A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse prepare the child for next?

Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck.

Provide a nebulizer treatment with bronchodilators.

Obtain bedside trays for intubation or tracheotomy by the healthcare provider.

Begin prescribed intravenous antibiotic administration.

Answer and Explanation

The Correct Answer is C

Choice A reason: Scheduling the child for a STAT magnetic resonance imaging (MRI) of the neck is not a priority action for the nurse. MRI is a diagnostic test that uses magnetic fields and radio waves to produce images of the internal structures of the body. MRI of the neck may be useful to rule out other causes of respiratory distress, such as tumors, abscesses, or foreign bodies, but it is not an urgent procedure. Moreover, MRI requires the child to lie still for a long time, which may be difficult or impossible for a child who is anxious and in respiratory distress.

Choice B reason: Providing a nebulizer treatment with bronchodilators is not a suitable action for the nurse. Nebulizer is a device that delivers medication in the form of a mist that can be inhaled into the lungs. Bronchodilators are medications that relax the smooth muscles of the airways and improve airflow. Nebulizer treatment with bronchodilators may be helpful for children with respiratory distress caused by asthma, bronchiolitis, or chronic obstructive pulmonary disease, but not for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child.

Choice C reason: Obtaining bedside trays for intubation or tracheotomy by the healthcare provider is the most appropriate action for the nurse. Intubation is a procedure that involves inserting a tube through the mouth or nose into the trachea to secure the airway and provide ventilation. Tracheotomy is a surgical procedure that involves creating an opening in the neck and inserting a tube into the trachea to bypass the upper airway obstruction. Both procedures are life-saving interventions for children with respiratory distress caused by upper airway obstruction, which is the most likely scenario for this child. The nurse should prepare the necessary equipment and assist the healthcare provider in performing these procedures.

Choice D reason: Beginning prescribed intravenous antibiotic administration is not a relevant action for the nurse. Antibiotics are medications that kill or inhibit the growth of bacteria that cause infections. Antibiotics may be indicated for children with respiratory distress caused by bacterial infections, such as pneumonia, tonsillitis, or epiglottitis, but not for children with respiratory distress caused by non-infectious causes, such as foreign bodies, anaphylaxis, or congenital anomalies. Moreover, antibiotics are not an immediate intervention for respiratory distress, as they take time to exert their effects.

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Correct Answer is B

Explanation

Choice A reason: Chickenpox is not the most significant illness that may be associated with acute rheumatic fever. Chickenpox is a viral infection that causes an itchy rash and blisters. It is not caused by group A streptococcus (GAS) bacteria, which are the main trigger of acute rheumatic fever.

Choice B reason: Sore throat is the most significant illness that may be associated with acute rheumatic fever. Sore throat can be caused by GAS bacteria, which can also cause strep throat or scarlet fever. If these infections are not properly treated with antibiotics, they can lead to acute rheumatic fever, which is an inflammatory disease that can affect the heart, joints, skin, and brain.

Choice C reason: Mumps is not the most significant illness that may be associated with acute rheumatic fever. Mumps is a viral infection that causes swelling of the salivary glands. It is not caused by GAS bacteria, which are the main trigger of acute rheumatic fever.

Choice D reason: Influenza is not the most significant illness that may be associated with acute rheumatic fever. Influenza is a viral infection that causes fever, cough, sore throat, and muscle aches. It is not caused by GAS bacteria, which are the main trigger of acute rheumatic fever.

A. Take the child to a hair salon for a shampoo and a shorter haircut. B. Rewash the child's hair following a 24-hour isolation period. C. Wash the child's bed linens and clothing in hot soapy water. D. Dispose of the child's brushes, combs, and other hair accessories.

Correct Answer is C

Explanation

Choice A reason: Taking the child to a hair salon for a shampoo and a shorter haircut is not a good instruction that the nurse should provide. This is because a hair salon may not accept a child with head lice, as they can spread to other customers and staff. A shorter haircut may also not help to get rid of the lice or their eggs, which can attach to any length of hair.

Choice B reason: Rewashing the child's hair following a 24-hour isolation period is not a good instruction that the nurse should provide. This is because a 24-hour isolation period is not necessary or effective for treating head lice. Head lice do not survive long without a human host, and they do not spread through the air or by jumping. Rewashing the child's hair may also wash off the permethrin shampoo, which needs to stay on the hair for 10 minutes to kill the lice and their eggs.

Choice C reason: Washing the child's bed linens and clothing in hot soapy water is a good instruction that the nurse should provide. This is because head lice and their eggs can be transferred to the child's bedding and clothing through direct contact. Washing these items in hot water (at least 130°F or 54°C) and drying them on high heat can kill any remaining lice or eggs. Alternatively, the items can be sealed in plastic bags for two weeks to suffocate the lice.

Choice D reason: Disposing of the child's brushes, combs, and other hair accessories is not a good instruction that the nurse should provide. This is because it is not necessary to throw away these items, as they can be treated and reused. The nurse should advise the parents to soak the items in hot water (at least 130

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Naxlex Comprehensive Predictor Exams

A school-aged child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's parent, the recent occurrence of which illness is most significant?

Correct Answer is B

Explanation

A preschool-age boy in a daycare facility scratches his head frequently, and the nurse confirms the presence of head lice. The nurse washes the child's hair with permethrin shampoo and calls his parents. Which instruction should the nurse provide to the parents about treatment for head lice?

Correct Answer is C

Explanation

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