A nurse is caring for an 18-month-old client in a pediatric clinic for a well-child visit and assessment of new symptoms.
Complete the following sentence by using the lists of options. The nurse should recognize that the child is most likely experiencing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
The nurse should recognize that the child is most likely experiencing A. Spasmodic croup as evidenced by their A. Parent’s reports.
Rationale for correct answers:
Spasmodic croup typically presents in toddlers aged 1–3 years with sudden onset of a barking, seal-like cough, often at night, without fever or signs of systemic illness. This condition is usually triggered by allergens or minor viral infections and lacks daytime respiratory distress. The child’s physical exam shows no wheezing or abnormal lung sounds, and the temperature is within normal limits (37.3°C), suggesting a non-infectious etiology like spasmodic croup rather than viral or bacterial illness.
Parent’s reports of hoarse, barking nighttime cough, normal daytime behavior, and absence of fever or appetite change are hallmark subjective cues for spasmodic croup. Objective findings during the visit are normal, so clinical suspicion relies heavily on the history provided.
Rationale for incorrect Response 1 Options:
Respiratory syncytial virus (RSV) typically presents with cough, nasal congestion, wheezing, and often respiratory distress or fever, none of which are present.
Epiglottitis presents with sudden onset of high fever, drooling, muffled voice, and severe respiratory distress, often requiring emergency airway management—not consistent with this child’s stable, playful presentation.
Acute laryngitis in toddlers is rare and typically presents with hoarseness but not the classic barking cough, and it usually follows viral upper respiratory symptoms.
Rationale for incorrect Response 2 Options:
Lung sounds are clear, so they don't support a diagnosis involving significant airway inflammation or obstruction.
Immunization history helps with disease prevention but doesn't assist in diagnosing the acute condition.
Laboratory results are normal except for mildly elevated eosinophils (780/mm³), suggesting atopy or eczema but not a direct link to the cough pattern.
Take-home points:
- Spasmodic croup is often triggered by allergies or viral irritants and is characterized by nighttime barking cough in toddlers.
- It should be differentiated from viral croup, RSV, and epiglottitis based on onset, symptoms, and physical findings.
- Clinical history from caregivers is crucial when physical signs are minimal or absent during examination.
- Absence of fever, normal labs, and clear lungs support non-infectious causes like spasmodic croup in an otherwise healthy child.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Confronting bullying behavior directly establishes clear professional boundaries and expectations within the unit. This approach fosters a psychologically safe environment, which is crucial for team cohesion and optimal patient care. Addressing the issue promptly prevents escalation and demonstrates leadership commitment to a respectful workplace, promoting accountability and encouraging healthier communication patterns among staff.
Choice B rationale
Modeling bullying behavior is counterproductive and unethical, as it normalizes and perpetuates harmful actions within the workplace. Such actions undermine trust, decrease morale, and can lead to increased stress, burnout, and higher staff turnover rates. A nurse manager's role is to promote a positive and supportive work environment, not to emulate detrimental behaviors.
Choice C rationale
Ignoring horizontal violence, even if not physical, can have significant negative psychological and professional consequences for staff members and the unit. Verbal abuse and gossip erode trust, create a toxic work environment, and can lead to increased anxiety, depression, and decreased job satisfaction, ultimately impacting patient care quality.
Choice D rationale
While logging observed behavior is a useful documentation tool, waiting for an annual evaluation to address horizontal violence delays necessary intervention. Prompt and direct confrontation is essential to mitigate immediate harm and prevent further escalation. Addressing the issue in a timely manner demonstrates a commitment to a safe workplace and supports a healthy team dynamic.
Correct Answer is B
Explanation
Choice A rationale
A newborn's heart rate typically ranges from 120 to 160 beats per minute, and respirations are normally between 30 and 60 breaths per minute. A heart rate of 160/min and respirations of 40/min fall within these normal physiological ranges for a newborn, indicating adequate cardiovascular and respiratory adaptation to extrauterine life.
Choice B rationale
The average head circumference for a full-term newborn ranges from 33 to 35 cm, and the chest circumference is typically 2 to 3 cm less than the head circumference. A head circumference of 40 cm is significantly larger than the normal range, and a chest circumference of 32 cm suggests an abnormal head-to-chest ratio. These measurements could indicate hydrocephalus or other developmental anomalies and warrant immediate reporting to the provider for further assessment.
Choice C rationale
A positive Babinski reflex, characterized by dorsiflexion of the big toe and fanning of the other toes, is a normal neurological finding in newborns and infants up to 12-24 months of age, indicating an immature corticospinal tract. A negative Ortolani's sign indicates the absence of hip dislocation or dysplasia, which is a normal and desired finding, reflecting stable hip joints.
Choice D rationale
Acrocyanosis, which is the bluish discoloration of the hands and feet, is a common and normal finding in newborns during the first 24 to 48 hours after birth due to immature peripheral circulation. Caput succedaneum, a localized swelling of the scalp that crosses suture lines, is also a common and benign finding resulting from pressure during vaginal birth, typically resolving spontaneously within a few days.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.