A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?

A. Asking about recent injuries is not relevant to acute rheumatic fever because the condition is caused by an autoimmune response to a prior streptococcal infection, not trauma. While injury history is important for general pediatric assessment, it does not contribute to diagnosing or managing rheumatic fever. B. Inquiring about aspirin use is more relevant when evaluating for conditions like Reye’s syndrome in children with viral infections, due to the risk of liver toxicity. Although aspirin can be used therapeutically in rheumatic fever to reduce inflammation, recent aspirin use is not a diagnostic clue. C. Acute rheumatic fever typically develops 2–4 weeks after an untreated or partially treated group A streptococcal pharyngitis. Asking about recent sore throats helps the nurse identify potential streptococcal exposure, which is critical for linking the child’s current symptoms—such as joint pain, fever, or cardiac involvement, to rheumatic fever. D. Congenital heart defects are present at birth and are unrelated to acute rheumatic fever, which is an acquired inflammatory disease affecting the heart, joints, skin, and nervous system following infection. Asking about congenital defects does not provide information about the cause of the current illness.