A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (Select all that apply.)

Oxygen saturation 95%

Warm extremities

Wheezing

Nasal flaring

Retraction of sternal muscles

Answer and Explanation

Correct Answer : C,D,E

Choice A reason: An oxygen saturation of 95% is within the normal range and does not indicate respiratory deterioration.

Choice B reason: Warm extremities are not an indication of respiratory status deterioration; they are generally a sign of good circulation.

Choice C reason: Wheezing is a common sign of airway obstruction in asthma and can indicate a deterioration in respiratory status.

Choice D reason: Nasal flaring is a sign of increased work of breathing and can indicate respiratory distress in a child with asthma.

Choice E reason: Retraction of sternal muscles is a sign of respiratory distress and can indicate a worsening condition in a child with asthma.

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Correct Answer is ["C","D"]

Explanation

Choice A reason: Rapid growth spurts are not associated with cystic fibrosis. Instead, patients often experience poor growth due to malabsorption.

Choice B reason: Thin, watery mucus is not typical in cystic fibrosis. The mucus is usually thick and sticky, leading to blockages in the lungs and pancreas.

Choice C reason: Wheezing is a common symptom in cystic fibrosis due to the obstruction of the airways by thick mucus.

Choice D reason: A barrel-shaped chest can develop in cystic fibrosis due to chronic lung infections and air trapping.

Choice E reason: Clubbing of fingers and toes is a sign of chronic hypoxia, which can occur in cystic fibrosis due to long-standing lung disease.

A. Tell the caregiver to administer the medication. B. Calculate the safe dosage. C. Offer juice after the medication. D. Identify the toddler by asking the caregiver. E. Ask the toddler to pick a toy to hold during administration.

Correct Answer is ["B","C","D","E"]

Explanation

Choice A reason: It is the nurse's responsibility to administer medication, not the caregiver's, to ensure proper dosage and method.

Choice B reason: Calculating the safe dosage is essential to avoid underdosing or overdosing, which can be harmful to the toddler's health.

Choice C reason: Offering juice after medication can help wash down the taste and ensure the medication is swallowed properly.

Choice D reason: Identifying the toddler by asking the caregiver ensures that the correct child receives the medication, which is a critical safety step.

Choice E reason: Asking the toddler to pick a toy can provide comfort and distraction, making the administration process smoother and less stressful for the child.

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A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is performing an admission assessment for a child who has cystic fibrosis. Which of the following findings should the nurse expect? (Select all that apply.)

Correct Answer is ["C","D"]

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Correct Answer is ["B","C","D","E"]

Explanation

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