A 2-year-old child admitted to a burn unit with second and third-degree burns is scheduled for another wound dressing change.
The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?

The child is suffering post-traumatic stress.

The child is fearful of being separated from his/her parents.

The child is fearful of permanent scarring.

The child is worried about the pain associated with the procedure.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event. Symptoms may include flashbacks, nightmares, and severe anxiety. However, a 2-year-old child may not have the cognitive ability to develop PTSD as it requires a certain level of cognitive and psychological development.

Choice B rationale

While separation anxiety is a normal stage of development for infants and toddlers, a 2-year- old child in a burn unit is more likely to be afraid of the pain associated with wound dressing changes rather than being separated from his/her parents.

Choice C rationale

Fear of permanent scarring could be a concern for older children and adults who are more aware of their body image. A 2-year-old child may not have the cognitive ability to understand the concept of permanent scarring.

Choice D rationale

The child is likely worried about the pain associated with the procedure. Pain experienced by patients is likely to increase during procedures such as dressing changes. This is a common and immediate fear for children undergoing medical procedures, especially those associated with pain.

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Correct Answer is A

Explanation

Choice A rationale

A 6-month-old who has a high fever, dysphagia, stridor, and a muffled cry. This child is showing signs of epiglottitis, a severe and life-threatening condition that requires immediate medical attention. Epiglottitis is characterized by inflammation and swelling of the epiglottis, the flap at the base of the tongue that keeps food from going into the windpipe. Symptoms include high fever, difficulty swallowing (dysphagia), stridor (a high-pitched wheezing sound caused by disrupted airflow), and a muffled or hoarse voice. In severe cases, it can lead to complete blockage of the airway, which is a medical emergency.

Choice B rationale

A 13-year-old who has a high fever, stridor, and purulent secretions. While these symptoms are concerning and require medical attention, they are not as immediately life-threatening as the symptoms presented in Choice A. The presence of purulent secretions suggests a bacterial infection, which while serious, can typically be treated with antibiotics.

Choice C rationale

A 2-year-old who has a barky cough, is afebrile, and has mild intercostal retractions. These symptoms suggest croup, a common childhood condition that causes a barky cough and mild breathing difficulties. While croup can be distressing, it is usually not life-threatening and can often be managed at home with supportive care.

Choice D rationale

A 5-year-old who has an abrupt onset of moderate respiratory distress, a mild fever, and a barky cough. These symptoms also suggest croup. While this child is experiencing moderate respiratory distress, which requires medical attention, it is not as immediately life-threatening as the symptoms presented in Choice A2.

A. Administer enteral bolus feeds prior to surgery. B. Administer Famotidine prior to surgery. C. Administer IV antibiotics prior to surgery. D. Administer IV fluids during surgery. E. Administer 100% oxygen via a non-rebreather mask during surgery.

Correct Answer is ["B","C","D","E"]

Explanation

Choice A rationale

Administering enteral bolus feeds prior to surgery is not typically recommended for infants with a tracheoesophageal fistula. This is because the fistula can allow food or liquid to enter the trachea and lungs, leading to aspiration and potential respiratory complications.

Choice B rationale

Administering Famotidine prior to surgery can help reduce the risk of gastric acid reflux, which can lead to aspiration during surgery. This is particularly important in infants with a tracheoesophageal fistula, as the fistula can allow stomach contents to enter the trachea.

Choice C rationale

Administering IV antibiotics prior to surgery can help prevent infection. This is a common practice in many types of surgery, including surgery to repair a tracheoesophageal fistula.

Choice D rationale

Administering IV fluids during surgery can help maintain hydration and electrolyte balance. This is particularly important in infants, who have a higher risk of dehydration.

Choice E rationale

Administering 100% oxygen via a non-rebreather mask during surgery can help ensure that the infant has adequate oxygen levels. This is particularly important during surgery, as the infant will be under general anesthesia.

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A 2-year-old child admitted to a burn unit with second and third-degree burns is scheduled for another wound dressing change.The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which child requires urgent emergency medical intervention?

Correct Answer is A

Explanation

A nurse is caring for an infant with a tracheoesophageal fistula who is scheduled for surgery.What actions should the nurse anticipate taking in the pre-operative and intra-operative period? (Select all that apply)

Correct Answer is ["B","C","D","E"]

Explanation

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A 2-year-old child admitted to a burn unit with second and third-degree burns is scheduled for another wound dressing change.
The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?