A school-age client with asthma has been monitoring their daily peak expiratory flow rates(PEFR). The client's mother calls the clinic to report that the PEFR was at 45% of their personal best. Which guidance should the nurse provide to the mother?

"Your child needs to go to the hospital as soon as possible."

"Have your child use their inhaled corticosteroid and follow it with albuterol."

"Your child needs to administer salmeterol right away."

"Continue to watch the PEFR readings and call back if they go below 40%."

Answer and Explanation

The Correct Answer is B

A. A PEFR of 45% of the personal best indicates a moderate asthma exacerbation, but immediate hospitalization is not necessarily required unless there are severe symptoms or other indicators of serious distress.

B. At 45% of the personal best PEFR, the child is experiencing a moderate asthma exacerbation. The recommended action is to use a quick-relief inhaler like albuterol, which is effective in providing immediate relief. Inhaled corticosteroids are part of the long-term management but should not replace the use of a quick-relief inhaler during an exacerbation.

C. Salmeterol is a long-acting beta-agonist used for maintenance therapy and is not typically used for acute exacerbations. Albuterol is preferred in this situation for immediate relief.

D. While monitoring PEFR is important, action should be taken when PEFR falls below 50% of the personal best, and more immediate intervention is needed at 45% of the personal best.

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Correct Answer is B

Explanation

A. Mild illnesses like nasopharyngitis (a common cold) do not typically contraindicate vaccination, so there is no need to delay immunization.

B. It is essential to evaluate for allergies to vaccine components, such as gelatin or neomycin, which could contraindicate the administration of the varicella vaccine.

C. The first dose of the varicella vaccine is recommended at 12-15 months of age, not at 4 years of age, so it is appropriate to administer it during this well-check.

D. The varicella vaccine is administered subcutaneously, not intramuscularly, so this is not the correct route for administration.

A. Profound cyanosis B. Periorbital edema C. Absent femoral pulses D. Decreased blood pressure to lower extremities

Correct Answer is A

Explanation

A. Profound cyanosis is a key sign of tricuspid atresia, a congenital heart defect where the tricuspid valve is absent, leading to poor oxygenation of the blood.

B. Periorbital edema is not typically associated with tricuspid atresia; it might be seen in other conditions like nephrotic syndrome.

C. Absent femoral pulses suggest coarctation of the aorta rather than tricuspid atresia.

D. Decreased blood pressure in the lower extremities is also more indicative of coarctation of the aorta, not tricuspid atresia.

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A school-age client with asthma has been monitoring their daily peak expiratory flow rates(PEFR). The client's mother calls the clinic to report that the PEFR was at 45% of their personal best. Which guidance should the nurse provide to the mother?

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During a well-check for a 12-month-old, the nurse plans to administer the first dose of the varicella vaccine. What is an appropriate action for the nurse to take?

Correct Answer is B

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Correct Answer is A

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