a nurse is assessing a child with suspected rheumatic fever what clinical manifestation is the nurse likely to observe
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Pediatric Practice Exam HESI

1. A healthcare provider is assessing a child with suspected rheumatic fever. What clinical manifestation is the provider likely to observe?

Correct answer: D

Rationale: Severe joint pain is a classic symptom of rheumatic fever, resulting from inflammation of the joints. Rheumatic fever primarily affects the joints, heart, skin, and the central nervous system. Jaundice (Choice A) is not typically associated with rheumatic fever. Peeling skin on the hands and feet (Choice B) is more characteristic of conditions like Kawasaki disease. While high fever (Choice C) can be present in rheumatic fever, it is not as specific or characteristic as severe joint pain.

2. The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection?

Correct answer: B

Rationale: The correct answer is B: Invasive burn cellulitis. Invasive burn cellulitis presents with the burn developing a dark brown, black, or purplish color with discharge and a foul odor. Burn wound cellulitis (choice A) typically involves redness, warmth, and swelling around the burn site. Burn impetigo (choice C) is a superficial infection characterized by honey-colored crusting. Staphylococcal scalded skin syndrome (choice D) is a condition caused by exotoxins from Staphylococcus aureus, leading to widespread skin peeling.

3. What is an early sign of congestive heart failure that the nurse should recognize?

Correct answer: A

Rationale: Tachypnea is an early sign of congestive heart failure that nurses should recognize. Tachypnea refers to rapid breathing, which can be an indication of the body's attempt to compensate for decreased cardiac output in congestive heart failure. Bradycardia (choice B) is a slow heart rate and is not typically associated with congestive heart failure. Inability to sweat (choice C) and increased urinary output (choice D) are not specific early signs of congestive heart failure and are not typically recognized as such.

4. Which cardiac defects are associated with tetralogy of Fallot?

Correct answer: C

Rationale: The correct answer is C: Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta are the cardiac defects associated with Tetralogy of Fallot. In Tetralogy of Fallot, these specific abnormalities contribute to the classic features of the condition. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of Tetralogy of Fallot. Choice B describes transposition of the great arteries, not Tetralogy of Fallot. Choice D mentions an altered connection between the pulmonary artery and the aorta, which is not a defining characteristic of Tetralogy of Fallot.

5. A nurse is caring for a child with a diagnosis of acute lymphoblastic leukemia (ALL). What is the priority nursing intervention?

Correct answer: B

Rationale: The correct answer is preventing infection. In caring for a child with acute lymphoblastic leukemia (ALL), preventing infection is the priority nursing intervention. Children with ALL are immunocompromised due to the disease and its treatment, making them more susceptible to infections. Administering chemotherapy, while important, is not the priority as preventing infection takes precedence to avoid complications. Monitoring for signs of bleeding and providing nutritional support are also essential components of care for a child with ALL, but preventing infection is the priority to ensure the child's safety and well-being.

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