Nokea
A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition?
- A. Allergies
- B. Acute pharyngitis
- C. Foreign body in the nose
- D. Acute nasopharyngitis
Correct Answer: C
Rationale: A unilateral foul-smelling nasal discharge with sneezing suggests a foreign body causing local irritation and obstruction. Allergies cause bilateral clear discharge, pharyngitis lacks nasal discharge, and nasopharyngitis produces bilateral mucous discharge.
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The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this childs care?
- A. Monitor pulse oximetry.
- B. Monitor arterial blood gases.
- C. Administer oxygen if respiratory distress develops.
- D. Administer oxygen if childs lips become bright, cherry-red in color.
Correct Answer: B
Rationale: Monitoring arterial blood gases is essential for CO poisoning, as pulse oximetry is unreliable due to normal PaO2 levels. High-flow oxygen should be administered immediately, not only if distress or cherry-red lips (a late sign) appear, to displace CO from hemoglobin.
A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner?
- A. Make her lie down and rest quietly.
- B. Examine her oral pharynx and report to the physician.
- C. Auscultate her lungs and prepare for placement in a mist tent.
- D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.
Correct Answer: D
Rationale: The symptoms suggest epiglottitis, a medical emergency requiring immediate physician notification and preparation for airway support like tracheostomy or intubation. Lying down worsens breathing, examining the throat risks obstruction, and mist tents are ineffective for epiglottitis.
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition?
- A. Otitis media
- B. Diabetes insipidus (DI)
- C. Nephrotic syndrome
- D. Acute rheumatic fever
Correct Answer: D
Rationale: Antibiotics for streptococcal pharyngitis prevent serious sequelae like acute rheumatic fever and glomerulonephritis. Otitis media is caused by other pathogens, DI is unrelated to streptococcal infection, and nephrotic syndrome is not a complication, unlike glomerulonephritis.
The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition?
- A. Has a cough
- B. Becomes fussy
- C. Shows signs of an earache
- D. Has a fever higher than 37.5 C (99 F)
Correct Answer: C
Rationale: Signs of an earache in an infant with nasopharyngitis may indicate complications like otitis media or secondary bacterial infection, requiring medical evaluation. Cough and fussiness are common with viral illnesses, and a fever of 37.5 C is normal and not concerning.
When caring for a child after a tonsillectomy, what intervention should the nurse do?
- A. Watch for continuous swallowing.
- B. Encourage gargling to reduce discomfort.
- C. Apply warm compresses to the throat.
- D. Position the child on the back for sleeping.
Correct Answer: A
Rationale: Continuous swallowing, especially during sleep, signals bleeding from the tonsillectomy site, requiring immediate attention. Gargling may irritate the site, ice compresses are preferred to reduce inflammation, and side or abdominal positioning aids drainage, not back sleeping.