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

The correct answer is choice D. It is a belief common at this age.

Choice A rationale:

The statement does not suggest a failed attempt to develop a conscience. The scenario described is more related to the cognitive development of an 8-year-old child. Children at this age often have magical thinking and may interpret events, such as illness, as punishments for perceived wrongdoing. This is a normal aspect of their cognitive development rather than a reflection of a failed attempt to develop a conscience.

Choice B rationale:

While beliefs about punishment and consequences are present in many religions, the scenario is not about a general religious belief but rather a specific belief held by the individual child. This belief is reflective of the child's cognitive understanding and not necessarily a religious teaching common to most religions.

Choice C rationale:

The belief is not necessarily suggestive of excessive family pressure. While family dynamics can influence a child's beliefs and behaviors, the scenario describes a typical cognitive developmental stage where children are still learning to differentiate between reality and their own thoughts, leading to magical thinking and unique interpretations.

Choice D rationale:

The belief is indeed common at this age. During middle childhood, children often exhibit concrete operational thinking, which includes a tendency to interpret events in a self-centered and concrete manner. Beliefs like the one described in the scenario, where the child connects her illness to perceived bad behavior and potential consequences, are characteristic of this developmental stage.

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.