A 3-year-old admitted to the hospital with croup has the following vital signs: heart rate 90, respiratory rate 48, blood pressure 100/52, and temperature 98.8°F (37.1°C). The parents ask the nurse if these vital signs are normal. The nurse's best response is:
"Your son's respiratory rate is elevated, but the other vital signs are within the normal range."
"Your son's heart rate is elevated, but the other vital signs are within the normal range."
"Your son's blood pressure is elevated, but the other vital signs are within the normal range."
"Your son's temperature is elevated, but the other vital signs are within the normal range."
The Correct Answer is A
Choice A reason: This is the correct choice. A respiratory rate of 48 is high for a 3-year-old, indicating that the croup is affecting his breathing.
Choice B reason: This choice is incorrect. A heart rate of 90 is within the normal range for a 3-year-old.
Choice C reason: This choice is incorrect. A blood pressure of 100/52 is within the normal range for a 3-year-old.
Choice D reason: This choice is incorrect. A temperature of 98.8°F (37.1°C) is within the normal range for a 3-year-old.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Meningitis is not typically associated with ADD/ADHD, making it a correct choice as an exception among the risk factors listed.
Choice B reason: A family history of ADD/ADHD is a known risk factor for these conditions.
Choice C reason: Exposure to environmental toxins is a recognized risk factor for developing ADD/ADHD.
Choice D reason: While gestational diabetes can have various effects on a child's health, it is not a recognized risk factor for ADD/ADHD, making this the correct answer.
Correct Answer is B
Explanation
Choice A reason: Acute diarrhea and dehydration are not typical of Hirschsprung disease, which is characterized by bowel obstruction.
Choice B reason: This is the correct choice. Failure to pass meconium within the first 48 hours of life and abdominal distension are classic signs of Hirschsprung disease.
Choice C reason: Projectile vomiting and altered electrolytes could be signs of other conditions but are not specific to Hirschsprung disease.
Choice D reason: Currant jelly-like gelatinous stools and pain are more indicative of intussusception rather than Hirschsprung disease. Hirschsprung disease typically presents with a failure to pass stool and abdominal distension.
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