. An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse call 911?
The child is confused and cannot remember anything regarding the seizure.
The child fell at the onset of the seizure
The seizure lasts more than 5 minutes.
The child is sleepy and lethargic after the seizure
The Correct Answer is C
A. The child is confused and cannot remember anything regarding the seizure: Postictal confusion is normal after a seizure and does not require emergency services.
B. The child fell at the onset of the seizure: Falls can occur with seizures, but unless there is a suspected injury or prolonged seizure activity, calling 911 is unnecessary.
C. The seizure lasts more than 5 minutes: A seizure lasting more than 5 minutes is considered status epilepticus and is a medical emergency requiring immediate intervention.
D. The child is sleepy and lethargic after the seizure: Postictal sleepiness is a common and expected phase after a generalized seizure.
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Correct Answer is D
Explanation
A. "Get the child tested for Reye's syndrome if the child exhibits fever, vomiting, and lethargy.": While these are symptoms of Reye's syndrome, prevention focuses on avoiding triggers like salicylates during viral illnesses, not merely recognizing symptoms.
B. "Use aspirin instead of acetaminophen for children with viral illness.": Aspirin increases the risk of Reye's syndrome in children with viral illnesses.
C. "Advise parents to have their children immunized against Reye's syndrome.": There is no vaccine for Reye's syndrome; prevention relies on avoiding salicylate use during viral infections.
D. "Avoid giving salicylate-containing medications to a child who has a viral syndrome.": Salicylates, such as aspirin, are the primary risk factor for Reye's syndrome, so avoidance is critical.
Correct Answer is B
Explanation
A. Hide the medication in apple slices: This is inappropriate as the child might distrust caregivers if they realize the medication was hidden.
B. Offer the child an ice pop prior to administering the medication: An ice pop numbs taste buds and can reduce the unpleasant taste of medication.
C. Tell the child the medicine tastes like candy: Providing false information undermines trust and is unethical.
D. Inform the child that if he does not take the medication he will need a shot: Threats increase anxiety and do not foster cooperation.