A nurse is caring for a toddler who has acute laryngotracheobonchitis after a repair of an intussusception. Which of the indicates that the treatment has been effective?
Barking cough
Decreased stridor
Decreased temperature
Improved hydration
The Correct Answer is B
A. Barking cough: A barking cough is a characteristic symptom of acute laryngotracheobronchitis (croup), indicating inflammation of the upper airway. While it may improve with treatment, it is not necessarily an indication that the treatment has been effective on its own.
B. Decreased stridor: Stridor is a high-pitched, wheezing sound heard during inspiration and indicates upper airway obstruction. In acute laryngotracheobronchitis, stridor is a prominent symptom. Decreased stridor suggests that the airway obstruction is resolving, which indicates that the treatment has been effective.
C. Decreased temperature: While fever may be present in some cases of acute laryngotracheobronchitis, it is not a defining characteristic. A decreased temperature alone does not necessarily indicate that the treatment has been effective in managing the condition.
D. Improved hydration: Hydration is important in managing any illness, including acute laryngotracheobronchitis, but improved hydration alone does not indicate that the treatment has been effective in resolving the condition. It may be an important aspect of supportive care but does not directly reflect the resolution of airway obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Assist the client to the correct room: This option addresses the immediate safety concern by guiding the client back to their own room, reducing distress for both the client and the other resident. It promotes dignity and minimizes the risk of agitation or further disruptive behavior.
B. Place the client in restraints: Restraints should only be used as a last resort for safety when all other measures have been exhausted and when there's an immediate risk of harm to the client or others. Restraints can be physically and psychologically harmful to individuals with Alzheimer's disease and should not be used unless absolutely necessary.
C. Reorient the client to time and place: Reorientation may not be effective for clients with advanced Alzheimer's disease, as their cognitive impairments may limit their ability to understand or retain this information. Additionally, reorientation may not address the immediate safety concern posed by the client's behavior.
D. Move the client to a room at the end of the hall: While this option may be considered in some situations to minimize disruption to other residents, it does not address the underlying issue of the client's confusion or wandering behavior. Additionally, moving the client may cause further distress and confusion.
Correct Answer is B
Explanation
A. Identify cues in the client's behavior that might have warned them that he was contemplating suicide: While identifying cues in the client's behavior is important for understanding potential risk factors and improving suicide prevention measures in the future, it is not the priority intervention immediately following a client's suicide. Staff members may need support and debriefing to process the emotional impact of the event before effectively analyzing cues and implementing changes.
B. Provide professional counseling for staff members: Following a client's suicide, the priority intervention is to ensure the well-being of the staff members who may be experiencing emotional distress, guilt, or trauma as a result of the incident. Professional counseling provides an opportunity for staff to process their feelings, receive support, and develop coping strategies to manage the emotional impact of the event.
C. Change policies for staff observation of clients who are suicidal: While reviewing and updating policies for staff observation of suicidal clients is important for improving safety measures, it is not the immediate priority following a client's suicide. Policy changes should be informed by a thorough review of the incident, including staff debriefing, analysis of contributing factors, and consultation with mental health professionals.
D. Give the family an opportunity to talk about their feelings: While providing support to the client's family is important, especially in the aftermath of a suicide, it is not the priority intervention for staff immediately following the incident. Staff members need to address their own emotional needs and well-being first before they can effectively support the client's family.
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