Nokea
A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect
- A. croup
- B. epiglottitis
- C. lower respiratory infection
- D. foreign body airway obstruction
Correct Answer: D
Rationale: In a 3-year-old child presenting with sudden respiratory distress without fever or recent illness, the most likely cause is a foreign body airway obstruction. Foreign body airway obstruction can lead to a sudden onset of respiratory distress as it blocks the air passage. Croup typically presents with a barking cough and stridor, often preceded by a viral illness. Epiglottitis is characterized by high fever, drooling, and a muffled voice. Lower respiratory infections usually present with symptoms such as cough, fever, and chest congestion. Therefore, in this case, the absence of recent illness or fever makes foreign body airway obstruction the most likely cause of the respiratory distress.
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A healthcare professional plans to discuss childhood nutrition with a group of parents whose children have Down syndrome in an attempt to minimize a common nutritional problem. What problem should be addressed?
- A. Rickets
- B. Obesity
- C. Anemia
- D. Rumination
Correct Answer: B
Rationale: The correct answer is B: Obesity. Children with Down syndrome are at a higher risk of obesity due to various factors such as lower metabolic rate, hormonal imbalances, and reduced physical activity levels. Addressing healthy eating habits early can help prevent obesity in these children. Choice A (Rickets) is incorrect because rickets is primarily associated with vitamin D deficiency and is not a common nutritional problem in children with Down syndrome. Choice C (Anemia) is incorrect as anemia may not be a common nutritional problem specific to children with Down syndrome. Choice D (Rumination) is incorrect as rumination is a behavioral disorder characterized by repeated regurgitation of food and is not a common nutritional problem associated with Down syndrome.
The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?
- A. They will increase tidal volumes.
- B. Drainage of air and fluid will be facilitated.
- C. They will maintain positive intrapleural pressure.
- D. Pressure on the pericardium and chest wall will be regulated.
Correct Answer: B
Rationale: Chest tubes are necessary after open-heart surgery to facilitate the drainage of air and fluid from the chest cavity. These tubes help prevent complications such as pneumothorax (accumulation of air in the pleural space) or cardiac tamponade (build-up of fluid in the pericardial sac), which can be serious postoperative issues. Options A, C, and D are incorrect because chest tubes are primarily used for draining purposes and not for increasing tidal volumes, maintaining positive intrapleural pressure, or regulating pressure on the pericardium and chest wall.
The caregiver is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the caregiver indicates a need for further teaching?
- A. I need to avoid pushing or pulling on an arm or leg.
- B. I should carefully lift the baby by supporting the head and neck.
- C. I should not bend an arm or leg into an awkward position.
- D. We must avoid lifting the legs by the ankles to change diapers.
Correct Answer: B
Rationale: Lifting the baby by supporting the head and neck can cause fractures in infants with osteogenesis imperfecta. Caregivers should avoid lifting infants in this manner due to the risk of injury. Choices A, C, and D demonstrate correct understanding of how to prevent injuries in infants with osteogenesis imperfecta by avoiding excessive force on the arms or legs, preventing awkward positions, and lifting the legs in a safer manner to change diapers.
During postoperative care for a child who has had a tonsillectomy, what is an important nursing intervention?
- A. Encouraging deep breathing exercises
- B. Encouraging the child to eat
- C. Administering antibiotics
- D. Applying ice to the throat
Correct Answer: C
Rationale: Administering antibiotics is crucial post-tonsillectomy to prevent infection, as the surgical site is susceptible to bacterial growth. Encouraging deep breathing exercises can also be beneficial for lung expansion and preventing respiratory complications. However, administering antibiotics takes precedence as it directly addresses the risk of infection. Encouraging the child to eat may not be appropriate immediately post-tonsillectomy due to the risk of throat irritation and potential discomfort. Applying ice to the throat is typically not recommended after a tonsillectomy, as it may constrict blood vessels and hinder the healing process.
A 4-year-old child is scheduled for a myringotomy. What should the nurse include in the preoperative teaching?
- A. Explain the procedure in simple terms
- B. Encourage fluid intake
- C. Allow the child to play with medical equipment
- D. Use play therapy to prepare the child
Correct Answer: A
Rationale: Explaining the procedure in simple terms is essential preoperative teaching for a 4-year-old child scheduled for a myringotomy. This approach helps the child understand what will happen during the procedure, reducing anxiety and fear. Encouraging fluid intake is a good general health practice but not directly related to preoperative teaching for this procedure. Allowing the child to play with medical equipment may not be safe or appropriate as it can lead to misunderstanding or fear. Using play therapy can be beneficial but explaining the procedure in simple terms is more direct and effective for preoperative teaching in this case.