A child diagnosed with allergic rhinitis is rubbing his nose upward and backward. Which response is the child exhibiting?
The child is trying to relieve the itching and open the air passages.
The child is attempting to draw attention to his/her nose.
The child has a nasal discharge and is trying to keep his nose from running.
The child is concerned that he is going to sneeze and is trying to stop the sneeze.
The Correct Answer is A
Choice A reason: Rubbing the nose upward and backward, known as the "allergic salute," is a common response in allergic rhinitis to relieve nasal itching and congestion. This action temporarily opens air passages and alleviates discomfort, aligning with pediatric allergy evidence, making it the correct explanation for the child’s behavior observed in clinical settings.
Choice B reason: Drawing attention to the nose is not a typical response in allergic rhinitis. The "allergic salute" is a reflexive action to relieve itching and congestion, not a deliberate attempt to gain attention. This choice misinterprets the physiological basis of the behavior, making it incorrect for the child’s action in the context of allergic rhinitis symptoms.
Choice C reason: Nasal discharge may occur in allergic rhinitis, but rubbing upward and backward aims to relieve itching and open airways, not prevent discharge. This action is not primarily about controlling runny nose, making this choice less accurate compared to addressing the itching and congestion relief central to the child’s behavior.
Choice D reason: Preventing a sneeze is not the purpose of the "allergic salute." Rubbing the nose upward and backward relieves itching and congestion, common in allergic rhinitis. Sneezing is a separate reflex, and this action does not address it, making this incorrect for the child’s observed behavior in the context of allergy symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Using tweezers to gently remove a tick without crushing it minimizes infection risk and ensures complete removal, reducing Lyme disease transmission. This aligns with pediatric infectious disease guidelines for tick removal, making it the best action for the caregiver to follow for the 4-year-old.
Choice B reason: Crushing the tick risks releasing pathogens into the bite site, increasing infection risk. Gentle tweezer removal is the standard, as it avoids dispersing tick contents, making this unsafe and incorrect for the proper method of removing a swollen tick from the child’s arm.
Choice C reason: Using a hot match to remove a tick is ineffective and risks burning the child or driving pathogens deeper. Tweezers ensure safe, complete removal, making this dangerous and incorrect compared to the recommended technique for tick removal in a child in a wooded area.
Choice D reason: Taking the child to a healthcare facility is unnecessary for a routine tick removal, which caregivers can perform with tweezers. This delays action and increases inconvenience, making it incorrect compared to the effective, immediate tweezer method for tick removal in this scenario.
Correct Answer is ["C","D","E"]
Explanation
Choice A reason: Discussing care options involves clinical judgment, which is the nurse’s responsibility, not delegable to family. Providing comfort tasks like swabs or pads is appropriate, making this incorrect, as it involves professional decision-making unsuitable for family delegation in the adolescent’s care.
Choice B reason: Keeping medical equipment like a blood pressure cuff involves monitoring, a nursing task, not delegable to family. Comfort tasks like providing swabs or pillows are suitable, making this incorrect, as it requires clinical skills beyond family’s role in the terminally ill adolescent’s care.
Choice C reason: Supplying mouth swabs for lip moistening is a simple comfort task family can perform, promoting involvement and patient comfort. This aligns with pediatric palliative care delegation, making it a correct intervention to delegate to family for the terminally ill adolescent’s care.
Choice D reason: Providing disposable pads for hygiene is a non-clinical task family can manage, supporting dignity and comfort. This aligns with family involvement in palliative care, making it a correct intervention to delegate for the terminally ill adolescent’s care in the hospital setting.
Choice E reason: Supplying pillows for repositioning is a comfort-focused task family can handle, enhancing the adolescent’s well-being. This aligns with pediatric palliative care principles, making it a correct intervention to delegate to family members for the terminally ill adolescent’s hospital care.
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