth) for 6 hours is generally recommended before procedures requiring sedation or anesthesia to reduce the risk of aspiration. However, lumbar punctures do not typically require such prolonged fasting, especially in infants, unless sedation is planned.

Choice C: Hold the infant’s chin to his chest and knees to his abdomen during the procedure.

This is the correct positioning for a lumbar puncture in infants. The infant should be held in a curled-up position, with the chin to the chest and knees to the abdomen, to maximize the space between the vertebrae and allow easier access to the lumbar region. This position helps to stabilize the infant and reduce movement during the procedure.

Choice D: Place the infant in an infant seat for 2 hr following the procedure.

Post-procedure care for a lumbar puncture typically involves monitoring the infant for any signs of complications, such as headache or infection. Placing the infant in an infant seat for 2 hours is not a standard recommendation. Instead, the infant should be observed and allowed to rest comfortably.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has pertussis. The child's parent asks the nurse what the common name for this disease is. The nurse should respond with which of the following common names?

Correct Answer is B

Explanation

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Correct Answer is C

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