The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?
Coughing spells may be triggered by dust or smoke."
We need to maintain droplet precautions and a quiet environment for at least 2 weeks.
"We need to encourage our child to drink fluids.
Vomiting may occur when our child has coughing episodes."
The Correct Answer is B
A. Coughing spells may be triggered by dust or smoke:
Incorrect: This is a correct statement. Irritants like dust or smoke can trigger coughing spells in a child recovering from pertussis.
B. We need to maintain droplet precautions and a quiet environment for at least 2 weeks.
Correct Answer: Pertussis is highly contagious during the catarrhal and paroxysmal stages, but once the child has reached the convalescent stage (usually after 2-4 weeks of illness), the risk of spreading the infection decreases significantly. Continuing strict droplet precautions and a quiet environment for two weeks after the convalescent stage is not necessary.
C. "We need to encourage our child to drink fluids":
Incorrect: This is a correct statement. Encouraging fluid intake is important to prevent dehydration, especially during coughing spells.
D. Vomiting may occur when our child has coughing episodes:
Incorrect: This is a correct statement. Vomiting can be a common occurrence during coughing episodes in pertussis due to the forceful nature of the cough. Parents should be aware of this symptom.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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.
Correct Answer is C
Explanation
A. "The immunization schedule will need to be altered."
Incorrect: This is too vague and does not provide specific information about the child's immunization schedule.
B. "The child will receive all of the immunizations except for the polio series."
Incorrect: There is no indication that the child should not receive the polio vaccine. Children with cystic fibrosis are generally recommended to receive all appropriate vaccinations.
C. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
Correct Answer: Children with cystic fibrosis should receive the recommended basic series of immunizations, including vaccines for diseases such as diphtheria, pertussis, tetanus, measles, mumps, rubella, polio, Haemophilus influenzae type b (Hib), hepatitis B, and others. Additionally, they should receive a yearly influenza vaccination to help prevent respiratory complications.
D. "The child should not receive any hepatitis vaccines."
Incorrect: There is no general contraindication for children with cystic fibrosis to receive hepatitis vaccines. The nurse should recommend the appropriate vaccines, including those for hepatitis B, as per the standard immunization schedule.
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