In the Emergency Department, four children are awaiting treatment for respiratory illnesses.
Given that only one treatment room is available, which child should be prioritized based on the assessment findings?

A 12-month-old with a weak cry, pale complexion, decreased breath sounds, retractions, and an oxygen saturation of 93%.

A 5-year-old speaking in full sentences, pink complexion, bilateral wheezing, and an oxygen saturation of 93%.

A 16-year-old speaking in short phrases, wheezing, sitting upright, and an oxygen saturation of 93%.

A 9-year-old who is quiet, pale, sitting on his father’s lap, bilateral wheezing, and an oxygen saturation of 93%.

Answer and Explanation

The Correct Answer is A

Choice A rationale

A 12-month-old with a weak cry, pale complexion, decreased breath sounds, retractions, and an oxygen saturation of 93% is showing signs of severe respiratory distress. The weak cry and pale complexion suggest poor oxygenation and possible hypoxia. Decreased breath sounds and retractions indicate the child is struggling to breathe. An oxygen saturation of 93% is below the normal range for infants, further indicating respiratory distress. This child should be prioritized for treatment.

Choice B rationale

A 5-year-old speaking in full sentences, pink complexion, bilateral wheezing, and an oxygen saturation of 93% is showing signs of respiratory distress, but not as severe as Choice A12. The ability to speak in full sentences and having a pink complexion suggest that the child is getting

enough oxygen. However, bilateral wheezing indicates some airway obstruction. An oxygen saturation of 93% is on the lower end of the normal range for children this age.

Choice C rationale

A 16-year-old speaking in short phrases, wheezing, sitting upright, and an oxygen saturation of 93% is also showing signs of respiratory distress. Speaking in short phrases and sitting upright are signs that the teenager is working harder to breathe. Wheezing indicates airway obstruction. An oxygen saturation of 93% is on the lower end of the normal range for teenagers.

Choice D rationale

A 9-year-old who is quiet, pale, sitting on his father’s lap, bilateral wheezing, and an oxygen saturation of 93% is showing signs of respiratory distress. Being quiet and pale can indicate poor oxygenation. Bilateral wheezing suggests airway obstruction. An oxygen saturation of 93% is below the normal range for children this age. However, this child’s symptoms are not as severe as those of the 12-month-old in Choice A.

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Correct Answer is ["A","B","C","D"]

Explanation

Choice A rationale

After a tonsillectomy, it’s crucial to manage the child’s pain effectively. Pain can deter children from eating or drinking, which can lead to dehydration. Therefore, ensuring that the child’s pain is well managed is an essential part of post-operative care.

Choice B rationale

Mild ear pain or foul breath after surgery are common symptoms following a tonsillectomy. These symptoms do not necessarily indicate a problem, but they should be monitored. If these symptoms persist or worsen, it may be necessary to seek medical attention.

Choice C rationale

After a tonsillectomy, it’s recommended that the child eat soft foods for the first few days. Crunchy foods can irritate the throat and delay healing. Therefore, avoiding crunchy foods initially is an important part of post-operative care.

Choice D rationale

Following a tonsillectomy, it’s normal for the child to form scabs on their tonsils as they heal. This is a normal part of the healing process and is not a cause for concern.

A. “I will administer tobramycin prior to vest therapy.”. B. “I will administer dornase alfa prior to vest therapy.”. C. “I will administer flutter valve therapy after vest therapy.”. D. “I will administer albuterol prior to vest therapy.”.

Correct Answer is D

Explanation

Choice A rationale

Tobramycin is an antibiotic often used in people with cystic fibrosis to combat bacterial infections in the lungs. However, it is not typically administered prior to vest therapy.

Choice B rationale

Dornase alfa is a medication used to thin the thick, sticky mucus in the lungs of people with cystic fibrosis. While it can help improve lung function and reduce the risk of respiratory infections, it is not typically administered prior to vest therapy.

Choice C rationale

Flutter valve therapy is another method used to clear mucus from the lungs. It is not typically administered after vest therapy.

Choice D rationale

Albuterol is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. Administering albuterol prior to vest therapy can help open the airways and make the therapy more effective.

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In the Emergency Department, four children are awaiting treatment for respiratory illnesses.Given that only one treatment room is available, which child should be prioritized based on the assessment findings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What instructions must the nurse include in the post-operative discharge instruction for a 6-year-old who just had a tonsillectomy? (Select All That Apply).

Correct Answer is ["A","B","C","D"]

Explanation

A nurse is reviewing the care plan with a school-aged child who has cystic fibrosis and a prescription to receive vest therapy to mobilize respiratory secretions.Which of the following statements by the child indicates an understanding of the plan?

Correct Answer is D

Explanation

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In the Emergency Department, four children are awaiting treatment for respiratory illnesses.
Given that only one treatment room is available, which child should be prioritized based on the assessment findings?