A 2-year-old is brought to the emergency department (ED) with a history of several days of rhinitis and now exhibits a productive barking cough and difficulty breathing. Which additional finding should alert the nurse that the child is experiencing respiratory distress?

A resting respiratory rate of 35 breaths/minute.

Flaring of the nares.

Diaphragmatic respirations.

Bilateral bronchial breath sounds.

Answer and Explanation

The Correct Answer is B

A. A respiratory rate of 35 breaths/minute can be normal for a 2-year-old, so it is not necessarily indicative of distress by itself.

B. Flaring of the nares is a sign of increased work of breathing and is an indication of respiratory distress, as the child is using accessory muscles to breathe.

C. Diaphragmatic respirations are typical for young children and not indicative of distress unless other signs are present.

D. Bilateral bronchial breath sounds do not necessarily indicate respiratory distress and could be normal depending on the context.

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Correct Answer is A

Explanation

A.Beginning with less sensitive questions helps establish trust and rapport with the client, making it easier to discuss more difficult topics later. This approach can make the client feel more comfortable and less threatened, thereby improving the quality of the information gathered.

B.Sharing personal values can introduce bias and potentially influence the client's responses, making the interview less objective.

C.Starting with the most difficult questions can make the client feel anxious and defensive, reducing the likelihood of obtaining honest and thorough responses.

D.Asking vague, non-specific questions can lead to ambiguous answers and fail to provide the detailed information needed for a proper assessment.

A. An older client with continuous bladder irrigation who is 2 days postoperative for bladder surgery. B. An older client who is receiving packed red blood cells on the third day postoperative for colon resection. C. An adult one day postoperative laparoscopic cholecystectomy requesting pain medication. D. An adult who is in traction, and scheduled for hip arthroplasty within the next 12 hours.

Correct Answer is B

Explanation

A. Continuous bladder irrigation postoperatively is a routine procedure and does not require immediate intervention unless there are complications.

B. This client may be at risk for complications such as a transfusion reaction or hemorrhage. Close monitoring is required to ensure the client's vital signs are stable and there are no adverse reactions to the transfusion.
C. A client requesting pain medication one day postoperative from a laparoscopic cholecystectomy, would follow as effective pain management is important for recovery, but this situation is not immediately life-threatening.
D. While hip arthroplasty is a significant procedure, the client in traction is not in an acute postoperative state requiring immediate attention.

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A 2-year-old is brought to the emergency department (ED) with a history of several days of rhinitis and now exhibits a productive barking cough and difficulty breathing. Which additional finding should alert the nurse that the child is experiencing respiratory distress?

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Explanation

A 2-year-old is brought to the emergency department (ED) with a history of several days of rhinitis and now exhibits a productive barking cough and difficulty breathing. Which additional finding should alert the nurse that the child is experiencing respiratory distress?

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