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A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?
- A. Dry, hacking cough
- B. Inspiratory stridor
- C. Nasal congestion
- D. Severe coughing spells
Correct Answer: D
Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.
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The parents of an infant ask the nurse why their baby is scheduled to receive the intramuscular polio vaccine rather than the oral vaccine. What is the nurse's best response?
- A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
- B. The consensus is that either can be used, since both produce the same results and are equally safe.
- C. The oral vaccine is more expensive, so the intramuscular vaccine is preferred unless it is contraindicated.
- D. The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised.
Correct Answer: A
Rationale: The American Academy of Pediatrics recommends the intramuscular polio vaccine because it has a better safety profile compared to the oral vaccine. Choice B is incorrect because the AAP specifically recommends the intramuscular vaccine over the oral vaccine. Choice C is incorrect as cost is not the primary reason for preferring the intramuscular vaccine. Choice D is incorrect as the recommendation is based on safety rather than the immunocompromised status of the infant or family members.
A nurse is assessing a child with suspected pertussis. What clinical manifestation is the nurse likely to observe?
- A. Dry, hacking cough
- B. Inspiratory stridor
- C. Nasal congestion
- D. Severe coughing spells
Correct Answer: D
Rationale: The correct answer is D: Severe coughing spells. Pertussis, also known as whooping cough, typically presents with severe coughing spells that can be followed by a characteristic 'whoop' sound. These coughing fits can be intense and prolonged, often causing the child to gasp for air between coughs. Option A, dry hacking cough, is a common symptom of other respiratory conditions like bronchitis. Option B, inspiratory stridor, is more commonly associated with conditions like croup. Option C, nasal congestion, is not a typical symptom of pertussis.
A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?
- A. Suction the oropharynx
- B. Insert a nasopharyngeal airway
- C. Initiate positive pressure ventilations
- D. Administer oxygen via mask
Correct Answer: A
Rationale: In this scenario, the patient is experiencing airway compromise due to the fall and potential oropharyngeal obstruction from bleeding. Performing a jaw-thrust maneuver with head stabilization helps maintain the airway patency. The next step should be to suction the oropharynx to clear any blood or secretions, which can obstruct the airway and lead to aspiration. Inserting a nasopharyngeal airway may worsen bleeding or cause further injury to the patient's airway. Initiating positive pressure ventilations can be ineffective if the airway is not cleared first. Administering oxygen via mask is not the immediate priority; ensuring a patent airway by suctioning takes precedence.
When developing the plan of care for a child with burns requiring fluid replacement therapy, what information would the nurse expect to include?
- A. Administration of colloid initially followed by a crystalloid
- B. Determination of fluid replacement based on the type of burn
- C. Administration of most of the volume during the first 8 hours
- D. Monitoring of hourly urine output to achieve less than 1 mL/kg/hr
Correct Answer: C
Rationale: The correct answer is C. In fluid replacement therapy for burns, it is crucial to administer most of the volume during the first 8 hours to prevent shock and maintain perfusion. This rapid administration is essential to stabilize the child's condition. Choices A and B are incorrect because the initial fluid replacement in burns typically involves administering crystalloids, not colloids, and the fluid replacement is generally calculated based on the extent of the burn injury, not the type of burn. Choice D is incorrect as monitoring hourly urine output to achieve less than 1 mL/kg/hr is not recommended in burn patients; instead, urine output should be monitored to achieve 1-2 mL/kg/hr in children to ensure adequate renal perfusion.
A nurse plans to talk to the parents of a toddler about toilet training. What should the nurse explain is the most important factor in the process of toilet training?
- A. Parents' attitude towards it
- B. Child's motivation to remain dry
- C. Child's ability to sit independently on the toilet
- D. Parents' commitment to work on the toilet training
Correct Answer: D
Rationale: The most crucial factor in successful toilet training is the parents' commitment to consistently work with their child. While parents' attitude and willingness are important, the key is their dedication to the process. The child's motivation and ability are also significant but rely heavily on parental guidance and support. Therefore, the correct choice is the parents' commitment to work on toilet training.