A 3-year-old child is brought to the emergency room by her parents.
They report that she has been coughing and is drooling excessively.
She also seems to be in distress and is refusing to eat.
Based on these symptoms, which of the following is the most likely cause?
The child has gastroenteritis.
The child has a viral infection causing a sore throat.
The child has ingested a foreign object.
The child is experiencing an allergic reaction.
The Correct Answer is C
Choice A rationale
Gastroenteritis typically presents with vomiting, diarrhea, and abdominal pain. While a sore throat can occur with some viral gastroenteritis, excessive drooling and refusal to eat are less common primary symptoms.
Choice B rationale
A viral infection causing a sore throat can lead to refusal to eat and some difficulty swallowing, potentially causing mild drooling. However, excessive drooling and the described level of distress are less typical of a simple viral sore throat.
Choice C rationale
Excessive drooling, coughing, distress, and refusal to eat in a young child are highly suggestive of foreign body ingestion causing airway obstruction or irritation of the esophagus or trachea. The body's attempt to expel the object and the difficulty swallowing saliva lead to drooling and coughing.
Choice D rationale
An allergic reaction can cause throat swelling and difficulty breathing, but excessive drooling is not a primary symptom. Hives, itching, or other systemic symptoms would also likely be present.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Inserting a nasogastric tube for decompression of the abdomen is a standard intervention for suspected Hirschsprung's disease, which is characterized by a lack of ganglion cells in a segment of the colon, leading to impaired motility and potential bowel obstruction. Decompression helps relieve abdominal distension and pressure.
Choice B rationale
NPO status and initiating IV fluids are appropriate initial management for a child with suspected Hirschsprung's disease to rest the bowel and maintain hydration and electrolyte balance while further diagnostic tests are performed.
Choice C rationale
Monitoring abdominal girth every 4 hours is essential to assess for increasing abdominal distension, which can indicate worsening obstruction in Hirschsprung's disease. An increasing girth would warrant further investigation and intervention.
Choice D rationale
Administering a large-volume liquid enema is contraindicated in suspected Hirschsprung's disease. Due to the aganglionic segment's impaired motility, the enema fluid may not be expelled and could lead to fluid overload or bowel perforation. Diagnostic enemas using contrast are performed under controlled conditions.
Correct Answer is B
Explanation
Choice A rationale
Preschoolers (ages 3-5 years) are at risk for drowning, often due to their increasing independence and exploration without fully understanding water hazards. However, they are generally more coordinated than toddlers and may have some understanding of safety rules.
Choice B rationale
Toddlers (ages 1-3 years) are at the greatest risk for drowning due to their natural curiosity, developing mobility, and lack of awareness of danger. They can wander off and fall into pools, bathtubs, or even buckets of water. Their head-to-body ratio makes it difficult for them to lift their heads if they fall face-first into water.
Choice C rationale
Infants (under 1 year) are dependent on caregivers and are typically supervised closely around water. While they can drown in shallow water, their lack of mobility reduces their risk compared to toddlers who are actively exploring their environment.
Choice D rationale
Teenagers, while still at risk for drowning, often due to risk-taking behaviors around water or substance use, generally have a better understanding of water safety than younger children and are more physically capable in the water.
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