A nurse on a cardiac care unit is caring for a preschooler who has a history of congenital mitral stenosis. Which of the following statements indicates that the client is at risk for developing rheumatic carditis?

The client has a nonproductive cough and wheezes in the lower lobes.

The client has dyspnea with a respiratory rate of 30/min and oxygen at 2 L/min via nasal cannula.

The client has a peripheral saline lock intact to the right forearm with no signs and symptoms of infection.

The client has lower extremity edema and decreased skin pigmentation noted to bilateral lower extremities.

Answer and Explanation

The Correct Answer is D

Choice A reason: This statement does not indicate a risk for rheumatic carditis, but rather a possible respiratory infection or asthma. Rheumatic carditis is an inflammatory condition of the heart valves that can result from untreated streptococcal pharyngitis.

Choice B reason: This statement does not indicate a risk for rheumatic carditis, but rather a sign of heart failure. Dyspnea, tachypnea, and hypoxia are common manifestations of heart failure in children with congenital heart defects.

Choice C reason: This statement does not indicate a risk for rheumatic carditis, but rather a normal finding for a client who has an IV access. A peripheral saline lock is used to administer fluids and medications as needed, and it should be monitored for signs of infection, infiltration, or phlebitis.

Choice D reason: This statement indicates a risk for rheumatic carditis, as lower extremity edema and decreased skin pigmentation are signs of erythema marginatum, a characteristic rash that occurs in some cases of rheumatic fever. Erythema marginatum is a pink or red rash that spreads from the trunk to the extremities, and it may fade and reappear with changes in temperature.

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Correct Answer is D

Explanation

Choice A reason: Headaches are not a specific finding for rhabdomyosarcoma of the nasopharynx, as they can be caused by many other conditions. Headaches may occur if the tumor compresses the cranial nerves or the brain, but this is not a common manifestation.

Choice B reason: Bleeding is not a specific finding for rhabdomyosarcoma of the nasopharynx, as it can be caused by many other conditions. Bleeding may occur if the tumor erodes the blood vessels or the mucosa, but this is not a common manifestation.

Choice C reason: Tearing is not a specific finding for rhabdomyosarcoma of the nasopharynx, as it can be caused by many other conditions. Tearing may occur if the tumor affects the lacrimal duct or the eye, but this is not a common manifestation.

Choice D reason: Swelling is an expected finding for rhabdomyosarcoma of the nasopharynx, as it indicates the presence of a mass in the nasal cavity or the pharynx. Swelling may cause nasal obstruction, difficulty breathing, or facial asymmetry. Swelling may also be palpable or visible on imaging studies.

A. Include fluoridated water in the toddler's diet. B. Avoid a diet that consists primarily of milk. C. Administer fat-soluble vitamins daily. D. Limit intake of high-protein foods.

Correct Answer is B

Explanation

Choice A reason: Including fluoridated water in the toddler's diet is not a method of preventing iron deficiency anemia. Fluoride is beneficial for dental health, but it does not affect iron levels in the blood.

Choice B reason: Avoiding a diet that consists primarily of milk is a method of preventing iron deficiency anemia. Milk is low in iron and can interfere with iron absorption from other foods. It can also cause gastrointestinal bleeding in some children, leading to iron loss. The nurse should teach the parents to limit milk intake to no more than 24 ounces per day and offer iron-rich foods such as meat, eggs, beans, and green leafy vegetables.

Choice C reason: Administering fat-soluble vitamins daily is not a method of preventing iron deficiency anemia. Fat-soluble vitamins are vitamins A, D, E, and K, which are stored in the body and do not need to be taken daily. They do not affect iron levels in the blood.

Choice D reason: Limiting intake of high-protein foods is not a method of preventing iron deficiency anemia. High-protein foods are good sources of iron and can help prevent or treat iron deficiency an

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A nurse on a cardiac care unit is caring for a preschooler who has a history of congenital mitral stenosis. Which of the following statements indicates that the client is at risk for developing rheumatic carditis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a child who has rhabdomyosarcoma of the nasopharynx. What is an expected finding for this malignancy?

Correct Answer is D

Explanation

A nurse is providing teaching about iron deficiency anemia to the parents of a toddler. Which of the following should the nurse include as a method of preventing iron deficiency anemia?

Correct Answer is B

Explanation

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