A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include?

Provide the child with a warm blanket.

Assess the oral cavity for Koplik spots.

Administer aspirin for fever.

Initiate airborne precautions.

Answer and Explanation

The Correct Answer is D

Rationale:
A.   Providing the child with a warm blanket can help keep the child comfortable during the course of the illness but initiating airborne precautions is best intervention required.
B.   Assessing the oral cavity for Koplik spots is not relevant for varicella, as Koplik spots are associated with measles.
C.   Administering aspirin for fever is contraindicated in children with varicella due to the risk of Reye's syndrome.
D.   The nurse should initiate airborne precautions, which include placing the child in a private room with negative air pressure, wearing a mask or respirator when entering the room, and limiting visitors and staff exposure. Airborne precautions prevent the transmission of varicella through small droplets that can remain suspended in the air for long periods of time.

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Correct Answer is A

Explanation

A) Tachypnea is a sign of respiratory distress and may indicate hypoxia, dehydration, or increased work of breathing. The nurse should report this finding to the provider and monitor the infant's oxygen saturation, heart rate, and respiratory rate.
B) Coughing is a common symptom of RSV and may not require immediate reporting unless severe.
C) Rhinorrhea (runny nose) is a common symptom of RSV and may not require immediate reporting unless severe.
D) Pharyngitis (sore throat) is a common symptom of RSV but is not as urgent as tachypnea.

A. Hypothermia B. Hyperactive reflexes C. Ataxia D. Pinpoint pupils

Correct Answer is C

Explanation

A) Inhalation of gasoline is more likely to cause hyperthermia due to its effects on the central nervous system and metabolic rate.
B) Hyperactive reflexes are not typically associated with gasoline inhalation but rather with stimulant use such as amphetamines or cocaine.
C) Ataxia, or lack of coordination, is a common neurological symptom of gasoline inhalation due to its toxic effects on the brain and nervous system.
D) Pinpoint pupils are more commonly associated with opioid overdose, not gasoline inhalation.

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A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include?

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Naxlex Comprehensive Predictor Exams

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