A 3-year-old child was brought into the emergency room this morning with a sudden onset of "fast and noisy breathing". According to his parents, he had sneezing and a runny nose last week but seemed to have recovered. The child lives with 2 older, school-age siblings, his parents, and 3 dogs. He was born at 37 weeks' gestation. The parents deny smoking, but his grandmother cares for him in the afternoons and smokes outside when she is at the house.

He has no significant medical history. He has received all vaccines except for those due at 3 years. Upon exam, the child is found to have inspiratory stridor and retractions. Will admit to the pediatric floor for treatment

The nurse collects items to replace the peripheral Intravenous line.

Which 2 items must the nurse make sure is available before attempting to place the intravenous line?

Elbow restraints

The child's favorite toy

Manual resuscitation bag

A dose of subcutaneous epinephrine

An advanced airway kit

Nebulised albuterol

Answer and Explanation

Correct Answer : C,E

C. Manual resuscitation bag: In the case of a child with inspiratory stridor and retractions, there is a concern about airway obstruction. Having a manual resuscitation bag available is crucial to ensure that the child's airway can be effectively managed in case of respiratory distress.

E. An advanced airway kit: If the child's condition worsens and he experiences severe respiratory distress or failure, an advanced airway may be necessary to secure the airway and provide proper oxygenation. Having an advanced airway kit available is important in case intubation becomes necessary.

Incorrect answers:

A. Elbow restraints: Elbow restraints are not typically used during peripheral intravenous line placement. They are used to prevent children from bending their arms excessively after specific surgeries or procedures.

B. The child's favorite toy: While having a favorite toy might help distract the child and reduce anxiety, it is not a critical item needed for the placement of a peripheral intravenous line.

D. A dose of subcutaneous epinephrine: Subcutaneous epinephrine is not used for the placement of an intravenous line. It is typically used to treat severe allergic reactions (anaphylaxis).

F. Nebulized albuterol: Nebulized albuterol is a medication used to treat bronchospasm in conditions such as asthma. While the child is experiencing respiratory distress, the priority is to secure the airway and provide oxygenation, which may involve using a manual resuscitation bag and an advanced airway kit.

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Correct Answer is C

Explanation

A.While non-pharmacologic strategies are important for pain management, they are typically introduced after initial assessment and understanding of the client's pain experience. In this case, the priority is to clarify the apparent discrepancy between the reported pain level and observed behavior.

B.Respecting the client's privacy and providing time for personal activities like phone calls is important but does not directly address the concern of incongruent pain assessment and behavior.

C.Incongruence between reported pain intensity (10/10) and observed behavior (laughing on the phone) suggests a potential discrepancy that needs to be documented and further investigated. This documentation is crucial for accurate assessment and communication among the healthcare team.

D.Administering pain medication immediately without further assessment may not be appropriate if there is uncertainty about the accuracy of the pain report. It's important to first clarify and validate the client's pain experience before proceeding with medication administration.

A. Increased number of red blood cells. B. Increased respiratory effort. C. Decreased cardiac murmur. D. Decreased urinary output

Correct Answer is C

No explanation

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adolescent hospitalized with sickle cell anaemia reports to the nurse of experiencing a pain level of 10 on a 0 to 10 numerical scale. The nurse observes the adolescent on a phone call laughing. Which action should the nurse take?

Correct Answer is C

Explanation

When administering indomethacin to a premature infant who has patent ductus arteriosus, the nurse should anticipate which outcome?

Correct Answer is C

A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents?

A mother brings her male pre-schooler to the clinic because he has had diarrhea, vomiting, and high fevers for the past three days. The child begins to cry and cling to his mother when the nurse enters the examination room. Which action should the nurse implement to get the child to cooperate?

What are some possible changes that might explain the trend in glycosylated haemoglobin in this client? Select all that apply.

A clinic nurse is assessing infants and toddlers for fine and gross motor development. Which child should the nurse refer to a healthcare provider for further evaluation?

The nurse is providing education to a group of adolescents about smoking prevention. Which approach should the nurse include to incorporate Piaget's cognitive development theory of formal operations?