A caregiver calls the pediatrician’s office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6°F (39.2°C). The caregiver has tried to get the child to nap but the child gets panicky, sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which condition?

Epiglottitis

Mild asthma

Spasmodic laryngitis

Acute laryngotracheobronchitis

Answer and Explanation

The Correct Answer is A

A. Epiglottitis:

Epiglottitis is an inflammation of the epiglottis, which can result in rapid onset of symptoms such as severe sore throat, high fever, and difficulty breathing. The characteristic position described, with the child preferring to sit up, lean forward, and keep the mouth open, is known as the "tripod position." This is a protective mechanism to maintain a patent airway.

B. Mild asthma:

Asthma is a chronic respiratory condition characterized by recurrent episodes of wheezing, coughing, and shortness of breath. However, the scenario does not describe typical asthma symptoms, and the child's preference for sitting up and leaning forward is more indicative of an airway obstruction.

C. Spasmodic laryngitis:

Spasmodic laryngitis is characterized by sudden episodes of severe respiratory distress, a barking cough, and sometimes stridor. It often occurs at night and is usually not associated with high fever. The child's behavior in the scenario, particularly the preference for sitting up and leaning forward, is not a common feature of spasmodic laryngitis.

D. Acute laryngotracheobronchitis:

Acute laryngotracheobronchitis, or croup, typically presents with a barking cough, stridor, and respiratory distress. It does not usually cause the preference for sitting up and leaning forward as described in the scenario. Croup is more commonly associated with a distinctive cough sound.

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Free Nursing Study Resources

Correct Answer is ["B","C","D"]

Explanation

A. Apply warm, moist compresses to the neck area:

Warm, moist compresses are not typically used in the postoperative care of a tonsillectomy. Cold compresses or ice packs may be recommended to reduce swelling.

B. Observe for excessive swallowing:

Excessive swallowing may indicate bleeding, and close monitoring for any signs of bleeding is important.

C. Provide liquid acetaminophen with codeine as ordered:

Pain management is crucial postoperatively, and providing pain medication as ordered helps ensure the child's comfort.

D. Place the child in a partially prone position with the head turned to one side in the immediate post-operative period:

This position helps facilitate drainage and reduce the risk of aspiration. However, the specific positioning may vary based on the surgeon's preference.

E. Offer orange juice, lemonade, or milk to drink once awake and alert:

Citrus juices and milk are usually avoided in the immediate postoperative period to prevent irritation to the surgical site. Clear fluids or those recommended by the healthcare provider are typically introduced gradually.

A. Exposure to contaminated body fluid B. Mother-to-child transmission C. Blood transfusions D. Sharing of infected needles

Correct Answer is B

Explanation

A. Exposure to contaminated body fluid:

HIV can be transmitted through exposure to contaminated body fluids such as blood, semen, vaginal fluids, and breast milk. However, in the context of infants, mother-to-child transmission is the primary mode of concern.

B. Mother-to-child transmission:

Mother-to-child transmission, also known as perinatal or vertical transmission, is the major means of HIV transmission in infants. It can occur during pregnancy, childbirth, or breastfeeding when the virus is passed from an HIV-positive mother to her child.

C. Blood transfusions:

While HIV transmission through blood transfusions was a concern in the past, current blood screening and testing procedures have significantly reduced this risk. It is not a major means of transmission in the infant population.

D. Sharing of infected needles:

The sharing of infected needles is a risk factor for HIV transmission among individuals who use injection drugs. However, this mode of transmission is not relevant to infants, as they are not typically exposed to such risk factors.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Nursing care of the child who is postoperative from a tonsillectomy should include: (Select All That Apply)?

Correct Answer is ["B","C","D"]

Explanation

A nurse is preparing a presentation for a group of nurses about human immunodeficiency virus infection. Which of the following would the nurse include as the major means of transmission responsible for almost all new HIV infections in the infant population?

Correct Answer is B

Explanation

The nurse is performing a physical assessment on a 6-month-old baby. Which finding should the nurse understand as abnormal for this child?

An infant weighing 6 pounds 3 ounces has morphine 0.5 mg IV q 2 hours prn ordered for post op pain. The recommended dosage for a child is 0.1-0.2 mg/kg/dose q2-4 hours prn. Prove mathematically the ordered dose by the physician (mg/kg/dose) and is it safe to give.

The physician has ordered 350 mg of ampicillin IM. The ampicillin is available as 1 g/5 mL. How many mLs does the nurse need to draw up for an IM injection?

A breast-feeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother’s concerns?

Which common childhood communicable disease may cause severe defects in the fetus when it occurs in its congenital form?

A child comes to the clinic for evaluation of skin lesions and is diagnosed with impetigo. Which of the following medications would the nurse anticipate the physician might prescribe?

The pediatric nurse is meeting with a group of preschoolers family members to discuss various health topics. The nurse determines the sexual development session is successful after overhearing which comment by one of the participants?

Order: Ceftriaxone 300 mg IV Q12H for a 6 month old infant with a serious infection who weighs 18 lbs. The recommended dosage is 50-75 mg/kg/day in divided doses BID. Prove mathematically (mg/kg/day) the ordered dose and is it safe to give Safe/Unsafe)?