A caregiver calls the pediatrician’s office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6°F (39.2°C). The caregiver has tried to get the child to nap but the child gets panicky, sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which condition?
Epiglottitis
Mild asthma
Spasmodic laryngitis
Acute laryngotracheobronchitis
The Correct Answer is A
A. Epiglottitis:
Epiglottitis is an inflammation of the epiglottis, which can result in rapid onset of symptoms such as severe sore throat, high fever, and difficulty breathing. The characteristic position described, with the child preferring to sit up, lean forward, and keep the mouth open, is known as the "tripod position." This is a protective mechanism to maintain a patent airway.
B. Mild asthma:
Asthma is a chronic respiratory condition characterized by recurrent episodes of wheezing, coughing, and shortness of breath. However, the scenario does not describe typical asthma symptoms, and the child's preference for sitting up and leaning forward is more indicative of an airway obstruction.
C. Spasmodic laryngitis:
Spasmodic laryngitis is characterized by sudden episodes of severe respiratory distress, a barking cough, and sometimes stridor. It often occurs at night and is usually not associated with high fever. The child's behavior in the scenario, particularly the preference for sitting up and leaning forward, is not a common feature of spasmodic laryngitis.
D. Acute laryngotracheobronchitis:
Acute laryngotracheobronchitis, or croup, typically presents with a barking cough, stridor, and respiratory distress. It does not usually cause the preference for sitting up and leaning forward as described in the scenario. Croup is more commonly associated with a distinctive cough sound.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["25"]
Explanation
To calculate the drops per minute for an IV infusion, we need to use the following formula:
gtt/min = (volume x drop factor) / time
In this case, the volume is 50 mL, the drop factor is 20 gtt/mL, and the time is 40 minutes. Plugging these values into the formula, we get:
gtt/min = (50 x 20) / 40
gtt/min = 1000 / 40
gtt/min = 25
Therefore, the adolescent patient should receive 25 drops per minute of Cefazolin IV.
Correct Answer is B
Explanation
A. The mother opens the capsule and some medication spills on the fingers:
Pancreatic enzymes are usually taken intact, and their contents are meant to be sprinkled on soft food, not opened and spilled. This observation suggests a misunderstanding of the proper administration.
B. The child takes a dose before having an afternoon snack.
In cystic fibrosis, pancreatic enzyme replacement therapy is commonly used to help digest and absorb nutrients. The enzymes are typically taken with meals and snacks to aid in the digestion of food.
C. The child chews an enteric form of the medication:
Pancreatic enzymes are usually enteric-coated to protect them from stomach acid, and they are not meant to be chewed. Chewing can reduce their effectiveness. This observation indicates a need for clarification on administration.
D. The father tells the child that diarrhea is expected with this medication:
While gastrointestinal side effects can occur with pancreatic enzyme use, persistent diarrhea may indicate a dosage issue or other problems. It's important to address this with the healthcare provider. The statement suggests a potential misunderstanding or need for clarification.
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