The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse would make which response?

"Range-of-motion exercises must be performed every day."

"Administer additional pain medication before performing range-of-motion exercises."

"Have the child perform simple isometric exercises during this time."

"Avoid all exercise during painful periods."

Answer and Explanation

The Correct Answer is C

A. "Range-of-motion exercises must be performed every day."
Explanation: While range-of-motion exercises are important for maintaining joint flexibility in juvenile idiopathic arthritis, it is not advisable to perform these exercises during painful exacerbations. The frequency and intensity of exercises may need to be adjusted based on the child's current condition.
B. "Administer additional pain medication before performing range-of-motion exercises."
Explanation: While pain management is important in the care of a child with juvenile idiopathic arthritis, relying solely on pain medication before exercises may not be the most effective approach. Isometric exercises that are less likely to cause pain can be a better option during exacerbations.
C. "Have the child perform simple isometric exercises during this time."
Explanation:
During a painful exacerbation of juvenile idiopathic arthritis, it is important to maintain joint flexibility and prevent joint contractures. Simple isometric exercises that do not involve joint movement can help in maintaining muscle strength and joint flexibility without exacerbating pain. Range-of-motion exercises may be too painful during an exacerbation, but isometric exercises can be less painful and still beneficial.
D. "Avoid all exercise during painful periods."
Explanation: Complete avoidance of exercise during painful periods is not recommended. Maintaining joint flexibility and muscle strength is important for managing juvenile idiopathic arthritis. However, the type and intensity of exercises should be adjusted based on the child's pain level during exacerbations.

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Correct Answer is D

Explanation

A. Administer 0.9% sodium chloride IV solution: Although IV fluids might be necessary to maintain hydration and circulation, this is not the priority over preventing the spread of infection.

B. Assist with obtaining an x-ray of the child's neck.Imaging can help confirm the diagnosis but should be done after ensuring infection control measures.
C. Initiate IV antibiotics.Antibiotics are crucial for treatment but should follow the implementation of droplet precautions to prevent the spread of infection.
D. Place the child on droplet precautions.
Epiglottitis is a medical emergency primarily caused by bacterial infections, such as Haemophilus influenzae type B (Hib). The first priority is to ensure the safety of both the patient and others by preventing the spread of infection.Placing the child on droplet precautions helps to contain the bacteria and protect healthcare workers and other patients.

A. Sausage-shaped mass palpated in the upper right abdominal quadrant B. The passage of currant jelly-like stools C. Bile-stained fecal emesis D. Failure to pass meconium stool in the first 24 hours after birth

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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The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse would make which response?

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A nurse is admitting a child who has suspected epiglottitis. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

Correct Answer is D

Explanation

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