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The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition?
- A. Has a cough
- B. Becomes fussy
- C. Shows signs of an earache
- D. Has a fever higher than 37.5 C (99 F)
Correct Answer: C
Rationale: Signs of an earache in an infant with nasopharyngitis may indicate complications like otitis media or secondary bacterial infection, requiring medical evaluation. Cough and fussiness are common with viral illnesses, and a fever of 37.5 C is normal and not concerning.
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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.
Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39 C (102.2 F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication?
- A. Decongestants to ease stuffy nose
- B. Antihistamines to help the child sleep
- C. Aspirin for pain and fever management
- D. Benzocaine ear drops for topical pain relief
Correct Answer: D
Rationale: Benzocaine ear drops provide topical relief for otitis media pain. Decongestants and antihistamines are not recommended, and aspirin is contraindicated in children due to Reye syndrome risk.
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.
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.
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.