Nokea
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation?
- A. Reverse isolation
- B. Airborne isolation
- C. Contact Precautions
- D. Standard Precautions
Correct Answer: C
Rationale: RSV requires Contact Precautions, including gloves and gowns, to prevent droplet transmission, in addition to Standard Precautions. Reverse isolation protects immunocompromised patients, airborne isolation is for diseases like measles, and Standard Precautions alone are insufficient.
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Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which information?
- A. Do not use for more than 3 days.
- B. Keep drops to use again for nasal congestion.
- C. Administer drops after feedings and at bedtime.
- D. Give two drops every 5 minutes until nasal congestion subsides.
Correct Answer: A
Rationale: Using decongestant nose drops for no more than 3 days prevents rebound congestion. Drops should be discarded after illness to avoid contamination, administered before feedings for better effect, and given in two doses 5-10 minutes apart, not repeatedly every 5 minutes.
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. What nursing action should be included in the care of the child?
- A. Force fluids.
- B. Monitor pulse oximetry.
- C. Institute seizure precautions.
- D. Encourage a high-protein diet.
Correct Answer: B
Rationale: Monitoring pulse oximetry is critical to assess oxygenation in ARDS, guiding respiratory support. Fluids are given parenterally to maintain hydration, seizures are not typical in ARDS, and a high-protein diet is not specifically beneficial compared to balanced nutrition.
The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the childs throat using a tongue depressor might precipitate what condition?
- A. Sore throat
- B. Inspiratory stridor
- C. Complete obstruction
- D. Respiratory tract infection
Correct Answer: C
Rationale: Examining the throat of a child with suspected epiglottitis risks complete airway obstruction due to irritation of an inflamed epiglottis. Sore throat is already present, stridor worsens with positioning, and the infection is pre-existing, not caused by examination.
What consideration is most important in managing tuberculosis (TB) in children?
- A. Skin testing
- B. Chemotherapy
- C. Adequate rest
- D. Adequate hydration
Correct Answer: B
Rationale: Chemotherapy with drugs like isoniazid, rifampin, and pyrazinamide is the cornerstone of TB management in children, administered for 2 months daily and then 4 months biweekly. Skin testing aids diagnosis, while rest and hydration support but are secondary to drug therapy.
The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37 C (98.6 F). The nurse suspects mild croup and should recommend which intervention?
- A. Admit to the hospital and observe for impending epiglottitis.
- B. Provide fluids that the child likes and use comfort measures.
- C. Control fever with acetaminophen and call if cough gets worse tonight.
- D. Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement.
Correct Answer: B
Rationale: For mild croup, providing hydration with preferred fluids and comfort measures minimizes distress. Hospital admission is unnecessary without epiglottitis signs, the temperature is normal, and over-the-counter cough medicine is not recommended; parents should return if noisy breathing or drooling occurs.