When is it generally recommended that a child being treated for acute streptococcal pharyngitis may return to school?

The correct answer is choice C. Treating the underlying disease.

Choice A rationale:

Administration of digoxin. Administering digoxin is not the initial goal for the treatment of secondary hypertension. Digoxin is a medication commonly used to treat heart failure and certain arrhythmias, but it is not a primary intervention for hypertension. The rationale for this choice being incorrect lies in the fact that digoxin primarily affects the heart's contractility and is not a preferred option for managing high blood pressure.

Choice B rationale:

Weight control and diet. Weight control and dietary modifications are important aspects of managing hypertension, both primary and secondary. However, they are not the initial goal for the treatment of secondary hypertension. While these lifestyle modifications can contribute to blood pressure reduction, the primary focus in secondary hypertension is to identify and address the underlying condition causing the high blood pressure.

Choice C rationale:

Treating the underlying disease. Correct Answer. The initial goal for the treatment of secondary hypertension is to address the underlying disease or condition that is causing the elevated blood pressure. Unlike primary hypertension, which often lacks a specific underlying cause, secondary hypertension results from an identifiable condition such as kidney disease, hormonal disorders, or certain medications. Treating the root cause can lead to blood pressure normalization.

Choice D rationale:

Administration of β-adrenergic receptor blockers. Administering β-adrenergic receptor blockers is not typically the initial goal for the treatment of secondary hypertension. While these medications can lower blood pressure by blocking the effects of adrenaline and reducing heart rate, they are not the first-line approach for addressing the underlying cause of secondary hypertension.

The correct answers are choices A, C, and D: Tachycardia, Hyperthermia, and Vomiting.

Choice A rationale:

Tachycardia. Tachycardia, an abnormally fast heart rate, is a classic manifestation of thyroid storm. In this life-threatening condition, there is an excessive release of thyroid hormones, leading to increased metabolic rate and subsequent cardiovascular effects such as tachycardia.

Choice B rationale:

Constipation. This choice is incorrect for thyroid storm. Hyperthyroidism typically leads to increased bowel motility and can cause diarrhea rather than constipation.

Choice C rationale:

Hyperthermia. This is a correct choice. Thyroid storm is associated with severe hyperthermia due to the increased metabolic rate caused by excessive thyroid hormones. The body's temperature regulation is disrupted, leading to dangerously high body temperatures.

Choice D rationale:

Vomiting. This is a correct choice. Gastrointestinal symptoms, including vomiting and nausea, can occur in thyroid storm due to the heightened metabolic state. Thyroid storm affects various systems, including the gastrointestinal system, leading to symptoms like vomiting.

Choice E rationale:

Hypotension. This choice is incorrect for thyroid storm. Thyroid storm is more likely to cause hypertension rather than hypotension due to the increased cardiac output and sympathetic stimulation.