Nokea
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.
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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.
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.
What statement best represents infectious mononucleosis?
- A. Herpes simplex type 2 is the principal cause.
- B. A complete blood count shows a characteristic leukopenia.
- C. A short course of ampicillin is used when pharyngitis is present.
- D. Clinical signs and symptoms and blood tests are both needed to establish the diagnosis.
Correct Answer: D
Rationale: Diagnosing infectious mononucleosis requires both clinical symptoms (e.g., sore throat, lymphadenopathy) and blood tests (heterophil antibody, monospot), as symptoms mimic other diseases. Epstein-Barr virus, not herpes simplex, causes it; lymphocytosis, not leukopenia, is typical; and penicillin, not ampicillin, is used due to rash risks.
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.
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.