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An infants parents ask the nurse about preventing otitis media (OM). What information should be provided?
- A. Avoid tobacco smoke.
- B. Use nasal decongestants.
- C. Avoid children with OM.
- D. Bottle- or breastfeed in a supine position.
Correct Answer: A
Rationale: Avoiding tobacco smoke reduces the risk of otitis media and other childhood illnesses. Nasal decongestants don?t prevent OM, it?s not contagious unless other symptoms are present, and feeding in a semivertical position, not supine, helps prevent OM.
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The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action?
- A. Mothers of hospitalized toddlers often experience guilt.
- B. The mothers presence will reduce anxiety and ease the childs respiratory efforts.
- C. Separation from the mother is a major developmental threat at this age.
- D. The mother can provide constant observations of the childs respiratory efforts.
Correct Answer: B
Rationale: The mother?s presence reduces the toddler?s anxiety, easing respiratory efforts in acute laryngotracheobronchitis. While guilt and separation are concerns, the primary benefit is decreased distress improving breathing, and constant observation is secondary to emotional support.
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.
Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections?
- A. They are safer.
- B. They are less expensive.
- C. Respiratory secretions are dried by steam vaporizers.
- D. A more comfortable environment is produced.
Correct Answer: A
Rationale: Cool-mist vaporizers are safer than steam vaporizers, reducing the risk of burns and microbial growth. Costs are comparable, steam vaporizers loosen rather than dry secretions, and both types enhance comfort, but safety is the primary reason for choosing cool-mist.
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.
An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent?
- A. Administer all of the prescribed medication.
- B. Continue medication until all symptoms subside.
- C. Immediately stop giving medication if hearing loss develops.
- D. Stop giving medication and come to the clinic if fever is still present in 24 hours.
Correct Answer: A
Rationale: Completing the full course of amoxicillin prevents recurrence of resistant bacteria. Stopping when symptoms subside risks incomplete treatment, hearing loss requires evaluation but not stopping antibiotics, and fever may persist for 24-48 hours despite treatment.