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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.
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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.
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 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.
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.
Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms?
- A. Severe pain in the ear
- B. Anorexia and vomiting
- C. A feeling of fullness in the ear
- D. Fever as high as 40 C (104 F)
Correct Answer: C
Rationale: Chronic otitis media with effusion (OME) typically presents with a feeling of fullness in the ear and nonspecific symptoms, unlike acute otitis media (AOM), which involves severe pain, fever, and systemic symptoms like anorexia or vomiting.