A nurse is assessing a 4-year-old child who presents with symptoms suggestive of epiglottitis. Which of the following clinical manifestations would be most consistent with this condition?
Difficulty swallowing drooling, hoarseness, and sitting in a tripod position
Rhinorrhea, congestion, mild sore throat, and hoarseness
Sudden onset of cough, wheezing, rapid breathing and difficulty swallowing
Hoarseness, stridor, and a barking cough
The Correct Answer is A
A. These are classic signs of epiglottitis, a potentially life-threatening condition caused by inflammation and swelling of the epiglottis, usually from Haemophilus influenzae type b. The child often presents suddenly, is toxic-appearing, prefers to sit upright leaning forward (tripod position) to ease breathing, has drooling due to inability to swallow, and may have muffled or hoarse voice. Stridor may develop as airway obstruction worsens. This is a medical emergency.
B. These are symptoms of upper respiratory tract infections, such as the common cold, and are not indicative of epiglottitis, which presents more acutely and severely.
C. Wheezing and cough are more typical of lower airway diseases like croup or bronchiolitis, not epiglottitis. Difficulty swallowing alone is not sufficient without drooling and tripod positioning.
D. These are classic for viral croup, which affects the larynx and trachea. Epiglottitis differs because it progresses rapidly, causes drooling, and children often refuse to lie down.
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Related Questions
Correct Answer is A
Explanation
A. Tonsils are part of the lymphatic system, which is most active in early childhood to help the body respond to infections and build immunity. It is common for tonsils to appear large in healthy children between ages 3 and 6. This is a normal physiological finding and usually does not indicate illness unless accompanied by symptoms such as fever, difficulty breathing, or recurrent infections.
B. While significantly enlarged tonsils causing airway obstruction, sleep apnea, or recurrent infections may require evaluation, tonsillar enlargement alone in an otherwise healthy child is typically normal and does not require urgent referral.
C. Enlarged tonsils in this age group indicate a normally active immune system, not underdevelopment. They help the body recognize and respond to antigens, supporting healthy immune function.
D. Chronic or acute infections may cause tonsillar enlargement, but in the absence of symptoms such as fever, redness, or exudate, there is no evidence of infection, and antibiotics are not indicated.
Correct Answer is D
Explanation
A. Differentiation refers to the progression from simple, global behaviors to more complex, specific skills, such as grasping with fingers instead of the whole hand. While differentiation occurs during development, the sequence described focuses on head-to-toe progression, not skill refinement.
B. Proximodistal development describes growth and skill acquisition from the center of the body outward (e.g., control of the trunk before the hands and fingers). The sequence in this example emphasizes head and upper body control first, not central-to-peripheral development.
C. Individual differences refer to the variations in the timing and rate at which children reach developmental milestones. While relevant, this principle does not explain the specific head-to-toe progression demonstrated.
D. Cephalocaudal development refers to growth and motor control that progresses from head to tail (top to bottom). The infant first gains control of the head and neck, then the upper body, and later the lower body and sitting posture. This head-to-toe pattern of motor development is exemplified by lifting the head, rolling over, and sitting with support.
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