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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Bowel sounds are a general indicator of intestinal activity and can be assessed in patients with various conditions. However, they are not specific to the effectiveness of Esomeprazole, which is primarily used to reduce gastric acid production and prevent stress ulcers, particularly in patients with burn injuries⁷.
Choice B reason:
Stool frequency may indicate gastrointestinal motility and function but does not directly assess the effectiveness of Esomeprazole. This drug's main role is to decrease stomach acidity, which would not necessarily change stool frequency unless there was a pre-existing issue related to acid production⁷.
Choice C reason:
Abdominal distention can be caused by a variety of factors, including gas, fluid, or enlargement of organs. While it's important to monitor in burn patients, it does not specifically evaluate the effectiveness of Esomeprazole in preventing gastric acid-related complications⁷.
Choice D reason:
A fecal occult blood test is used to detect bleeding in the gastrointestinal tract, which could signify the development of stress ulcers. Since Esomeprazole is prescribed to prevent such ulcers by reducing stomach acid, this test is a direct measure of the drug's effectiveness in burn patients⁷.
Correct Answer is A
Explanation
The correct answer is a. "Children play alongside each other but do not interact."
Choice A reason: Parallel play is characterized by children playing next to each other without engaging in direct interaction or cooperative play, which is typical behavior at certain developmental stages.
Choice B reason: Organized play involves interaction and cooperation, which is not characteristic of parallel play.
Choice C reason: While children may play independently in a group, this statement does not capture the essence of parallel play, which involves proximity without interaction.
Choice D reason: Observing others play is more indicative of onlooker behavior rather than parallel play.
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