A 3-year-old male was brought into the emergency room this morning with a sudden onset of “fast and noisy breathing”. What other symptoms is the nurse likely to note in a child diagnosed with epiglottitis?
High-pitched wheezing
Thick, muffled voice
Purulent nasal discharge
Productive cough
Dyspnea
The Correct Answer is B
The correct answer is choice B: Thick, muffled voice.
Choice B rationale: A thick, muffled voice is a characteristic symptom of epiglottitis. The inflammation and swelling of the epiglottis cause an obstruction in the airway, leading to changes in the child's voice quality.
Choice A rationale: High-pitched wheezing is typically associated with conditions affecting the lower airways, such as asthma or bronchiolitis. Epiglottitis primarily affects the upper airway, causing stridor (a high-pitched, harsh sound during inhalation) rather than wheezing.
Choice C rationale: Purulent nasal discharge is not a typical symptom of epiglottitis. Epiglottitis usually presents with minimal or no secretions, while purulent discharge is more commonly seen in bacterial infections like sinusitis or pneumonia.
Choice D rationale: A productive cough is not a common symptom of epiglottitis. Coughing is associated with conditions affecting the lower respiratory tract, such as bronchitis or pneumonia. Epiglottitis primarily affects the upper airway, causing difficulty breathing and a characteristic "thick, muffled voice."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A. Praise the client for her actions and offer to discuss ways to decrease consumption even more.
Why? During pregnancy, any amount of alcohol poses a risk to the developing fetus, but abruptly shaming or forcing action may not be effective. The best approach is motivational interviewing, which involves acknowledging the client's reduction while encouraging further progress. A supportive conversation can help guide the client toward complete cessation of alcohol use.
Here’s why the other options are incorrect:
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B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit – While alcohol cessation is the goal, forcing the client without a supportive approach can lead to resistance. Routine blood alcohol testing is not standard unless substance dependence is suspected.
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C. Notify child protective services of the client’s illicit drug use and probable child endangerment – Alcohol is not classified as an illicit drug, and reporting at this stage would be premature unless clear evidence of abuse or harm to the fetus exists.
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D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy – Disulfiram (Antabuse) is not recommended in pregnancy, as it may cause adverse effects. Instead, behavioral counseling and support groups are preferred interventions.
Correct Answer is B
Explanation
Choice A rationale
If the child is sleeping now and is difficult to wake, this could be a sign of worsening respiratory status. Children with respiratory distress often have difficulty sleeping due to discomfort and difficulty breathing. If the child is now sleeping and difficult to wake, this could indicate a decrease in oxygen levels, leading to lethargy and decreased responsiveness. This would require immediate attention.
Choice B rationale
The vital signs provided indicate a potentially serious situation. A heart rate of 130 beats/minute is high for a 3-year-old child, indicating that the heart is working harder to pump blood. A respiratory rate of 15 breaths/minute is on the lower end of normal for a 3-year-old, which could indicate that the child is not getting enough oxygen. An oxygen saturation of 66% on a 5L face mask is dangerously low, indicating severe hypoxia. A temperature of 102.8° F(39.3° C) axillary indicates a fever, which could be a sign of infection. A blood pressure of 92/48 mm Hg is within normal range for a 3-year-old.
Choice C rationale
If the child is active and playing with toys, this could indicate that his respiratory status is not worsening. Children who are experiencing respiratory distress often have difficulty engaging in normal activities due to discomfort and shortness of breath. If the child is able to play normally, this could indicate that he is getting enough oxygen and his condition is stable.
Choice D rationale
If the child’s breathing has returned to normal, this could indicate that his respiratory status is improving. However, it’s important to continue monitoring the child closely, as respiratory conditions can change rapidly, especially in young children.
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