while caring for a child with reyes syndrome the nurse should give which action the highest priority
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Community Health HESI Test Bank

1. When caring for a child with Reye's Syndrome, which action should the nurse give the highest priority?

Correct answer: C

Rationale: Assessing the level of consciousness is crucial when caring for a child with Reye's Syndrome. Changes in neurological status can indicate deterioration of the condition, necessitating immediate medical attention. Monitoring intake and output is important but not the highest priority compared to assessing the child's level of consciousness. Providing good skin care and assisting with range of motion are also important aspects of care but take a lower priority than assessing the child's neurological status in this critical condition.

2. During the care of a client with Legionnaire's disease, which finding would require the nurse's immediate attention?

Correct answer: D

Rationale: A decrease in chest wall expansion suggests that the client may be experiencing a serious complication, such as worsening pneumonia or respiratory failure, requiring immediate medical attention. This finding indicates a potential decrease in lung function, which could lead to respiratory distress. Pleuritic pain on inspiration may be related to the disease process but does not indicate an immediate need for intervention. Dry mucus membranes in the mouth may require attention but are not as critical as a decrease in chest wall expansion. A decrease in respiratory rate could be concerning but is not as urgent as a decrease in chest wall expansion, which directly impacts respiratory function.

3. A 15-year-old client with a lengthy confining illness is at risk for altered growth and development of which task?

Correct answer: C

Rationale: A 15-year-old client with a lengthy confining illness is at risk for altered growth and development of the task of dependence. Prolonged illness and confinement can lead to the development of dependence as the individual may become reliant on others for their care and needs. Choices A, B, and D are incorrect in this context. Loss of control, insecurity, and lack of trust are important factors to consider but are not directly related to the altered growth and development task of dependence due to illness and confinement.

4. The healthcare provider is screening children at a local community health clinic for infectious diseases. Which child is at the highest risk for hepatitis B virus?

Correct answer: A

Rationale: Newborns are at the highest risk for hepatitis B virus due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Children born to mothers infected with hepatitis B are at the highest risk of acquiring the infection. Choices B, C, and D are at lower risk compared to a newborn as they are less likely to have been exposed to the virus during childbirth.

5. A community hospital is an example of which level of health care?

Correct answer: A

Rationale: A community hospital is categorized under secondary level health care. Secondary level health care facilities, like community hospitals, provide specialized outpatient care, diagnostic services, and treatment that are more complex than what is offered in primary health care settings. Choice B, primary health care, refers to basic and routine health care services typically provided by family doctors or general practitioners, which is not the level of care provided by community hospitals. Tertiary level care (choice C) involves highly specialized and complex medical services such as neurosurgery or organ transplants, which are beyond the scope of services provided by community hospitals. Intermediate level care (choice D) is not a recognized category in the hierarchy of health care levels.

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