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“We will do a simple blood test to determine whether your child has RSV” RSV is not diagnosed by blood testing. Blood work may show general infection markers, but it is not specific for RSV.

“There is no specific test for RSV. The diagnosis is made based on the child’s symptoms” There are reliable diagnostic tests such as antigen detection and PCR from nasal swabs.

“We will have to send a viral culture to an outside lab for testing” Viral cultures for RSV are possible but rarely used because they are time-consuming and not practical for rapid clinical decision-making.

Keeping the infected child away from siblings is correct and helps prevent transmission.

Handwashing is the most effective way to prevent RSV spread among household members.

Avoiding contact with sick individuals reduces the chance of introducing the virus into the home.

A 16-month-old with a tracheostomy: This child is vulnerable, but age >12 months reduces RSV severity risk. While tracheostomy care poses challenges, hospitalization risk is not as high as in very young premature infants.

A 3-year-old with a congenital heart defect: congenital heart disease increases risk, but at age 3, RSV is usually milder compared to the first year of life.

A 4-year-old who was born at 30 weeks: Past prematurity matters less after infancy. At age 4, lung and immune development are more mature, lowering the risk compared to a young premature infant.

Intravenous antibiotics are not indicated for RSV management since the disease is viral, not bacterial. Antibiotics are only indicated in case of a secondary bacterial infection.

Intravenous steroids are not recommended for routine RSV treatment since they have limited effectiveness in bronchiolitis.

Alternating acetaminophen and ibuprofen are used to treat fever and discomfort but do not address airway swelling, stridor, or respiratory distress.

“Pneumonia is most frequently caused by bacterial agents.” This is incorrect since in children, viral causes are more common, especially RSV, influenza, parainfluenza, and adenovirus.

“Children with viral pneumonia are usually sicker than children with bacterial pneumonia.” Viral pneumonia tends to be less severe with symptoms being milder and self-limiting unlike bacterial pneumonia which requires treatment with antibiotics.

“Children with viral pneumonia must be treated with a complete course of antibiotics.” Antibiotics are not effective against viruses and are not indicated for viral pneumonia. Management of viral pneumonia is supportive with oxygen, antipyretics, and adequate hydration.

Setting up and facilitating the use of a mist tents are largely outdated and not considered effective. Supportive care with humidified oxygen and suctioning is preferred.

Bronchiolitis is caused by a virus (RSV), so antibiotics are not appropriate unless there is a confirmed secondary bacterial infection.

Providing a cough suppressant as necessary is contraindicated in infants and toddlers. Coughing is a protective mechanism that helps clear secretions. Suppressing it may worsen obstruction.

Education on signs and symptoms of aspiration pneumonia is helpful but reactive. By the time symptoms appear, pneumonia has already developed hence education on the prevention strategies is most beneficial.

Education on the treatment plan for aspiration pneumonia is important for current management, but it does not reduce the risk of recurrence.

Education on the risks associated with recurrent aspiration pneumonia is educational but not as useful as teaching practical prevention strategies that address the root cause.

Klebsiella infection is a bacterial pathogen, not the usual cause of bronchiolitis. It is more associated with severe bacterial pneumonia.

Mycoplasma pneumoniae is an atypical bacterial that causes pneumonia in older children and adolescents, not bronchiolitis in infants.

Haemophilus influenzae is a bacterial pathogen associated with epiglottitis and pneumonia, not bronchiolitis.

Providing a positive-pressure airflow room is incorrect. TB requires a negative-pressure room, which prevents contaminated air from escaping into hallways. Positive pressure would spread the infection.

Wearing gown and gloves when handling the client’s stool or urine is incorrect since TB is not spread via stool or urine. Standard precautions apply, but the key infection control focus is airborne transmission.

Initiating antibiotic therapy is important, but precautions must begin immediately upon admission, not delayed until after medication is started. The client should remain in airborne isolation until considered noninfectious, usually after several weeks of effective therapy and negative sputum smears.

Asking for pain medicine before he coughs may help overall discomfort but are not practical for each coughing episode. Pain medication should not be timed specifically before coughing.

Taking a sip of water before coughing may help soothe the throat but do not relieve chest pain associated with pneumonia-related coughing.

Trying very hard not to cough is unsafe. Coughing is essential to clear secretions and prevent worsening infection or atelectasis. Suppressing cough could cause complications.

Placing the child on the right side places the diseased lung down, impairing oxygenation because blood flow is directed to poorly ventilated lung tissue.

Supine position can compromise lung expansion, increase risk of pooling secretions, and make breathing more difficult in pneumonia.

While prone positioning may help in severe ARDS, it is not the best choice for unilateral pneumonia in a 3-year-old child. It may also be uncomfortable and unsafe.

Airway obstruction from aspiration of a solid object describes foreign body aspiration, not bronchiolitis.

Inflammation of the pulmonary parenchyma refers to pneumonia, not bronchiolitis.

Acute highly contagious croup-like syndrome refers to croup (laryngotracheobronchitis), which involves the upper airway, not the bronchioles.

Infants with bronchiolitis usually present with tachycardia due to fever, hypoxia, or distress. Bradycardia is a late, pre-arrest sign of severe hypoxia.

Infants typically have a decreased appetite/poor feeding due to respiratory distress and fatigue.

Bronchiolitis usually begins with nasal congestion, rhinorrhea, and cough, which are signs of an upper respiratory infection before progressing to lower airway involvement.