The parent of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis. the nurse determines that which requires further investigation?

Possible sexual abuse

Possible trauma

Presence of an allergy

Presence of a respiratory infection

Answer and Explanation

The Correct Answer is A

A. Possible sexual abuse.
Correct Answer: Chlamydial conjunctivitis in a child can raise concerns about possible sexual abuse. Chlamydia trachomatis, the bacterium responsible for chlamydial conjunctivitis, is commonly transmitted through contact with infected genital secretions. Therefore, the presence of chlamydial conjunctivitis in a child may warrant further investigation into the possibility of sexual abuse.
B. Possible trauma:
Incorrect: While trauma can cause eye-related symptoms, chlamydial conjunctivitis is specifically associated with an infection caused by Chlamydia trachomatis.
C. Presence of an allergy:
Incorrect: Allergic conjunctivitis may cause itchy, red, and swollen eyes, but chlamydial conjunctivitis is caused by a bacterial infection and is not related to allergies.
D. Presence of a respiratory infection:
Incorrect: Chlamydial conjunctivitis is not typically associated with respiratory infections. It is primarily caused by Chlamydia trachomatis and is more commonly linked to genital tract infections.

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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.

A. Edema in the lower extremities B. Ascites C. Shortness of breath D. Hepatomegaly

Correct Answer is C

Explanation

A. Edema in the lower extremities:
Incorrect: Edema in the lower extremities is more characteristic of right-sided heart failure. In left-sided failure, pulmonary congestion is more prominent.
B. Ascites:
Incorrect: Ascites, or fluid accumulation in the abdominal cavity, is also more commonly associated with right-sided heart failure.
C. Shortness of breath:
Correct Answer: Left-sided congestive heart failure can lead to pulmonary congestion, resulting in difficulty breathing or shortness of breath. This is often observed as increased work of breathing, rapid breathing, or other signs of respiratory distress in infants.
D. Hepatomegaly:
Incorrect: Hepatomegaly, or enlargement of the liver, is another manifestation more commonly associated with right-sided heart failure.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

The nurse is collecting data on a 2 month-old-child with left-sided congestive heart failure. Which clinical manifestation would support this diagnosis of left-sided congestive heart failure?

Correct Answer is C

Explanation

A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate?

On assessment, the school nurse notes that the child has a rash. The nurse suspects that the child has erythema infectiosum (fifth disease). because the skin assessment revealed a rash that has which characteristics?

A nurse is caring for a child who has tinea pedis. The child's parent asks the nurse what this infection is commonly called. The nurse should respond with which of the following common names?

A nurse is teaching an assistive personnel to measure a newborn's respiratory rate. Which of the following statements indicates an understanding of why the respiratory rate should be counted for a complete minute?

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply.

The parent of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the pediatrician did not prescribe antibiotics. Which response would the nurse make?

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions would be included on the list? Select all that apply.