A nurse is assessing a 6-month-old infant who has respiratory syncytial virus.
The nurse should immediately report which of the following findings to the provider?
Cough or difficulty in breathing.
Oxygen saturation < 90% or central cyanosis.
Severe respiratory distress (e.g grunting, very severe chest indrawing).
Signs of pneumonia with a general danger.
The Correct Answer is B
This is because oxygen saturation below 90% indicates that the infant is not getting enough oxygen and central cyanosis (bluish color of the skin due to lack of oxygen) is a sign of severe respiratory distress.
Both of these findings require immediate medical attention.
Choice A is wrong because cough or difficulty in breathing, while concerning, may not require immediate reporting to the provider as they are common symptoms of RSV infection.
Choice C is wrong because severe respiratory distress (e.g grunting, very severe chest indrawing), while concerning, may not require immediate reporting to the provider as they are common symptoms of RSV infection.
Choice D is wrong because signs of pneumonia with a general danger, while concerning, may not require immediate reporting to the provider as they are common symptoms of RSV infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
After an arterial cardiac catheterization, the patient will need to keep their leg straight for several hours following the procedure to prevent bleeding from the catheter insertion site.
Choice B is wrong because droplet isolation precautions are not necessary after an arterial cardiac catheterization.
Choice C is wrong because assisting the child into a supine position may not be necessary and could be uncomfortable for the child.
Choice D is wrong because checking oxygen saturation every 4 hours may not be frequent enough for a child who has undergone an arterial cardiaccatheterization and may require more frequent monitoring of oxygen saturation.
Correct Answer is ["B","C","E"]
Explanation
This laboratory test can contribute to confirming a diagnosis of rheumatic fever.
Choice A is wrong because Blood urea nitrogen (BUN) is not used to diagnose rheumatic fever.
Choice D is wrong because Partial thromboplastin time (PTT) is not used to diagnose rheumatic fever.
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