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A child who is experiencing an acute asthma attack
A nurse is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse administer first?
- A. Methylprednisolone
- B. Albuterol
- C. Fluticasone
- D. Beclomethasone
Correct Answer: B
Rationale: The correct answer is B: Albuterol. During an acute asthma attack, bronchodilation is crucial to relieve airway constriction quickly. Albuterol is a short-acting beta-agonist that acts rapidly to relax the airway muscles, allowing for improved airflow. Methylprednisolone (A) is a corticosteroid that is used for long-term control, not for immediate relief. Fluticasone (C) and Beclomethasone (D) are inhaled corticosteroids for maintenance therapy and do not provide immediate relief during an acute attack. Administering Albuterol first is essential to address the acute symptoms and stabilize the child's condition.
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An 8-month-old infant who will be admitted for surgery
A nurse is reinforcing teaching with the parents of an 8-month-old infant who will be admitted for surgery. Which of the following instructions should the nurse include in the teaching?
- A. You should begin to manipulate the infant's bedtime based on the hospitals visiting hours.
- B. You should bring the infant's favorite blanket to the hospital
- C. You should read the child a story about hospitalization.
- D. You will need to go home when it is not visiting hours.
Correct Answer: B,C
Rationale: The correct answer is B and C. Bringing the infant's favorite blanket to the hospital (B) provides comfort and familiarity in an unfamiliar environment, reducing anxiety. Reading the child a story about hospitalization (C) can help prepare the child for the upcoming experience, easing fears.
Choice A is incorrect because manipulating bedtime based on visiting hours disrupts the infant's routine. Choice D is incorrect as parents are usually allowed to stay with their child in the hospital. Choices E, F, and G are not provided in the question.
In summary, choices B and C are crucial for providing comfort and emotional support to the infant before surgery, while the other options either disrupt the routine or are not necessary for the child's well-being during hospitalization.
A toddler who has laryngotracheobronchitis
A nurse is caring for a toddler who has laryngotracheobronchitis. For which of the following findings should the nurse monitor to detect airway obstruction?
- A. Decreased stridor
- B. Increased restlessness
- C. Decreased heart rate
- D. Decreased temperature
Correct Answer: B
Rationale: The correct answer is B: Increased restlessness. Restlessness is a common sign of airway obstruction in toddlers with laryngotracheobronchitis. As the airway becomes more obstructed, the toddler may feel increasingly anxious and agitated, leading to increased restlessness. Monitoring for this sign is crucial as it indicates worsening respiratory distress and the need for prompt intervention.
Decreased stridor (choice A) is not indicative of airway obstruction in this condition, as stridor is a high-pitched sound heard on inspiration and can be present in both mild and severe cases of laryngotracheobronchitis. Decreased heart rate (choice C) and decreased temperature (choice D) are not typically associated with airway obstruction and are less relevant in this context.
A school-age child who has cystic fibrosis
A nurse is reinforcing teaching with the parents of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make?
- A. Your child's diet should be high in carbohydrates & proteins with no restriction of fats.
- B. Limit your child's intake of sodium to avoid complications.
- C. A pigeon-shaped chest might become evident as the disease progresses.
- D. Administer a bronchodilator to the child after chest percussion therapy.
Correct Answer: C
Rationale: The correct answer is C: A pigeon-shaped chest might become evident as the disease progresses. In cystic fibrosis, the chest may appear pigeon-shaped due to the abnormal growth of the ribs and sternum. This is caused by chronic respiratory issues and increased work of breathing. It is important for the nurse to educate the parents about this potential physical manifestation of the disease so they can monitor their child's condition closely.
Incorrect choices:
A: Your child's diet should be high in carbohydrates & proteins with no restriction of fats - This is incorrect as children with cystic fibrosis often require a high-calorie, high-fat diet to meet their increased energy needs.
B: Limit your child's intake of sodium to avoid complications - While monitoring sodium intake can be important for some conditions, it is not a primary concern in cystic fibrosis.
D: Administer a bronchodilator to the child after chest percussion therapy - While bronchodilators may be used in cystic fib
A child who has spina bifida occulta
A nurse is collecting data from a child who has spina bifida occulta. Which of the following findings should the nurse expect?
- A. Flaccid paralysis of lower extremities
- B. Hip dislocation
- C. Hydrocephalus
- D. Dimple in sacral area
Correct Answer: D
Rationale: The correct answer is D: Dimple in sacral area. In spina bifida occulta, there is a small gap in the spine but no protrusion of the spinal cord or meninges. A dimple in the sacral area is a common physical finding. Flaccid paralysis of lower extremities (A) is more characteristic of myelomeningocele, not occulta. Hip dislocation (B) is not typically associated with spina bifida occulta. Hydrocephalus (C) is more commonly seen with myelomeningocele as well. The presence of a dimple in the sacral area is a key indicator of spina bifida occulta due to the incomplete closure of the spinal column.
An adolescent who is having a sickle cell crisis
A nurse is caring for an adolescent who is having a sickle cell crisis. Which of the following nursing actions should the nurse take?
- A. withhold opioids to avoid dependence
- B. Assist RN with administering a blood transfusion
- C. Initiate a 2 L/day fluid restriction
- D. Encourage exercise
Correct Answer: B
Rationale: The correct answer is B: Assist RN with administering a blood transfusion. During a sickle cell crisis, blood transfusions can help improve oxygen delivery to tissues by increasing the number of normal red blood cells. This can help alleviate symptoms and prevent complications. Withholding opioids (choice A) can lead to inadequate pain management. Initiation of fluid restriction (choice C) is inappropriate as hydration is crucial during a sickle cell crisis. Encouraging exercise (choice D) can worsen the crisis by increasing the risk of vaso-occlusive events.