A nurse is taking vital signs on an infant diagnosed with bronchiolitis. Which of the following findings should the nurse immediately report to the provider?

Heart rate of 152 beats per minute

Temperature of 99.5°F (37.5°C)

Respiratory rate of 74 breaths per

Blood pressure of 90/60 mmHg

Answer and Explanation

The Correct Answer is C

A.   An elevated heart rate can be expected in infants with bronchiolitis due to increased work of breathing.
B.   A slight elevation in temperature may be indicative of infection but is not an immediate concern.
C.   A respiratory rate of 74 breaths per minute may indicate respiratory distress and warrants immediate attention.
D.   A blood pressure of 90/60 mmHg is within the normal range for infants and not immediately concerning.

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Correct Answer is D

Explanation

A. Family history of asthma is a well-established risk factor.

B. Allergies can contribute to asthma development or exacerbation.

C. Exposure to secondhand smoke is a known risk factor for asthma.

D. Physical activity is not a risk factor for asthma; in fact, regular physical activity can have protective effects against asthma.

A. Identifying the degree of parental anxiety related to the diagnosis B. Using a pain-rating tool to determine the severity of the joint pain C. Assessing the client's erythematous rash D. Auscultating the rate and characteristics of the child's heart sounds

Correct Answer is D

Explanation

A. Assessing parental anxiety is important but not the priority immediately after admission.
B. Pain assessment is important but not the priority assessment in acute rheumatic fever.
C. Assessing the erythematous rash is relevant but not the priority compared to cardiac assessment.
D. Auscultating the rate and characteristics of the child's heart sounds is crucial for early detection of cardiac involvement, which is a priority in acute rheumatic fever.

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A nurse is taking vital signs on an infant diagnosed with bronchiolitis. Which of the following findings should the nurse immediately report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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