A nurse is assessing a 3-year-old toddler diagnosed with bronchitis. Which clinical finding should prompt the nurse to anticipate a prescription for a chest x- ray?
The toddler is coughing intermittently without respiratory distress.
The toddler has a persistent high fever and audible crackles lung auscultation.
The toddler has a normal oxygen saturation and clear lung sounds.
The toddler has mild nasal congestion and occasional wheezing.
The Correct Answer is B
A. The toddler is coughing intermittently without respiratory distress: Intermittent coughing without additional concerning signs is typical of viral bronchitis and does not usually require imaging. Supportive care is often sufficient in these cases.
B. The toddler has a persistent high fever and audible crackles on lung auscultation: Persistent high fever and crackles may indicate a bacterial infection or pneumonia rather than simple bronchitis. A chest x-ray is warranted to evaluate for lung consolidation or other complications and guide treatment.
C. The toddler has a normal oxygen saturation and clear lung sounds: Normal oxygen levels and clear lungs suggest mild illness that does not necessitate imaging. Routine bronchitis is often managed without a chest x-ray in this scenario.
D. The toddler has mild nasal congestion and occasional wheezing: These findings are common in viral respiratory infections and mild bronchitis. They are not indications for a chest x-ray unless symptoms worsen or fail to improve.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "An infant's lymph nodes may be large and tender at 2 months of age.": While lymph nodes can be slightly enlarged in infants, tenderness or significant enlargement at 2 months may indicate infection or another underlying condition and is not considered a normal finding.
B. "Infants should be able to hold their head steady without support by 3 months of age.": Most infants develop good head control by 4 months, not 3 months. Expecting full head steadiness at 3 months is premature and reflects misunderstanding of typical developmental milestones.
C. "Facial drooping during assessment is a normal finding and does not require further action.": Facial drooping is abnormal at any age and may indicate neurologic compromise, such as cranial nerve VII palsy. It warrants immediate evaluation rather than being considered normal.
D. "Inspection and palpation should be used to evaluate the skull, eyes, ears, nose, mouth, throat, and neck structures.": This statement correctly describes the comprehensive approach to pediatric head and neck assessment. Both inspection and palpation are essential for identifying abnormalities in structure, symmetry, and function.
Correct Answer is B
Explanation
A. The child has autism spectrum disorder. The child should be referred to an early intervention program: A negative M-CHAT-R/F screening does not indicate a diagnosis of autism spectrum disorder. Referral to early intervention is reserved for children who screen positive or show concerning developmental delays.
B. The child may still have autism spectrum disorder. The child should be screened again at 24 months old: The M-CHAT-R/F is a screening tool, not a diagnostic test. Children can develop or exhibit signs of autism after 18 months, so rescreening at 24 months is recommended to identify late-emerging symptoms. This approach ensures ongoing monitoring of developmental progress.
C. The child does not have autism spectrum disorder and further assessment is not warranted: A negative screen reduces concern but does not rule out autism. Symptoms may emerge later, and continued developmental surveillance is necessary. No single screening can definitively exclude the disorder.
D. The child may or may not have autism spectrum disorder. The child needs to be rescreened with the correct tool for the age of the child: The M-CHAT-R/F is age-appropriate for 16–30 months. Since the child is 18 months old, the correct tool was used, so repeating with a different tool is not necessary. Monitoring at subsequent ages is appropriate.
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