Nokea
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.
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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.
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.
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.
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.
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.