What information should a nurse provide a mother who is concerned about preventing sleep problems in her 4-year-old child?

Choice A reason: This statement is correct, as asking about the child's contacts over the last three weeks can help the nurse identify the possible source of infection and the risk of transmission. Rubella is a viral infection that spreads through respiratory droplets or direct contact with an infected person. The incubation period of rubella is 14 to 21 days, meaning that the child could have been exposed to the virus up to three weeks before developing symptoms.

Choice B reason: This statement is incorrect, as asking about the child's immunizations is not the most effective way to determine how the child was exposed to the virus. Although immunization can prevent rubella infection, it is not 100% effective, and some children may still get the disease despite being vaccinated. The nurse should also consider other factors, such as the child's medical history, travel history, and exposure to other people with rash or fever.

Choice C reason: This statement is incorrect, as asking about the medications given to the child is not the most effective way to determine how the child was exposed to the virus. Medications can help relieve the symptoms of rubella, such as fever, rash, or joint pain, but they do not affect the transmission or the course of the infection. The nurse should focus on the epidemiological aspects of the disease, such as the mode of transmission, the incubation period, and the contagious period.

Choice D reason: This statement is incorrect, as asking about the onset of the rash is not the most effective way to determine how the child was exposed to the virus. The rash of rubella usually appears 14 to 17 days after exposure, and lasts for about three days. However, the child can be contagious from seven days before to seven days after the rash appears, meaning that the child could have been exposed to the virus up to four weeks before or after the rash. The nurse should ask about the child's contacts during this period, not just the rash.

Choice A reason: This is not a good choice. Removing the dressing to identify where the bleeding is coming from can increase the risk of infection and further bleeding. The nurse should keep the dressing in place and apply direct pressure to control the bleeding.

Choice B reason: This is not a good choice. Letting the parent hold the child to calm him can worsen the bleeding by increasing the blood pressure and heart rate. The nurse should keep the child in a supine position and reassure him while applying direct pressure to the dressing.

Choice C reason: This is the correct choice. Putting direct pressure on the dressing to stop the bleeding is the first and most effective action to take in this situation. The nurse should use a sterile gauze pad or a gloved hand to apply firm and continuous pressure to the dressing until the bleeding stops or medical assistance arrives.

Choice D reason: This is not a good choice. Drawing up the ordered morphine to calm the child is not the priority action in this situation. The nurse should first stop the bleeding and then assess the child's pain level and administer the appropriate analgesic. Morphine can also cause respiratory depression and hypotension, which can complicate the child's condition.