A 2-year-old boy is brought to the emergency department with a barking cough, hoarseness, and inspiratory stridor.
His parents report that he has been sick for 2 days and that his symptoms have been getting worse.
The boy's vital signs are as follows: temperature 102°F (38.9°C), heart rate 120 beats/minute, respiratory rate 28 breaths/minute, and oxygen saturation 95% on room air.
Physical examination reveals a well-developed, well-nourished boy in moderate respiratory distress.
He is using accessory muscles of respiration and has intercostal retractions.
His lungs are clear to auscultation.
Which of the following statements by the nurse is most appropriate?

"Your son has croup.

"Your son has epiglottitis.

"Your son has asthma.

"Your son has pneumonia.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A, “Your son has croup.”

Choice A rationale:

The symptoms described, including a barking cough, hoarseness, and inspiratory stridor, are classic signs of croup. Croup is a common respiratory condition in young children that leads to swelling of the larynx and trachea, causing the characteristic cough and stridor.

Choice B rationale:

While epiglottitis can present with respiratory distress, it is more commonly associated with high fever, severe sore throat, drooling, and difficulty swallowing, rather than a barking cough and stridor.

Choice C rationale:

Asthma typically presents with wheezing and difficulty exhaling, not the barking cough and inspiratory stridor seen in croup. Additionally, asthma is often associated with a history of allergies or atopic conditions, which are not mentioned in the scenario.

Choice D rationale:

Pneumonia usually presents with fever, cough producing phlegm, and crackles or wheezes on lung auscultation. The clear lungs on auscultation and the absence of productive cough make pneumonia less likely in this case.

In summary, the presentation of a barking cough, hoarseness, and inspiratory stridor in a young child who is in moderate respiratory distress with a recent onset of symptoms is most indicative of croup. This is supported by the age of the child and the clinical findings, which align with the typical presentation of croup.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

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

Explanation

Choice A rationale:

Administering oxygen therapy is essential in cases of severe croup where the child has difficulty breathing.

Oxygen therapy helps ensure adequate oxygenation, which is crucial in managing respiratory distress.

Choice B rationale:

Positioning the child upright facilitates breathing by allowing the airways to remain open and reducing airway obstruction.

This position helps alleviate symptoms like stridor and allows the child to breathe more comfortably.

Choice C rationale:

Providing humidified air helps loosen secretions and makes it easier for the child to breathe.

Humidification can reduce airway irritation and soothe the inflamed throat, providing relief from croup symptoms.

Choice D rationale:

This choice is incorrect because encouraging the child to drink plenty of fluids is generally good advice for any illness but is not specific to croup.

While it is essential to keep the child hydrated, it is not a direct nursing intervention for managing croup symptoms.

Choice E rationale:

Monitoring the child's respiratory status closely is crucial in assessing the effectiveness of the interventions and identifying any signs of respiratory distress.

Close monitoring allows nurses to make timely decisions and take appropriate actions to maintain the child's respiratory function.

A. The child's oxygen saturation is 95%. B. The child's respiratory rate is 30 breaths per minute. C. The child has mild retractions. D. The child is able to speak in complete sentences.

Correct Answer is B

Explanation

Choice A rationale:

An oxygen saturation level of 95% is within the normal range (normal range is typically 95-100%).

While it is essential to monitor oxygen saturation, this value does not indicate worsening of the child's condition.

Choice B rationale:

A respiratory rate of 30 breaths per minute is above the normal range for a child and can indicate respiratory distress.

An increased respiratory rate is a concerning sign, suggesting the child is having difficulty breathing.

This finding indicates the child's condition is worsening and requires prompt attention.

Choice C rationale:

Mild retractions suggest that the child is working harder to breathe but may not necessarily indicate a severe worsening of the condition.

Retractions are a sign of increased respiratory effort but may vary in severity.

Choice D rationale:

A child with croup experiencing severe respiratory distress may not be able to speak in complete sentences due to the difficulty in breathing.

However, the ability to speak in complete sentences alone may not be a definitive indicator of worsening.

Monitoring the respiratory rate and effort is crucial in assessing the child's condition accurately.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Select all that apply.Which of the following are nursing interventions for a child with croup?

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

Explanation

A nurse is caring for a child with croup in the hospital.The child is receiving humidified air and nebulized racemic epinephrine.The nurse monitors the child's respiratory status closely.Which of the following findings would indicate to the nurse that the child's condition is worsening?

Correct Answer is B

Explanation

A nurse is assessing a 2-year-old child with croup.The child's mother states that the child has had a barking cough for 2 days, which is worse at night.The child also has a fever and is hoarse.Which of the following statements by the nurse is most appropriate?

A nurse is educating parents of a child with croup about the signs and symptoms.Which clinical manifestations should the nurse include in the teaching? Select all that apply.

A nurse is educating a parent about the prevention of croup.Which of the following statements should the nurse include in the teaching?

A nurse is teaching the parents of a child with croup about home care management.The nurse explains that it is important to keep the child hydrated and to provide humidified air.Which of the following statements by the parent indicates that they understand the nurse's instructions?

A nurse is caring for a child with croup and needs to implement nursing interventions.What interventions are appropriate for a child with croup? Select all that apply.