A 6-month-old child presented to the Emergency Department with tachypnea, marked retractions, listlessness, and poor eating and drinking. Nasal swab was positive for respiratory syncytial virus (RSV) and she was just admitted to the hospital with the diagnosis of RSV bronchiolitis. What nursing interventions would be most appropriate, assuming you have a physician's order?

Administer Synagis® immediately and encourage fluids by mouth.

Administer antiviral medication, limit fluids and give antitussives.

Encourage fluids by mouth, IV antibiotics, and oxygen mist therapy.

Provide oxygen mist therapy, administer IV fluids, and hand washing.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not the correct answer because Synagis® is a monoclonal antibody that is given as a prophylaxis to prevent severe RSV infection in high-risk infants. It is not effective as a treatment for RSV bronchiolitis.

Choice B reason: This is not the correct answer because antiviral medication is not routinely recommended for RSV bronchiolitis, as it has not been shown to improve outcomes. Limiting fluids and giving antitussives may also be harmful, as they can cause dehydration and suppress the cough reflex.

Choice C reason: This is not the correct answer because IV antibiotics are not indicated for RSV bronchiolitis, which is a viral infection. Antibiotics may increase the risk of antibiotic resistance and adverse effects.

Choice D reason: This is the correct answer because oxygen mist therapy can help humidify the air and relieve the respiratory distress. IV fluids can prevent dehydration and maintain electrolyte balance. Hand washing can prevent the spread of RSV infection to other patients and staff.

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Correct Answer is D

Explanation

Choice A reason: This situation does not require the involvement of the hospital ethics committee, as the parents are not refusing or requesting any treatment that is contrary to the standard of care. The surgeon is providing them with information and options, and the parents are free to make their own decision.

Choice B reason: This situation does not involve any ethical dilemma, as the parents are giving their permission for the surgery, and the telephone consent is legally valid. The hospital ethics committee is not needed to resolve any conflict or uncertainty.

Choice C reason: This situation is an example of ethical research involving children, as the child is giving assent and the parents are giving consent for the new protocol. The hospital ethics committee is not required to intervene, as the research protocol has already been approved by the institutional review board.

Choice D reason: This situation is an appropriate case for the hospital ethics committee, as it involves a life-and-death decision that affects the child's best interests and the parents' rights. The hospital ethics committee can help to mediate the conflict, provide guidance, and facilitate a resolution.

A. Does your Indian tribe believe in immunizing children? B. Do you attend Native American Pow Wows with the family? C. Have you consulted with your tribal healer about your child's illness? D. What herbal remedies have you given your child today?

Correct Answer is C

Explanation

Choice A reason: This is not a relevant question for the admission history, as it does not address the child's current condition or treatment plan. It may also be perceived as insensitive or judgmental by the parents.

Choice B reason: This is not a pertinent question for the admission history, as it does not relate to the child's medical history or needs. It may also be seen as intrusive or irrelevant by the parents.

Choice C reason: This is an appropriate question for the admission history, as it acknowledges the cultural beliefs and practices of the parents and the child. It also helps the nurse to identify any potential interactions or conflicts between the tribal healer's recommendations and the medical treatment.

Choice D reason: This is a valid question for the admission history, as it informs the nurse of any alternative therapies or substances that the child may have received or ingested. It also helps the nurse to assess the effectiveness and safety of the herbal remedies, and to prevent any adverse effects or interactions with the prescribed medications.

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Naxlex Comprehensive Predictor Exams

Which situation would be appropriate to refer to the hospital ethics committee?

Correct Answer is D

Explanation

A 3-year-old Native American child is admitted to the pediatric unit for emergency surgery. Which of the following questions should the nurse include when taking the admission history from the child's parents?

Correct Answer is C

Explanation

The nurse is assessing a child with epiglottitis in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate which of the following?

The nurse discovers welts on the back of a child whose parents identify as 1st generation Vietnamese. The mother states she rubbed the edge of a coin on her child's oiled back. The nurse should recognize that this is:

A second grader enters the school nurse's office crying and states, "I feel sick. My tummy hurts." The nurse replies, "I'll call your mommy or daddy to come pick you up." The child replies, "I don't have a mommy. I have two daddies." Which of the following comments by the nurse is appropriate?

Which factor is most likely to contribute to respiratory compromise in a child?

Shortly before a child's elective surgery, the parent tells the nurse, "I am having second thoughts about my child undergoing this surgery." The nurse respects the parent's concern and calls the surgeon. What ethical/moral principle is represented by this situation?

The nurse is using the FLACC scale to evaluate pain in a preverbal child. The nurse makes the following assessment: Face: occasional grimace; Leg: relaxed; Activity: squirming, tense; Cry: no cry; Consolability: content, relaxed. The nurse records the patient's pain using the FLACC assessment as:

Which assessment indicates to a nurse that a school-age child is in need of pain medication?

The father of a hospitalized child tells the nurse, "He can't have meat. We are Buddhist and vegetarians." The nurse's best intervention is to: