Nokea
A 4-month-old girl is brought to the clinic by her mother because she has had a cold for 2 to 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress?
- A. Bilateral bronchial breath sounds.
- B. Diaphragmatic respiration.
- C. A resting respiratory rate of 35 breaths per minute.
- D. Flaring of the nares.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A 6-year-old child with a history of asthma is brought to the emergency department with difficulty breathing and a severe cough. The nurse notes that the child is using accessory muscles to breathe and has a peak flow reading in the red zone. What should the nurse do first?
- A. Administer a nebulized bronchodilator
- B. Obtain an arterial blood gas
- C. Start the child on oxygen therapy
- D. Contact the healthcare provider
Correct Answer: A
Rationale: In a 6-year-old child with asthma experiencing difficulty breathing and using accessory muscles to breathe with a peak flow reading in the red zone, the priority intervention is to administer a nebulized bronchodilator first. Nebulized bronchodilators help open the airways quickly, providing immediate relief and improving breathing. This intervention aims to address the acute respiratory distress the child is experiencing before considering other assessments or interventions such as obtaining arterial blood gases, starting oxygen therapy, or contacting the healthcare provider.
The nurse is assessing a 6 month old infant. Which response requires further evaluation by the nurse?
- A. Has doubled birth weight.
- B. Turn head to locate sound.
- C. Plays peek-a-boo.
- D. Demonstrates startle reflex.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the most important information for the PN to reinforce with the parents when caring for a child diagnosed with acute rheumatic fever?
- A. Complete the full course of prescribed antibiotics.
- B. Ensure the child gets plenty of physical exercise.
- C. Keep the child on a low-sodium diet.
- D. Administer prescribed pain medications as needed.
Correct Answer: A
Rationale: Completing the full course of antibiotics is crucial in the management of acute rheumatic fever as it helps prevent recurrence and complications. Antibiotics are essential in eradicating the underlying infection that triggers the autoimmune response leading to rheumatic fever. Reinforcing the importance of completing the prescribed antibiotic regimen is vital to ensure the child's recovery and prevent further health issues.
When assessing the breath sounds of an 18-month-old child who is crying, what action should the healthcare professional take?
- A. Document that the assessment is not available because the child is crying.
- B. Ask the caregiver to quiet the child so breath sounds can be auscultated.
- C. Allow the child to play with a stethoscope to distract them during auscultation.
- D. Auscultate and document breath sounds, noting that the child was crying at the time.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A male toddler is brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin). What intervention should the nurse implement first?
- A. Administer activated charcoal
- B. Prepare gastric lavage
- C. Obtain a 12-lead electrocardiogram
- D. Give IV digoxin immune fab (Digibind)
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.