Nokea
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.
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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.
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.
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.