A nurse is planning care for a toddler who has epiglottitis. Which of the following interventions should the nurse include?
Continuously monitor the child's respiratory status.
Administer pancreatic enzymes with meals.
Assess the child for frequent swallowing.
Carefully suction the child's oropharynx to remove secretions.
The Correct Answer is A
A. Correct. Epiglottitis can cause airway obstruction, so continuous respiratory monitoring is crucial to detect any signs of respiratory distress.
B. Incorrect. Administering pancreatic enzymes is not relevant to epiglottitis.
C. Incorrect. Frequent swallowing assessment is not the priority for epiglottitis. Airway management is.
D. Incorrect. Suctioning may be necessary, but continuous respiratory monitoring takes precedence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Performing a sterile dressing change falls within the scope of practice for a licensed practical nurse (LPN).
B. Incorrect. Discharge teaching often involves complex information and considerations, which are typically better suited for a registered nurse.
C. Incorrect. An admission assessment requires comprehensive assessment skills that are typically performed by registered nurses.
D. Incorrect. Completing assessments related to complex neurological changes, such as the Glasgow Coma Scale for a stroke, is typically within the scope of a registered nurse.
Correct Answer is B
Explanation
Choice B rationale:
Teaching the client to tighten a muscle group, release the tension, and then move to the next one is a technique used in progressive muscle relaxation (PMR) PMR is a stress management technique that involves tensing and relaxing different muscle groups to reduce muscle tension and promote relaxation. This method helps individuals become more aware of the sensations associated with muscle tension and relaxation, making it an effective strategy for managing anxiety and stress.
Choice A rationale:
Thinking about a positive outcome to a stressful situation is a cognitive-behavioral technique that can help shift the client's focus from negative thoughts to positive ones. While this technique can be beneficial, it does not specifically pertain to progressive relaxation as described in choice B.
Choice C rationale:
Picturing taking the stress and pushing it out of the feet is a visualization technique, which can be helpful for some individuals in managing stress. However, it is not a component of progressive relaxation as described in choice B.
Choice D rationale:
Focusing on a pleasant memory and expressing emotions in writing is a form of journaling or expressive writing, which can be a therapeutic technique for managing emotions and stress. While it can be a helpful strategy, it is not the same as progressive relaxation involving muscle tension and release.
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