A 2-year-old toddler is seen for croup (acute laryngotracheobronchitis). What observation would lead the nurse to suspect airway occlusion?

The nasal discharge is increasing.

The cough is becoming harsher.

The respiratory rate is gradually increasing.

The toddler states being tired and wanting to sleep.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Increasing nasal discharge is a common symptom of upper respiratory tract infections and does not specifically indicate a progression to airway occlusion in croup. While it contributes to overall respiratory distress, it is not the most critical sign of a life-threatening compromise of the airway in this condition.

Choice B rationale

A harsher cough, often described as a "barking" cough, is a characteristic symptom of croup caused by inflammation of the larynx, trachea, and bronchi. While concerning, it is not the most reliable indicator of impending airway occlusion. The cough may be present throughout the illness without a complete occlusion.

Choice C rationale

An increasing respiratory rate is an early compensatory mechanism in response to airway obstruction and hypoxia. While it indicates respiratory distress, it is not the most significant sign of impending airway occlusion. It can occur with many respiratory issues and is often a precursor to more severe signs.

Choice D rationale

A toddler stating they are tired and wanting to sleep is a serious and late sign of hypoxia. This indicates that the child is becoming fatigued from the increased work of breathing, leading to decreased respiratory effort. This mental status change signals that the body's compensatory mechanisms are failing, and respiratory failure and airway occlusion are imminent.

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Correct Answer is B

Explanation

Choice A rationale

The average number of deciduous teeth at 2.5 years of age is 20. The first set of teeth, also known as primary or milk teeth, typically begins to erupt around 6 months of age and all 20 are generally present by the time a child is 3 years old. Twelve deciduous teeth would be an expected number for a younger toddler, around 1 to 1.5 years old.

Choice B rationale

A 2.5-year-old child should have a full set of 20 deciduous teeth. These teeth typically erupt in a predictable sequence, starting with the central incisors and ending with the second molars, which usually appear between 2 and 3 years of age. By 30 months, all 20 primary teeth are typically present and functional for chewing and speech development.

Choice C rationale

This combination is incorrect for a 2.5-year-old. The first permanent teeth, the molars, do not typically begin to erupt until around age 6. A 2.5-year-old would only have deciduous teeth, and the number would be 20. The permanent teeth are not yet present at this age, as the jaw is still growing.

Choice D rationale

This combination is incorrect. A 2.5-year-old has a full set of 20 deciduous teeth. The presence of permanent teeth at this age is not typical. The first permanent teeth erupt between ages 6 and 7. The number of deciduous teeth would also be an incorrect count, as 16 deciduous teeth would be present in a younger toddler.

A. Insomnia. B. Intermittent crying in the first week postpartum, now resolved. C. Delusions. D. Induced vomiting.

Correct Answer is D

Explanation

Choice A rationale

Insomnia is a common symptom of postpartum depression, often characterized by difficulty falling or staying asleep, or waking up early. This sleep disturbance, when coupled with other symptoms such as persistent sadness, loss of interest in activities, and fatigue, is a key diagnostic criterion for the condition.

Choice B rationale

Intermittent crying in the first week postpartum, now resolved, is a common symptom of the "baby blues.”. The baby blues are a transient condition, typically resolving within the first two weeks. Postpartum depression, in contrast, involves more severe and persistent symptoms lasting longer than two weeks.

Choice C rationale

Delusions are a symptom of postpartum psychosis, a rare and severe mental health condition that is distinct from postpartum depression. Postpartum psychosis involves a break from reality and is a psychiatric emergency. Delusions are not characteristic of postpartum depression.

Choice D rationale

Induced vomiting is a symptom associated with eating disorders, such as bulimia nervosa. While eating disorders can coexist with postpartum depression, induced vomiting is not a defining symptom of postpartum depression itself. It is a separate clinical finding.

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A 2-year-old toddler is seen for croup (acute laryngotracheobronchitis). What observation would lead the nurse to suspect airway occlusion?

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Correct Answer is B

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Correct Answer is D

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