The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?
Coughing spells may be triggered by dust or smoke."
We need to maintain droplet precautions and a quiet environment for at least 2 weeks.
"We need to encourage our child to drink fluids.
Vomiting may occur when our child has coughing episodes."
The Correct Answer is B
A. Coughing spells may be triggered by dust or smoke:
Incorrect: This is a correct statement. Irritants like dust or smoke can trigger coughing spells in a child recovering from pertussis.
B. We need to maintain droplet precautions and a quiet environment for at least 2 weeks.
Correct Answer: Pertussis is highly contagious during the catarrhal and paroxysmal stages, but once the child has reached the convalescent stage (usually after 2-4 weeks of illness), the risk of spreading the infection decreases significantly. Continuing strict droplet precautions and a quiet environment for two weeks after the convalescent stage is not necessary.
C. "We need to encourage our child to drink fluids":
Incorrect: This is a correct statement. Encouraging fluid intake is important to prevent dehydration, especially during coughing spells.
D. Vomiting may occur when our child has coughing episodes:
Incorrect: This is a correct statement. Vomiting can be a common occurrence during coughing episodes in pertussis due to the forceful nature of the cough. Parents should be aware of this symptom.

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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "The immunization schedule will need to be altered."
Incorrect: This is too vague and does not provide specific information about the child's immunization schedule.
B. "The child will receive all of the immunizations except for the polio series."
Incorrect: There is no indication that the child should not receive the polio vaccine. Children with cystic fibrosis are generally recommended to receive all appropriate vaccinations.
C. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
Correct Answer: Children with cystic fibrosis should receive the recommended basic series of immunizations, including vaccines for diseases such as diphtheria, pertussis, tetanus, measles, mumps, rubella, polio, Haemophilus influenzae type b (Hib), hepatitis B, and others. Additionally, they should receive a yearly influenza vaccination to help prevent respiratory complications.
D. "The child should not receive any hepatitis vaccines."
Incorrect: There is no general contraindication for children with cystic fibrosis to receive hepatitis vaccines. The nurse should recommend the appropriate vaccines, including those for hepatitis B, as per the standard immunization schedule.

Correct Answer is C
Explanation
A. That lethargy and vomiting are normal with mumps:
Incorrect: Lethargy and vomiting are not typical symptoms of mumps. These symptoms could indicate a separate issue that requires medical attention.
B. To continue to monitor the child:
Incorrect: Given the reported symptoms of lethargy and vomiting, a passive approach of continuing to monitor may delay necessary medical intervention. The child should be assessed promptly.
C. To bring the child to the clinic to be seen by the pediatrician:
Correct Answer: Lethargy and vomiting are not typical symptoms of uncomplicated mumps. These symptoms could be indicative of other issues, and it's important for the pediatrician to evaluate the child to determine the cause and provide appropriate care.
D. That there is nothing to be concerned about as long as there is no fever:
Incorrect: While fever is a common symptom of mumps, the absence of fever does not negate the need for further evaluation when there are concerning symptoms like lethargy and vomiting. The child should be seen by a healthcare provider to determine the cause of these symptoms.
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