Which vaccine is now recommended for the immunization of all newborns?

The correct answer is choice D. Birth history.

Choice A rationale:

The heading "Chief complaint" is used to document the primary reason for the patient seeking medical attention, such as their main symptom or concern. This is usually stated in the patient's own words and provides context for the visit, but it does not encompass information about the circumstances of birth or prematurity.

Choice B rationale:

"Review of systems" involves a systematic approach to inquire about the patient's current symptoms or physical complaints across different body systems. It helps to identify any additional issues the patient might not have mentioned initially, but it does not pertain to birth history or prematurity.

Choice C rationale:

"Present illness" is the section where the nurse documents the patient's current health concern, including the details of the symptoms, their onset, duration, and any associated factors. However, it does not encompass information about the circumstances of birth or prematurity.

Choice D rationale:

"Birth history" is the most appropriate heading for recording information about the infant's delivery, including any difficulties during delivery and the fact that the baby was born prematurely. This information is relevant for understanding the infant's medical background and potential risk factors associated with prematurity.

The correct answer is Choice D: Refer children with sore throats for throat cultures.

Choice A rationale:

Recommending salicylates instead of acetaminophen for minor discomforts is not relevant to the prevention of rheumatic fever. Rheumatic fever is primarily associated with untreated streptococcal infections, particularly streptococcal pharyngitis (strep throat), which can lead to complications such as rheumatic fever if left untreated. The choice of pain relievers like salicylates or acetaminophen doesn't play a significant role in preventing rheumatic fever.

Choice B rationale:

Encouraging routine cholesterol screenings is not relevant to the prevention of rheumatic fever. Rheumatic fever is an immune-mediated inflammatory response to certain strains of Streptococcus bacteria, particularly Streptococcus pyogenes. Cholesterol screenings are more related to assessing cardiovascular risk and are not directly linked to preventing rheumatic fever.

Choice C rationale:

Conducting routine blood pressure screenings is not directly related to the prevention of rheumatic fever. Blood pressure screenings are important for identifying hypertension and other cardiovascular risk factors, but they do not have a direct impact on preventing rheumatic fever, which is primarily a complication of untreated streptococcal infections.

Choice D rationale:

Refer children with sore throats for throat cultures. This is the correct choice. Rheumatic fever often develops as a result of untreated streptococcal pharyngitis (strep throat). Throat cultures are crucial for diagnosing streptococcal infections and determining the appropriate course of treatment with antibiotics. By identifying and treating streptococcal infections promptly, the risk of developing rheumatic fever can be significantly reduced.