The parents of the child with juvenile rheumatoid arthritis (JRA) ask

NCLEX Pediatric Questions

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Question 1 of 5.

The parents of the child with juvenile rheumatoid arthritis (JRA) ask the nurse why the child cannot have aspirin. The parents further explain that they have heard that aspirin is used in the elderly for arthritis and the use of the patients. The nurse correctly explains that children with JRA are given different medications than adults with arthritis and explains that the toxic effects of aspirin include which manifestations?

A. Constipation, weight gain, and fluid retention

B. Ringing in the ears, nausea, and vomiting

C. Anorexia, weight loss, and double vision

D. Headache, dry mouth, and dental cavities

Explanation: Aspirin in children can cause toxicity, including ringing in the ears (tinnitus), nausea, and vomiting, and is avoided due to the risk of Reye's syndrome, especially in children with viral infections.

Question 2 of 5.

Which finding documented by the nurse is most indicative of a client with rheumatic fever?

A. Slow, irregular heartbeat

B. Blotchy, diffuse erythema

C. Decreased antistreptolysin O titer (ASO titer)

D. Generalized migrating joint tenderness

Explanation: Generalized migrating joint tenderness (polyarthritis) is a hallmark symptom of rheumatic fever, reflecting the inflammatory process affecting multiple joints. An elevated ASO titer (not decreased) would indicate a recent streptococcal infection, and the other options are less specific.

Question 3 of 5.

Which statement by the parents best indicates that the nurse's teaching has been effective?

A. We'll give our child the penicillin for the full 10 days.

B. We will keep our child at home until fully recovered.

C. We will make sure that our child stays out of the sun with being treated.

D. We'll notify the physician if our child has a sore throat.

Explanation: Effective teaching about rheumatic fever emphasizes preventing recurrent streptococcal infections, which can trigger relapse. Notifying the physician about a sore throat ensures prompt treatment of potential streptococcal infections, reducing recurrence risk.

Question 4 of 5.

When is the correct time for the nurse to administer the child's morning dose of a combination regular and NPH insulin?

A. 30 minutes before breakfast is served

B. 15 minutes before breakfast is served

C. 30 minutes after breakfast is served

D. 15 minutes after breakfast is served

Explanation: Regular insulin peaks in 2-4 hours, and NPH peaks in 4-12 hours. Administering the combination 30 minutes before breakfast aligns insulin onset with food intake, controlling postprandial glucose levels effectively.

Question 5 of 5.

Which clinical manifestation of the client's full-thickness burns would the nurse detect during an assessment?

A. Moderate level of pain due to exposed nerve endings

B. Eschar formation throughout the area of the burn

C. The appearance of blister formation throughout the area of the burn

D. Noted tissue destruction extending to the subcutaneous layer

Explanation: Full-thickness burns involve destruction of all skin layers, including the subcutaneous layer, resulting in a leathery or charred appearance. Pain is minimal due to nerve destruction, and blisters are characteristic of partial-thickness burns.