A nurse in the provider's office is assisting with the care of a child.

Exhibits

Upon review of the child's electronic medical record (EMR), the nurse should determine the child is at risk for developing which of the following conditions? Drag 1 condition and 1 client finding to fill in each blank in the following sentence.
The client is at risk for developing
dropdown
due to
dropdown
.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Increased seizure activity

Finding: Phenytoin level

The child's phenytoin level is 6 mcg/mL, which is below the therapeutic range of 10-20 mcg/mL. Subtherapeutic levels of phenytoin mean the medication is not providing adequate seizure control, increasing the risk of more seizures. The recent seizure history and the low drug level indicate a direct correlation between insufficient phenytoin levels and increased seizure activity.

Pneumonia

Finding: Cough

A harsh, non-productive cough that worsens with activity and at night can be indicative of respiratory conditions, including asthma exacerbations. However, in the context of this child's history and symptoms, there is no evidence of a productive cough, fever, or other signs of infection that would typically suggest pneumonia. Hence, pneumonia is not the primary concern.

Liver failure

Finding: Skin rash

Liver failure is usually associated with jaundice, elevated liver enzymes, and systemic symptoms like fatigue or confusion. The child’s liver function tests are within normal ranges, and there are no signs of jaundice or systemic illness. The skin rash is more likely related to eczema or a possible drug reaction rather than indicating liver failure.

Steven-Johnson syndrome

Finding: Liver enzymes

Steven-Johnson syndrome (SJS) is a severe skin reaction typically triggered by medications, including anticonvulsants. Elevated liver enzymes can be seen in SJS, but the child’s liver enzymes are within normal ranges. The rash described does not match the characteristics of SJS, which typically presents with widespread, painful, blistering rashes, not localized eczema patches. Therefore, SJS is unlikely in this scenario.

Pneumothorax

Finding: Lung sounds

A pneumothorax would usually present with decreased breath sounds, possibly on one side, along with signs of respiratory distress such as tachypnea and cyanosis. The child has slight end expiratory wheezes but normal respiratory rates and oxygen saturation, which suggests asthma rather than pneumothorax. Therefore, pneumothorax is not a primary concern here.

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Correct Answer is C

Explanation

A. Supine: Lying on the back can limit lung expansion and is not the best position for a child with respiratory issues. It can contribute to atelectasis and does not facilitate effective breathing.

B. Prone: The prone position can improve oxygenation and ventilation, particularly in severe respiratory distress, but it may not be the most comfortable or practical for all patients, especially in a non-ICU setting.

C. Upright: Sitting upright or in a high Fowler's position is optimal for lung expansion. It facilitates easier breathing and helps the lungs expand more fully, allowing for better oxygenation.

D. Side-lying: Side-lying may be comfortable but does not provide as much benefit for lung expansion as the upright position. It is less effective in promoting maximal lung expansion compared to the upright position.

A. "SIDS is directly correlated to diphtheria, tetanus, and pertussis vaccines." B. "SIDS rates have been rising over the last 10 years." C. "You should place your baby on her back when sleeping to decrease the risk of SIDS." D. "Sleep apnea is the main cause of SIDS."

Correct Answer is C

Explanation

A. "SIDS is directly correlated to diphtheria, tetanus, and pertussis vaccines." This statement is incorrect and misleading. There is no direct correlation between SIDS and vaccinations like the diphtheria, tetanus, and pertussis (DTP) vaccines. In fact, immunizations are an important part of a child's health and can help prevent diseases that could lead to complications, including those that might be indirectly related to SIDS risk factors.

B. "SIDS rates have been rising over the last 10 years." This statement is false. SIDS rates have generally been decreasing, especially since the introduction of public health campaigns promoting safe sleep practices, such as placing infants on their backs to sleep.

C. "You should place your baby on her back when sleeping to decrease the risk of SIDS." This is the correct and evidence-based recommendation. Placing a baby on their back to sleep significantly reduces the risk of SIDS. This practice is part of the "Back to Sleep" campaign, which has been shown to lower the incidence of SIDS.

D. "Sleep apnea is the main cause of SIDS." This statement is incorrect. While sleep apnea has been studied as a potential risk factor, it is not considered the main cause of SIDS. The exact cause of SIDS is still unknown, but it is believed to be related to multiple factors, including sleep environment and infant physiology.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a school-age child who has respiratory failure due to pneumonia. Which of the following positions should the nurse encourage to allow maximal lung expansion?

Correct Answer is C

Explanation

A nurse is caring for a 2-week old Infant whose mother requests additional information about sudden infant death syndrome (SIDS). Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A nurse is assisting with the admission of a child who has pertussis. Which of the following actions should the nurse take?

A nurse is calculating the output of an infant admitted who has dehydration. When weighing the diaper, the nurse should equate 1 g of wet diaper weight to which of the following amounts of urine?

A nurse is reinforcing teaching about preventing disease transmission with the parents of a child who has a streptococcal infection. Which of the following instructions should the nurse include?

A nurse is caring for a preschooler who has epiglottitis from a streptococcal infection. Which of the following actions should the nurse take?

A nurse is caring for an adolescent. The nurse should expect that the adolescent is working on which of the following developmental tasks?

A nurse working at a clinic speaks on the telephone with a parent of a 2-month-old infant. The parent tells the nurse that the infant has projectile vomiting followed by hunger after meals. Which of the following responses by the nurse is appropriate?

A nurse is planning care for a child who has epiglottitis. Which of the following actions should the nurse plan to take?

A nurse is caring for a child who has Hirschsprung disease. Which of the following findings should the nurse expect?