A 3-year-old child is brought to the emergency department with a barking cough, stridor, and difficulty breathing.
The child's oxygen saturation is 92%.
The nurse assesses the child's respiratory status and determines that the child has moderate croup.
Which of the following statements by the nurse is most appropriate?

"We need to get you started on a ventilator so you can breathe easier.”..

"I'm going to give you some medicine to help your cough and make it easier to breathe.”..

"I'm going to take you to the ICU so we can monitor your breathing more closely.”..

"We're going to take you home now, and your parents can take care of you.”..

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Placing the child on a ventilator might be necessary in severe cases of croup, but it should not be the first action taken.

In this scenario, the child has moderate croup, so less invasive interventions should be attempted first.

Choice B rationale:

Administering medication to help the child's cough and breathing is an appropriate first step in managing moderate croup.

Nebulized epinephrine or corticosteroids are commonly used to reduce airway inflammation and relieve respiratory distress in croup.

This intervention can be effective in improving the child's symptoms and overall condition.

Choice C rationale:

Transferring the child to the ICU for closer monitoring is not immediately necessary in this case of moderate croup.

Such a step might be considered if the child's condition worsens despite initial interventions or if there are signs of severe respiratory distress.

Choice D rationale:

Discharging the child home without appropriate treatment and monitoring would be unsafe, given the child's symptoms and oxygen saturation level.

Immediate intervention and observation are required to ensure the child's respiratory status improves.

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Correct Answer is A

Explanation

The correct answer is choice A, “Your son has croup.”

Choice A rationale:

The symptoms described, including a barking cough, hoarseness, and inspiratory stridor, are classic signs of croup. Croup is a common respiratory condition in young children that leads to swelling of the larynx and trachea, causing the characteristic cough and stridor.

Choice B rationale:

While epiglottitis can present with respiratory distress, it is more commonly associated with high fever, severe sore throat, drooling, and difficulty swallowing, rather than a barking cough and stridor.

Choice C rationale:

Asthma typically presents with wheezing and difficulty exhaling, not the barking cough and inspiratory stridor seen in croup. Additionally, asthma is often associated with a history of allergies or atopic conditions, which are not mentioned in the scenario.

Choice D rationale:

Pneumonia usually presents with fever, cough producing phlegm, and crackles or wheezes on lung auscultation. The clear lungs on auscultation and the absence of productive cough make pneumonia less likely in this case.

In summary, the presentation of a barking cough, hoarseness, and inspiratory stridor in a young child who is in moderate respiratory distress with a recent onset of symptoms is most indicative of croup. This is supported by the age of the child and the clinical findings, which align with the typical presentation of croup.

A. The child's height and weight. B. The child's vaccination history. C. The degree of airway obstruction. D. The child's social activities.

Correct Answer is C

Explanation

The nurse should assess the degree of airway obstruction to determine the severity of respiratory distress.

Choice A rationale:

Assessing the child's height and weight is important for overall health assessment but does not specifically determine the severity of respiratory distress in croup.

Respiratory distress is primarily evaluated by assessing airway patency, effort of breathing, and oxygenation.

Choice B rationale:

The child's vaccination history is crucial for preventing certain infectious diseases, but it does not directly assess the severity of respiratory distress in croup.

Croup is commonly caused by viral infections such as parainfluenza viruses.

Choice C rationale:

Assessing the degree of airway obstruction is essential in determining the severity of respiratory distress in croup.

Children with croup often present with stridor, a high-pitched sound heard during inspiration, indicating partial airway obstruction.

The severity of stridor, along with signs of increased work of breathing, provides valuable information about the child's respiratory status.

Choice D rationale:

The child's social activities are not directly related to the assessment of respiratory distress in croup.

While social history is important in a comprehensive nursing assessment, it does not provide specific information about the severity of airway obstruction in croup.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is performing a nursing assessment of a child with croup.What should the nurse assess to determine the severity of respiratory distress?

Correct Answer is C

Explanation

A nurse is educating parents of a child with croup about the signs and symptoms.Which clinical manifestations should the nurse include in the teaching? Select all that apply.

A nurse is educating a parent about the prevention of croup.Which of the following statements should the nurse include in the teaching?

A nurse is caring for a child with croup in the hospital.The child is receiving humidified air and nebulized racemic epinephrine.The nurse monitors the child's respiratory status closely.Which of the following findings would indicate to the nurse that the child's condition is worsening?

Select all that apply.Which of the following are nursing interventions for a child with croup?

A nurse is teaching a parent about the signs and symptoms of croup.Which of the following statements should the nurse include in the teaching?Select all that apply.

A nurse is teaching the parents of a child with croup about home care management.The nurse explains that it is important to keep the child hydrated and to provide humidified air.Which of the following statements by the parent indicates that they understand the nurse's instructions?