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A toddler has had recurrent respiratory infections. The mother of the child expressed concern that her child seemed to be at increased risk for complications from infection in comparison with her older children. What is the best response from the nurse?

"Air passages are more likely to become blocked with mucus because younger children make more mucus than do older children."

"Airways structures are closer together so infection spreads faster in the young child."

"Younger children have more exposure to respiratory illnesses."

"Toddlers do not breathe as deeply as do older children."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "Air passages are more likely to become blocked with mucus because younger children make more mucus than do older children": Younger children are not constantly producing more mucus than older children. The increased risk is more related to anatomical and physiological differences rather than baseline mucus volume.

B. "Airways structures are closer together so infection spreads faster in the young child": In toddlers, airway structures are smaller and in closer proximity, allowing pathogens to quickly move from one area to another. This proximity, combined with immature immune defenses, increases the likelihood of widespread infection and associated complications.

C. "Younger children have more exposure to respiratory illnesses": While young children may be exposed frequently in settings like daycare, exposure alone does not explain increased severity or complications. The higher risk is due to their developing respiratory anatomy and immune system.

D. "Toddlers do not breathe as deeply as do older children": Tidal volume in toddlers is smaller due to their smaller lung size, but this factor alone does not significantly explain their increased risk of complications from infection.

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Correct Answer is C

Explanation

Rationale:

A. The child withdraws and attempts to hide because they think the pain is a form of punishment: This is more typical of toddlers who have limited understanding and may associate pain with punishment, rather than preschoolers who have a better grasp of cause and effect.

B. The child denies being scared about pain in an attempt to seem brave, and withdraws to a game on mom's phone: While distraction techniques are effective, preschoolers are more likely to show visible signs of distress rather than denying fear completely, as their emotional expression is more open.

C. The child makes facial expressions such as brow contracting and chin quivering in anticipation of the pain: Preschool-aged children often express fear and anxiety about painful procedures through facial cues and body language, showing clear anticipation and emotional response.

D. The child kicks, hits and cries due to lack of control over the situation: This aggressive and oppositional behavior is more characteristic of toddlers or children with less developed coping skills, rather than preschoolers who generally have more emotional regulation.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Rationale for Correct Choices:

• Cracked lips and strawberry tongue are hallmark mucocutaneous changes in Kawasaki disease, reflecting widespread inflammation of mucous membranes in the acute phase. These are often accompanied by conjunctival injection and rash.

• Aspirin and IV gamma globulin are the mainstay treatments for Kawasaki disease, reducing inflammation and significantly lowering the risk of coronary artery aneurysms when given early in the illness.

Rationale for Incorrect Choices:

• Petechiae and purpura rash are more commonly seen in platelet or clotting disorders such as idiopathic thrombocytopenic purpura or meningococcemia. Kawasaki disease typically presents with diffuse erythematous rash, not pinpoint hemorrhages.

• Polyarthritis may occur in the later stages of Kawasaki disease, but chorea is a neurological manifestation linked to rheumatic fever. This combination does not fit the acute presentation of Kawasaki disease.

• Corticosteroids and antibiotics are not first-line treatments for Kawasaki disease. Antibiotics are ineffective as the cause is not bacterial, and corticosteroids are generally reserved for IVIG-resistant cases.

• ACE inhibitors and NSAIDs are not standard therapy for Kawasaki disease. ACE inhibitors are used in hypertension or heart failure, and NSAIDs are not as effective as high-dose aspirin in reducing the acute inflammatory response in this condition.

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A toddler has had recurrent respiratory infections. The mother of the child expressed concern that her child seemed to be at increased risk for complications from infection in comparison with her older children. What is the best response from the nurse?

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Naxlex Comprehensive Predictor Exams

A nurse is about to administer a vaccination to a 4 year old. What developmental response to this painful procedure is MOST likely for a preschool aged child.

Correct Answer is C

Explanation

The nurse on the pediatric floor is taking care of a patient just diagnosed with Kawasaki Disease. On exam, the nurse can expect to find this hallmark clinical finding dropdown: and to administer these medications: dropdown.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

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