A nurse is assisting with the care of a preschooler who has epiglottitis. Which of the following actions should the nurse take?
Request an x-ray of the neck.
Monitor urine for protein.
Obtain a nasopharyngeal swab
Administer fluconazole.
The Correct Answer is A
A) Request an x-ray of the neck: In cases of suspected epiglottitis, a lateral neck x-ray can help confirm the diagnosis by showing the classic "thumbprint sign," which indicates swelling of the epiglottis. This is a critical diagnostic step, but it should only be performed in a controlled setting where the child’s airway can be monitored closely. The priority is to avoid any procedures that may cause irritation or further compromise the airway.
B) Monitor urine for protein: Monitoring urine for protein is not relevant to the management of epiglottitis. This condition is related to inflammation and obstruction of the upper airway, and the focus should be on respiratory management rather than renal function.
C) Obtain a nasopharyngeal swab: While obtaining a nasopharyngeal swab can help identify the organism causing an infection (often bacterial), it is not the immediate priority in a child with suspected epiglottitis. The child’s airway is the most critical concern, and diagnostic interventions that could potentially cause further distress or obstruction (such as swabbing) should be avoided until airway management is stable.
D) Administer fluconazole: Fluconazole is an antifungal medication, and its use is not appropriate for epiglottitis. Epiglottitis is most often caused by a bacterial infection, particularly Haemophilus influenzae type b (Hib), which requires antibiotic therapy, not antifungals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) "I will get you information about some head-covering options."
This response acknowledges the client's concern about hair loss and provides a supportive and proactive solution. Many chemotherapy clients experience hair loss, and offering resources for head coverings shows empathy while helping them cope with the anticipated changes in appearance. It demonstrates the nurse's willingness to assist the client with emotional and physical challenges related to treatment.
B) "Let’s discuss this when we have more time."
Delaying the discussion about hair loss is not ideal. It dismisses the client’s current concern and may make the client feel like their feelings are not a priority. Hair loss can be a significant emotional challenge, and the nurse should address it in a timely and compassionate manner rather than postponing the conversation.
C) "I can’t imagine how difficult it would be to lose my hair."
While this response is empathetic, it focuses on the nurse's feelings instead of addressing the client's concern. It is important to maintain a client-centered approach and focus on the client's needs. The nurse should offer concrete support or information, such as head-covering options, rather than expressing personal emotions that may not be helpful to the client.
D) "I wouldn’t worry about this right now. Let's focus on your chemotherapy."
This response dismisses the client's concern about hair loss, which can be a significant issue for many clients starting chemotherapy. Minimizing the concern or suggesting it is not worth discussing at this time may make the client feel unheard or undervalued. It’s important to acknowledge the client’s worries and provide support for them to manage the emotional impacts of chemotherapy.
Correct Answer is B
Explanation
A) I will take my inhaler treatment before each meal and at bedtime:
Budesonide is a corticosteroid inhaler used for asthma management, but it is not specifically required to be taken before meals. The timing of inhaler use should be directed by the healthcare provider based on the individual treatment plan. Taking the inhaler at meals is not typically necessary unless specifically instructed, and there is no standard requirement for it to be taken at bedtime either.
B) I will rinse my mouth and gargle with water after each inhaler treatment:
Rinsing the mouth and gargling with water after using an inhaled corticosteroid, like budesonide, is an essential step to reduce the risk of developing oral thrush, a fungal infection. Corticosteroids can promote fungal growth in the mouth, so rinsing helps to clear any residual medication from the mouth and prevent this complication. This statement demonstrates an accurate understanding of the proper use of the inhaler.
C) I should use my inhaler when I have an asthma attack:
Budesonide is a maintenance medication used to control asthma symptoms over the long term, not for immediate relief during an asthma attack. For acute asthma attacks, a fast-acting bronchodilator like albuterol is used, not a corticosteroid like budesonide. The adolescent’s statement reflects a misunderstanding of the purpose of budesonide, which is for prevention and long-term control.
D) I should use my inhaler before exercising:
Using an inhaler before exercise may be appropriate for clients who have exercise-induced bronchoconstriction or asthma, but budesonide is not typically used as a pre-exercise medication. Instead, a short-acting bronchodilator is used before exercise to prevent asthma symptoms during activity. Budesonide is generally used for long-term asthma management rather than for acute symptom relief.
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