A nurse is assessing a child whose history reveals an upper respiratory illness that has progressed to a persistent cough characterized by an inspiratory whoop. The nurse would suspect which of the following?
Pertussis
Asthma
Bronchiolitis
Acute Laryngotraceobronchitis (LTB)
The Correct Answer is A
A. Pertussis:
Pertussis, commonly known as whooping cough, is caused by the bacterium Bordetella pertussis. It is characterized by a persistent cough with a distinctive "whoop" sound during the inspiratory phase. The cough can be severe and may last for several weeks. The characteristic whooping sound is due to the rapid intake of breath after a coughing episode.
B. Asthma:
Asthma is a chronic respiratory condition characterized by recurrent episodes of wheezing, coughing, and shortness of breath. It is not typically associated with a whooping sound during the inspiratory phase. Asthma symptoms are often triggered by factors such as allergies, exercise, or exposure to irritants.
C. Bronchiolitis:
Bronchiolitis is commonly caused by respiratory syncytial virus (RSV), especially in infants. It presents with symptoms such as cough, wheezing, and respiratory distress. However, it does not involve the characteristic whooping cough sound seen in pertussis.
D. Acute Laryngotracheobronchitis (LTB):
Acute Laryngotracheobronchitis, or croup, is characterized by a barking cough, stridor (a high-pitched sound during inhalation), and respiratory distress. It is common in young children and is often caused by viruses. Unlike pertussis, it does not typically include the distinctive whooping sound.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Sore throat:
A sore throat is a common symptom of various respiratory tract infections, including acute epiglottitis. However, examining the throat with a tongue depressor is unlikely to directly precipitate a sore throat in this context.
B. Complete obstruction:
Examining the child's throat with a tongue depressor in acute epiglottitis can potentially trigger spasm or swelling of the already inflamed epiglottis, leading to a rapid and complete obstruction of the airway. This is a critical concern and is why healthcare providers approach suspected cases of epiglottitis with great caution.
C. Inspiratory stridor:
Inspiratory stridor (high-pitched sound during inhalation) is a common symptom of upper airway obstruction, including in conditions like acute epiglottitis. It may be present without manipulation, but using a tongue depressor in the throat could exacerbate this symptom.
D. Respiratory tract infection:
Acute epiglottitis is indeed a type of respiratory tract infection. However, examining the throat with a tongue depressor is not likely to directly precipitate a respiratory tract infection.
Correct Answer is B
Explanation
A.While cystic fibrosis is characterized by a high concentration of sodium chloride in sweat due to defective chloride channels, this is not the cause of the barrel chest and clubbing of the fingers.
B.The barrel chest and clubbing of the fingers are often seen in children with cystic fibrosis due to chronic hypoxia (lack of oxygen). Chronic lung infections, airway obstruction, and respiratory insufficiency associated with cystic fibrosis lead to prolonged low oxygen levels, which can result in these physical changes.
C.Decreased respiratory capacity, often due to the chronic respiratory issues associated with cystic fibrosis, can result in a barrel chest (increased chest diameter due to air trapping) and clubbing of the fingers (a sign of chronic hypoxia).
D.Decreased respiratory capacity (due to thick mucus and airway obstruction) does contribute to chronic respiratory issues in cystic fibrosis, but the direct cause of the barrel chest and clubbing is the chronic lack of oxygen (hypoxia) rather than decreased capacity alone. The changes in the chest and fingers are a result of prolonged oxygen deprivation.
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