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A 2-year-old child has had a common cold for 4 days. The caregiver calls the nurse in the emergency department at 2 a.m. on a cold winter night to say that the child has awakened with a barking cough and an elevated temperature; the child seems blue around the mouth. The nurse would appropriately recommend what action to the caregiver?

“Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there is no relief in an hour.”

“Bring the child to the emergency room immediately.”

“Bundle the child up and take the child out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”

“Turn on all of the hot water taps in the bathroom and close the door. Take the child into the steam-filled room for 15 minutes. If there is no relief, bring the child to the emergency room.”

Answer and Explanation

The Correct Answer is B

Choice A reason: A cool mist humidifier may help croup but is inadequate for a child with a barking cough, fever, and cyanosis (blue around the mouth), indicating severe respiratory distress. Immediate ER evaluation is critical, making this insufficient and incorrect for the urgent symptoms described in the scenario.

Choice B reason: A barking cough, fever, and cyanosis suggest severe croup or airway obstruction, requiring urgent medical evaluation. Bringing the child to the ER immediately ensures timely intervention for potential respiratory compromise, aligning with pediatric emergency protocols, making it the correct recommendation for the caregiver.

Choice C reason: Cold air exposure may temporarily relieve croup but is unsafe for a cyanotic child with fever, indicating severe distress. Immediate ER care is needed to address potential airway issues, making this risky and incorrect for managing the child’s critical symptoms in this urgent situation.

Choice D reason: Steam may help mild croup but delays care for a child with cyanosis, signaling severe respiratory compromise. Immediate ER evaluation is essential to prevent deterioration, making this inadequate and incorrect compared to the urgent need for professional assessment in the emergency department.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Choice A reason: Socializing with healthy peers may motivate but doesn’t directly teach self-care skills for chronic illness. A contract with rewards engages the child actively, making this less focused and incorrect compared to a structured strategy ensuring school-aged children achieve treatment goals effectively.

Choice B reason: Co-writing a contract with rewards engages the child in setting and achieving self-care goals, fostering responsibility and motivation. This aligns with pediatric chronic illness management, making it the most effective strategy to help school-aged children master treatment goals with caregiver involvement.

Choice C reason: Reinforcing the importance of goals educates but lacks active engagement compared to a reward-based contract. Contracts promote accountability, making this less effective and incorrect for directly helping chronically ill children achieve self-care treatment goals in a structured, motivating way.

Choice D reason: A sticker chart tracks progress but is less collaborative than a contract, which involves the child in goal-setting. Contracts better foster ownership, making this less engaging and incorrect compared to the co-written contract strategy for achieving self-care goals in school-aged children.

A. Place the infant on the back. B. Support the infant and place them on their side. C. Lay the infant on their stomach. D. Allow the parents to hold their infant.

Correct Answer is B

Explanation

Choice A reason: Placing the infant on the back post-pyloromyotomy risks aspiration during anesthesia recovery, as vomiting is common with pyloric stenosis. Side-lying positioning ensures airway protection, making this unsafe and incorrect for managing the infant’s recovery period effectively after this surgical procedure.

Choice B reason: Positioning the infant on their side with support prevents aspiration and maintains airway patency post-pyloromyotomy, addressing vomiting risks from pyloric stenosis. This aligns with postoperative pediatric nursing standards, making it the most appropriate position during anesthesia recovery for the infant.

Choice C reason: Laying the infant on the stomach is unsafe post-surgery, increasing aspiration and pressure on the surgical site. Side-lying positioning protects the airway and incision, making this incorrect for the infant’s recovery period following pyloromyotomy for pyloric stenosis in the hospital setting.

Choice D reason: Allowing parents to hold the infant may comfort but risks disrupting surgical recovery or airway management during anesthesia effects. Side-lying positioning ensures safety, making this less controlled and incorrect for the immediate postoperative period in this surgical context for the infant.

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Naxlex Comprehensive Predictor Exams

The nurse is working with a group of chronically ill school-aged children and their caregivers. Which strategy would be most effective in helping the children reach their self-care treatment goals?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

The nurse is doing discharge teaching for a child who has had a tonsillectomy. The nurse tells the client and family that the child should have plenty of fluids. In addition, the nurse would explain to the child’s caregiver that the child may:

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