A 2-year-old boy is brought to the emergency department with a barking cough, hoarseness, and inspiratory stridor.
His parents report that he has been sick for 2 days and that his symptoms have been getting worse.
The boy's vital signs are as follows: temperature 102°F (38.9°C), heart rate 120 beats/minute, respiratory rate 28 breaths/minute, and oxygen saturation 95% on room air.
Physical examination reveals a well-developed, well-nourished boy in moderate respiratory distress.
He is using accessory muscles of respiration and has intercostal retractions.
His lungs are clear to auscultation.
Which of the following statements by the nurse is most appropriate?

"Your son has croup.

"Your son has epiglottitis.

"Your son has asthma.

"Your son has pneumonia.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A, “Your son has croup.”

Choice A rationale:

The symptoms described, including a barking cough, hoarseness, and inspiratory stridor, are classic signs of croup. Croup is a common respiratory condition in young children that leads to swelling of the larynx and trachea, causing the characteristic cough and stridor.

Choice B rationale:

While epiglottitis can present with respiratory distress, it is more commonly associated with high fever, severe sore throat, drooling, and difficulty swallowing, rather than a barking cough and stridor.

Choice C rationale:

Asthma typically presents with wheezing and difficulty exhaling, not the barking cough and inspiratory stridor seen in croup. Additionally, asthma is often associated with a history of allergies or atopic conditions, which are not mentioned in the scenario.

Choice D rationale:

Pneumonia usually presents with fever, cough producing phlegm, and crackles or wheezes on lung auscultation. The clear lungs on auscultation and the absence of productive cough make pneumonia less likely in this case.

In summary, the presentation of a barking cough, hoarseness, and inspiratory stridor in a young child who is in moderate respiratory distress with a recent onset of symptoms is most indicative of croup. This is supported by the age of the child and the clinical findings, which align with the typical presentation of croup.

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Correct Answer is ["A","D"]

Explanation

Choice A rationale:

There is no vaccine to prevent croup, but practicing good hand hygiene and avoiding contact with sick people can help reduce the child's risk of getting croup.

Croup is mainly caused by viral infections, so minimizing exposure to viruses is essential in prevention.

Choice B rationale:

Giving a daily dose of vitamin C is not a proven method for preventing croup.

While vitamin C is essential for overall health, it does not specifically prevent croup.

Providing accurate and evidence-based information is crucial in parental education.

Choice C rationale:

Keeping the child's bedroom cool and humid may provide comfort during the illness, but it is not a proven method for preventing croup.

This statement does not contribute significantly to preventive measures against croup.

Choice D rationale:

Using a humidifier in the home can help maintain adequate humidity levels, which may reduce the risk of croup, especially during dry seasons.

Proper humidity can prevent irritation of the upper respiratory tract and decrease the likelihood of developing croup.

Including this information in the teaching is appropriate and beneficial for the parent to know.

A. Continue to monitor the child's respiratory status. B. Administer oxygen therapy as needed. C. Prepare to administer nebulized epinephrine. D. Notify the physician immediately.

Correct Answer is C

Explanation

Choice A rationale:

Continuing to monitor the child's respiratory status may not be the best action in this situation, as the child's respiratory status is worsening and they are becoming increasingly agitated.

Immediate intervention is required to alleviate the child's distress.

Choice B rationale:

Administering oxygen therapy as needed is a supportive measure in respiratory distress situations, but in the case of severe croup with worsening respiratory status and agitation, nebulized epinephrine is the treatment of choice to reduce airway inflammation and improve breathing.

Choice C rationale:

Nebulized epinephrine is the primary treatment for severe croup as it helps reduce upper airway edema, relieve stridor, and improve respiratory distress.

It acts by causing vasoconstriction, which reduces swelling in the upper airway, making breathing easier for the child.

Therefore, preparing to administer nebulized epinephrine is the most appropriate action in this situation.

Choice D rationale:

Notifying the physician immediately is essential, but immediate intervention to improve the child's respiratory distress is also necessary.

Nebulized epinephrine should be administered promptly to alleviate the child's symptoms and prevent further deterioration.

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Naxlex Comprehensive Predictor Exams

A nurse is educating a parent about the prevention of croup.Which of the following statements should the nurse include in the teaching?

Correct Answer is ["A","D"]

Explanation

A nurse is caring for a child with croup.The child's respiratory status is worsening, and they are becoming increasingly agitated.What action should the nurse take?

Correct Answer is C

Explanation

Select all that apply.Which of the following are nursing interventions for a child with croup?

A nurse is educating parents of a child with croup about the signs and symptoms.Which clinical manifestations should the nurse include in the teaching? Select all that apply.

A nurse is teaching a parent about the signs and symptoms of croup. Which of the following statements should the nurse include in the teaching? Select all that apply.

A nurse is performing a nursing assessment of a child with croup.What should the nurse assess to determine the severity of respiratory distress?

A nurse is caring for a child with croup in the hospital.The child is receiving humidified air and nebulized racemic epinephrine.The nurse monitors the child's respiratory status closely.Which of the following findings would indicate to the nurse that the child's condition is worsening?