The nurse is assessing a child admitted with a diagnosis of rheumatic fever. Which significant question would the nurse ask the child's parent during the assessment?
"Has your child been exposed to anyone with chicken pox
"Has any family member had a sore throat within the past few weeks?"
"Has any family member had a gastrointestinal disorder in the past few weeks?
"Has your child had difficulty urinating?
The Correct Answer is B
A. "Has your child been exposed to anyone with chicken pox?"
While chickenpox is caused by a different virus (varicella-zoster virus) and is not directly linked to rheumatic fever, the nurse might inquire about exposure to contagious illnesses as a general part of the assessment.
B. "Has any family member had a sore throat within the past few weeks?" 
This question is relevant because rheumatic fever often follows an untreated or inadequately treated group A streptococcal infection, such as strep throat. A sore throat in a family member could indicate the presence of streptococcal infection, which is a crucial factor in the development of rheumatic fever.
C. "Has any family member had a gastrointestinal disorder in the past few weeks?" 
Gastrointestinal disorders are not directly associated with the development of rheumatic fever. However, a comprehensive medical history might include questions about recent illnesses to understand the overall health context.
D. "Has your child had difficulty urinating?" 
Difficulty urinating is not a typical symptom or risk factor associated with rheumatic fever. This symptom would likely prompt investigation into other potential issues but is not specifically related to rheumatic fever.
 
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Symptoms are continuous throughout the day:
Incorrect: Continuous symptoms throughout the day are more indicative of moderate or severe persistent asthma, not mild persistent asthma.
B. Daytime symptoms occur more than twice a week:
Correct Answer: Children with mild persistent asthma may experience symptoms more than twice a week, but less than once a day.
C. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value:In mild persistent asthma, pulmonary function tests (e.g., PEF or FEV1) remain normal or close to normal, with values typically ≥80% of the predicted value, reflecting good lung function between episodes.
D. Nighttime symptoms occur approximately twice a month:
Mild persistent asthma often involves nighttime symptoms or awakenings occurring 3–4 times per month. If nighttime symptoms occur more frequently (e.g., once weekly), it suggests moderate persistent asthma.
E. Minor limitations occur with normal activity:Children with mild persistent asthma may experience minor limitations in their normal activities. These limitations are not severe and do not significantly impact daily life.
Correct Answer is D
Explanation
A. Sausage-shaped mass palpated in the upper right abdominal quadrant.
Explanation: A sausage-shaped mass in the upper right abdominal quadrant is more indicative of Hirschsprung's disease, not imperforate anus. In Hirschsprung's disease, there is a lack of ganglion cells in the rectum, leading to obstruction and a palpable mass.
B. The passage of currant jelly-like stools.
Explanation: The passage of currant jelly-like stools is characteristic of intussusception, a condition where one portion of the intestine telescopes into another. It is not associated with imperforate anus.
C. Bile-stained fecal emesis.
Explanation: Bile-stained fecal emesis suggests a possible intestinal obstruction or other gastrointestinal issue, but it is not a specific manifestation of imperforate anus. Imperforate anus is primarily characterized by the absence of a normal anal opening.
D. Failure to pass meconium stool in the first 24 hours after birth.
Explanation:
Imperforate anus refers to a congenital condition in which the opening to the anus is absent or improperly formed. One of the clinical manifestations is the failure to pass meconium stool within the first 24 hours after birth. Meconium is the thick, sticky, greenish-black substance that constitutes a newborn's first stools. The absence of meconium passage suggests a potential obstruction.
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