When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is:.
Infection or inflammation close to the site.
Some form of cancer.
Local scalp infection common in children.
Infection or inflammation distal to the site.
The Correct Answer is A
The correct answer is choice A. Infection or inflammation close to the site.
Choice A rationale:
Tender, enlarged, and warm lymph nodes are indicative of infection or inflammation in the nearby area. Lymph nodes are part of the immune system and can become enlarged and tender when fighting off infections in their drainage area.
Choice B rationale:
While cancer can cause lymph node enlargement, it is less likely in children, and the question doesn't provide any other context to suggest cancer as the primary explanation.
Choice C rationale:
Local scalp infection might cause enlargement of the lymph nodes in the neck, but it would not be the best explanation for tender, enlarged, and warm cervical lymph nodes. Infections or inflammation close to the site of lymph node involvement are more likely.
Choice D rationale:
Infection or inflammation distal to the site wouldn't directly explain the tenderness, warmth, and enlargement of the cervical lymph nodes. Lymph nodes generally react to infections or inflammation in their drainage area.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
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.
Correct Answer is C
Explanation
The correct answer is choice C. After taking antibiotics for 24 hours.
Choice A rationale:
Returning to school if no complications develop is not a sufficient guideline for allowing a child with streptococcal pharyngitis to return to school. Streptococcal pharyngitis (strep throat) is highly contagious, and children should be treated with antibiotics to prevent the spread of the infection.
Choice B rationale:
Waiting until the sore throat is better is not a specific enough criterion for returning to school. While the resolution of symptoms is an important factor, it's crucial to ensure that the child has also been on antibiotics for an appropriate duration to reduce the risk of spreading the infection to others.
Choice C rationale:
The recommended guideline is to return to school after taking antibiotics for 24 hours. This timeframe helps ensure that the child's contagiousness is significantly reduced, minimizing the risk of transmitting the infection to classmates and school staff.
Choice D rationale:
Waiting for three days after taking antibiotics is not as precise as waiting for 24 hours. With proper antibiotic treatment, the child's contagiousness decreases rapidly, and waiting for three days might be unnecessary and could potentially result in more missed school days than needed.
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