A nurse is teaching a 12yearold child who is newly diagnosed with asthma about managing the condition to prevent asthma attacks. Which of the following statements by the child should indicate to the nurse that the teaching has been effective?

"Eliminating allergens that irritate my lungs can help me avoid getting an asthma attack."

"If I control my asthma, I will miss fewer days of school."

"Even if I control my asthma well, I won't be able to participate in sports or physical activities."

"Coughing and shortness of breath in the morning can be a sign that my asthma is well controlled."

Answer and Explanation

The Correct Answer is A

Choice A reason: This statement indicates that the child understands the role of allergens in triggering asthma symptoms and the importance of avoiding or reducing exposure to them. Allergens such as dust mites, animal dander, mold, and pollen can cause inflammation and constriction of the airways, leading to wheezing, coughing, and shortness of breath. The nurse should teach the child how to identify and eliminate or minimize allergens in the home, school, and outdoor environments.
Choice B reason: This statement is true, but it does not indicate that the child has learned how to manage the condition to prevent asthma attacks. Missing school days is a consequence of poorly controlled asthma, not a cause or a trigger¹². The nurse should teach the child how to use a written asthma action plan, which includes daily medications, peak flow monitoring, and rescue medications, to achieve good asthma control and reduce the risk of exacerbations.
Choice C reason: This statement is false and indicates that the child has a misconception about the impact of asthma on physical activity. Physical activity is beneficial for children with asthma, as it can improve lung function, cardiovascular fitness, and quality of life. The nurse should teach the child how to prevent exercise-induced bronchoconstriction, which is a common trigger of asthma symptoms, by using a short-acting bronchodilator before exercise, warming up and cooling down, and avoiding exercise in cold or polluted air.
Choice D reason: This statement is false and indicates that the child does not recognize the signs of poor asthma control. Coughing and shortness of breath in the morning are common symptoms of nocturnal asthma, which is a sign of uncontrolled asthma and a risk factor for severe asthma attacks. The nurse should teach the child how to monitor and record asthma symptoms and peak flow readings, and how to adjust medications according to the asthma action plan.

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Correct Answer is B

Explanation

Choice A reason: Administering an inhaled glucocorticoid is not the priority intervention for a child with status asthmaticus. Inhaled glucocorticoids are anti-inflammatory drugs that reduce airway inflammation and prevent asthma attacks, but they do not provide immediate relief of bronchoconstriction.

Choice B reason: Administering a short acting beta agonist (SABA) is the priority intervention for a child with status asthmaticus. SABAs are bronchodilators that relax the smooth muscles of the airways and improve airflow within minutes. They are the first line treatment for acute asthma symptoms and exacerbations.

Choice C reason: Determining the cause of the acute exacerbation is not the priority intervention for a child with status asthmaticus. While it is important to identify and avoid potential triggers of asthma, such as allergens, infections, or stress, this is not an urgent action during a severe asthma attack.

Choice D reason: Obtaining a peak flow reading is not the priority intervention for a child with status asthmaticus. Peak flow is a measure of how quickly the child can blow air out of the lungs, and it can indicate the degree of airway obstruction. However, peak flow measurement is not reliable or feasible during a severe asthma attack, and it should not delay the administration of bronchodilators.

A. Development of subcutaneous emphysema B. Chest tube eyelets not visible C. Continuous bubbling in the suction control chamber D. Presence of tidal fluctuation in the water seal chamber

Correct Answer is A

Explanation

The correct answer is: a. Development of subcutaneous emphysema

Choice A: Development of subcutaneous emphysema

Reason: Subcutaneous emphysema occurs when air gets trapped under the skin, often due to a leak from the lung or chest tube. This can indicate a serious complication such as a pneumothorax or a malfunctioning chest tube, requiring immediate medical intervention. The presence of subcutaneous emphysema can lead to discomfort, respiratory distress, and further complications if not addressed promptly.

Choice B: Chest tube eyelets not visible

Reason: The eyelets of a chest tube are small holes at the end of the tube that allow air and fluid to drain from the pleural space. These eyelets are typically covered by a dressing and may not be visible. This is not necessarily a cause for concern unless there are other signs of malfunction or complications.

Choice C: Continuous bubbling in the suction control chamber

Reason: Continuous bubbling in the suction control chamber is expected and indicates that the suction is functioning properly. It does not indicate a problem unless the bubbling is in the water seal chamber, which would suggest an air leak.

Choice D: Presence of tidal fluctuation in the water seal chamber

Reason: Tidal fluctuation, or tidaling, in the water seal chamber is a normal finding. It indicates that the chest tube is patent and functioning correctly, as the water level rises with inhalation and falls with exhalation. The absence of tidaling could indicate a blockage or that the lung has fully re-expanded.

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A nurse is teaching a 12yearold child who is newly diagnosed with asthma about managing the condition to prevent asthma attacks. Which of the following statements by the child should indicate to the nurse that the teaching has been effective?

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