A parent brings her child to the pediatrician’s office because of difficulty breathing and a “barking” cough. These signs are associated with which of the following conditions?
Cystic fibrosis
Asthma
Epiglottitis
Croup
The Correct Answer is D
Croup (laryngotracheobronchitis) is a viral infection (commonly caused by the parainfluenza virus) that leads to inflammation and narrowing of the larynx and trachea, resulting in upper airway obstruction.
It typically affects children between 6 months and 3 years old. Symptoms are often worse at night and may follow an upper respiratory infection.
Rationale for correct answer:
4. The hallmark signs, barking cough and difficulty breathing, are classic indicators of croup. The cough results from laryngeal swelling, and inspiratory stridor occurs due to narrowing of the upper airway. Treatment typically includes humidified air, corticosteroids (e.g., dexamethasone), and, in moderate to severe cases, nebulized epinephrine to reduce airway edema.
Rationale for incorrect answers:
1. Cystic fibrosis is a genetic disorder causing thick mucus secretions affecting the lungs and pancreas. It presents with chronic cough, recurrent infections, and malabsorption, not a barking cough or acute airway obstruction.
2. Asthma causes wheezing, shortness of breath, and chest tightness due to lower airway bronchoconstriction, not a barking cough or stridor.
3. Epiglottitis presents with drooling, dysphagia, high fever, tripod positioning, and absence of cough not a barking cough. It’s a medical emergency due to risk of complete airway obstruction.
Take home points
- Barking cough and stridor are hallmark signs of croup which is viral and usually mild to moderate.
- Drooling, no cough, and high fever are symptoms of epiglottitis a bacterial emergency.
- Wheezing and chest tightness are typical of asthma.
- Chronic productive cough and malabsorption are symptoms of cystic fibrosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Croupis a common respiratory illness in toddlers characterized by a barking cough, often caused by viral inflammation leading to airway narrowing. Discharge teaching focuses on home management and recognizing signs of worsening illness.
Rationale for correct answers:
1. Cool mist helps soothe inflamed airwaysand can reduce airway irritation, making breathing easier. It is a safe, non-invasive home therapy to help alleviate symptoms.
3. Stridor at restindicates significantairway obstructionand respiratory distress that requires urgent medical evaluation to prevent respiratory failure.
4. Adequate hydration thins mucus secretions, prevents dehydration, and supports overall recovery.
Rationale for incorrect answers:
2. Over-the-counter cough syrups are not recommended for young children due to limited efficacy and potential side effects.
5. Aspirinis contraindicated in children because of the risk of Reye’s syndrome, a serious and potentially fatal condition.
Take home points
- Use cool-mist humidifiers and maintain hydration to support symptom relief in croup.
- Recognize signs of respiratory distress such as stridor at rest and seek emergency care promptly.
- Avoid cough syrups and aspirin in young children.
Correct Answer is A
Explanation
Croup (laryngotracheobronchitis)is a viral infectioncommonly caused by the parainfluenza virusthat causes inflammation and narrowing of the larynx, trachea, and bronchi, leading to upper airway obstruction. Typical signs include barking cough, inspiratory stridor, and hoarseness. Nebulized treatmentssuch as racemic epinephrinehelp reduce airway edemaand ease breathing.
Rationale for correct answer:
1. During naptime: Administering the nebulizer while the child is calm or asleep reduces agitation, crying, and airway stress, which can worsen obstruction in croup. Ensures effective delivery of the medication without struggle or additional respiratory distress. Children are often more tolerant of nebulization when relaxed, which improves outcomes.
Rationale for incorrect answers:
2. During playtime: The child may be active and uncooperative, making treatment less effective and potentially stressful.
3. After the child eats: Treatment immediately after meals may increase risk of vomiting or aspiration.
4. After the parents leave: Young children need parental reassurance during respiratory treatment. Administering nebulizers in the parent’s absence can increase anxiety and worsen symptoms.
Take home points
- Calm, relaxed children respond better to nebulizer treatments.
- Administering during naptime minimizes stress and agitation, improving airway safety and medication effectiveness.
- Always monitor respiratory status during and after the treatment.
- Ensure parental presence and reassurance to reduce anxiety.
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