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.

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Correct Answer is A

Explanation

The nurse should assess the child's vital signs and listen to his lungs.

Choice A rationale:

Assessing vital signs, including heart rate, respiratory rate, oxygen saturation, and temperature, is essential in evaluating the child's overall condition and the severity of respiratory distress.

Listening to the child's lungs can help identify abnormal breath sounds, such as stridor or wheezing, which are common in croup.

This information guides further interventions and helps determine the appropriate level of care.

Choice B rationale:

While croup can cause respiratory distress, not every case requires an emergency room visit.

The severity of symptoms, including the child's ability to breathe and oxygenate, should guide the decision to seek emergency care.

In this scenario, assessing vital signs and lung sounds is the initial appropriate action.

Choice C rationale:

Croup is a treatable condition, and there are specific interventions, such as providing humidified air and corticosteroids, that can alleviate symptoms and prevent complications.

It is incorrect to tell the parent that there is nothing that can be done for croup.

Medical intervention can significantly improve the child's condition.

Choice D rationale:

Croup is primarily caused by viral infections, not bacterial infections.

Administering antibiotics without confirming a bacterial infection is inappropriate and contributes to antibiotic resistance.

A. "Croup is a common viral infection of the upper respiratory tract that causes inflammation of the larynx.”.. B. "Croup is most common in children under the age of 3.”.. C. "The symptoms of croup usually appear at night.”.. D. "The classic croup cough is described as a barking cough.”.. E. "Croup can be treated with over-the-counter medications, such as cough syrup and expectorants.”..

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

Explanation

The correct answers are Choices A, B, C, and D.

Choice A rationale: Croup is typically caused by viral pathogens like parainfluenza, leading to inflammation of the larynx, trachea, and bronchi, resulting in airway narrowing and characteristic respiratory symptoms.

Choice B rationale: Croup most commonly affects children aged 6 months to 3 years due to their narrower airways and immature immune systems, making them more susceptible to upper airway obstruction.

Choice C rationale: Croup symptoms often worsen at night due to circadian variations in airway tone and increased mucus production, contributing to nocturnal stridor and respiratory distress.

Choice D rationale: The hallmark symptom of croup is a barking cough, resembling a seal’s bark, caused by turbulent airflow through an inflamed and narrowed upper airway, especially near the cricoid cartilage.

Choice E rationale: Over-the-counter cough syrups and expectorants are contraindicated in croup; they do not address airway inflammation and may worsen symptoms or delay appropriate treatment like corticosteroids or nebulized epinephrine.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

A nurse is teaching a parent about the signs and symptoms of croup. Which of the following statements should the nurse include in the teaching? Select all that apply.

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

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?

A nurse is performing a nursing assessment of a child with croup.What should the nurse assess to determine the severity of respiratory distress?

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 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.

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