A nurse is caring for a child who is to receive percussion, vibration, and postural drainage. Which of the following actions should the nurse take first?
Instruct the client to cough
Perform vibration while the client exhales slowly through the nose.
Percuss the upper posterior chest.
Administer albuterol by nebulizer.
The Correct Answer is D
A. Instruct the client to cough. Coughing is generally encouraged after chest physiotherapy to help expel loosened secretions, but it is not the first action. The bronchodilator should be administered first to maximize the effectiveness of the chest physiotherapy.
B. Perform vibration while the client exhales slowly through the nose. Vibration is a component of chest physiotherapy used to help loosen secretions during exhalation, but it is performed after the bronchodilator is administered and once the client is positioned properly.
C. Percuss the upper posterior chest. Percussion helps to mobilize secretions but is typically done after the bronchodilator has been administered to allow for more effective airway clearance.
D. Administer albuterol by nebulizer. Administering albuterol first dilates the airways, making it easier to mobilize and clear secretions during percussion, vibration, and postural drainage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Respiratory
Kawasaki disease primarily affects the cardiovascular system rather than the respiratory system. While respiratory symptoms such as cough or congestion may occur in some cases, they are not the primary focus of the disease.
B. Gastrointestinal
Although gastrointestinal symptoms such as abdominal pain, vomiting, or diarrhea can occur in Kawasaki disease, they are not the primary system affected. Gastrointestinal symptoms are considered part of the systemic manifestations of the disease but do not define its primary pathology.
C. Cardiovascular
This is the correct answer. Kawasaki disease primarily affects the cardiovascular system. It is characterized by inflammation of the blood vessels, particularly the medium-sized arteries, including the coronary arteries. Coronary artery involvement can lead to coronary artery aneurysms and other cardiovascular complications, making the cardiovascular system the primary focus of the disease.
D. Integumentary
The integumentary system (skin) is not primarily affected by Kawasaki disease. While changes in the skin, such as a rash, may occur as part of the systemic manifestations of the disease, they are not the primary focus of Kawasaki disease.

Correct Answer is A
Explanation
A. "Has your son had a sore throat recently?"
This question is relevant because acute rheumatic fever often occurs as a complication of untreated or inadequately treated streptococcal throat infection (strep throat). A recent history of sore throat could indicate a preceding streptococcal infection, which is an important predisposing factor for the development of acute rheumatic fever.
B. "Was your son born with this cardiac defect?"
This question is less relevant in the context of acute rheumatic fever. Acute rheumatic fever is not a congenital heart defect; it is an inflammatory condition that affects the heart valves following streptococcal infection. While it's important to assess the child's cardiac health, asking about congenital heart defects may not directly relate to the current condition.
C. "Are you aware that your son will have to be in isolation?"
This question is not applicable to acute rheumatic fever. Acute rheumatic fever is not a contagious condition that requires isolation. It is an autoimmune response triggered by streptococcal infection and does not pose a risk of transmission to others.
D. "Has your child had any injuries recently?"
Inquiring about recent injuries is not directly related to acute rheumatic fever. Acute rheumatic fever is an inflammatory condition primarily triggered by streptococcal infection and is not caused by physical injuries.
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