A 10-month-old patient presents to the nurse practitioner for treatment of mild bronchiolitis. Initial treatment should include:
an inhaled bronchodilator.
an over-the-counter antihistamine.
a cough suppressant.
supportive care.
The Correct Answer is D
Rationale:
A. Inhaled bronchodilators have limited efficacy in mild bronchiolitis and are not routinely recommended for initial treatment.
B. Over-the-counter antihistamines are not effective for bronchiolitis in infants.
C. Cough suppressants are not recommended in infants due to potential side effects and lack of proven benefit.
D. Supportive care is the mainstay of treatment for mild bronchiolitis, including ensuring adequate hydration, monitoring oxygenation, and providing comfort measures. Most cases are self-limited and resolve without pharmacologic intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Routine follow-up is inappropriate because an absent red reflex can indicate serious ocular pathology, such as congenital cataract, retinoblastoma, or other intraocular abnormalities. Waiting until the next routine exam could delay critical diagnosis and treatment.
B. Referral to a pediatric ophthalmologist is the correct action. Early evaluation is essential to preserve vision and rule out life-threatening conditions. Pediatric ophthalmologists can perform a thorough dilated eye exam and additional imaging if needed.
C. Delaying immunizations and ordering a CT scan is not the standard initial step; imaging may be indicated later depending on ophthalmologic findings, but urgent ophthalmology referral takes priority.
D. Referral to a pediatric neurologist is not indicated at this stage, as the absent red reflex points primarily to an ocular rather than neurologic issue.
Correct Answer is C
Explanation
Rationale:
A. 8–14 weeks is typically when first-trimester screening (nuchal translucency and serum markers like PAPP-A and free β-hCG) is performed, not AFP.
B. 10–15 weeks is not the standard window for serum AFP testing.
C. 16–18 weeks’ gestation is the recommended time for maternal serum alpha-fetoprotein (AFP) testing, which is part of the quad screen to assess risk for neural tube defects and certain chromosomal abnormalities.
D. 20–24 weeks is beyond the optimal window for AFP screening; levels may no longer provide accurate risk assessment for neural tube defects.
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