a nurse is caring for a child who has rheumatic fever which of the following actions should the nurse plan to take
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ATI Pediatrics Proctored Exam 2023 Quizlet

1. A child is being cared for by a nurse and has rheumatic fever. Which of the following actions should the nurse plan to take?

Correct answer: D

Rationale: Rheumatic fever can lead to cardiac complications, such as dysrhythmias. Therefore, it is essential for the nurse to monitor the child's heart rate closely for any signs of dysrhythmias. This will help in early identification and prompt management of potential cardiac issues associated with rheumatic fever. Choices A, B, and C are not the priority actions in this scenario. While aspirin may be used in the treatment of rheumatic fever, monitoring for cardiac complications takes precedence. Encouraging fluid intake and providing warm compresses are helpful interventions but do not directly address the cardiac risks associated with rheumatic fever.

2. A healthcare professional is assessing a child who has a rotavirus infection. Which of the following is an expected manifestation?

Correct answer: B

Rationale: Vomiting is a common manifestation of rotavirus infection in children. Rotavirus typically presents with symptoms such as watery diarrhea, vomiting, fever, and abdominal pain. Constipation, jaundice, and abdominal pain are less commonly associated with rotavirus infection in children.

3. A patient is 1 hour postoperative following an open reduction internal fixation of the left tibia. Which of the following actions should the nurse take?

Correct answer: A

Rationale: The correct action for the nurse to take 1 hour postoperative following an open reduction internal fixation of the left tibia is to assess neurovascular status of the extremities every 4 hours. This frequent assessment is crucial to monitor for any signs of complications such as impaired circulation or nerve damage. Monitoring every 4 hours allows for early detection of any issues, enabling timely intervention and prevention of potential complications. Monitoring the patient's pain level every 8 hours (choice B) is not as immediate or essential for postoperative care. Assisting the patient to the bathroom every 2 hours (choice C) may not be necessary if the patient is not ambulatory yet. Keeping the patient's left leg elevated on two pillows (choice D) can be beneficial but is not the priority in the immediate postoperative period compared to assessing neurovascular status.

4. When teaching a parent of a toddler with congenital heart disease, which of the following instructions should the nurse include?

Correct answer: A

Rationale: The correct instruction for a parent of a toddler with congenital heart disease is to offer small, frequent meals. This recommendation helps reduce the cardiac workload on the child's heart and supports easier digestion and nutrient absorption, promoting the child's overall health. Limiting physical activity (choice B) may be necessary but is not the priority in this case. While offering a low-sodium diet (choice C) can be beneficial, it is not the most critical instruction. Monitoring the toddler's intake and output (choice D) is important but not as essential as providing small, frequent meals to support the child's heart health.

5. A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?

Correct answer: D

Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety. Administering antibiotics as prescribed is essential in treating bacterial meningitis, but seizure precautions take precedence due to the immediate risk of injury. Maintaining NPO status and monitoring intake and output are important aspects of care but are not the priority when considering the risk of seizures.

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