Patient Data

Exhibits
Which findings indicate an improvement in the client’s condition?

Cool and dry skin

Temperature

Behavioural characteristic

Pain assessment

Increased irritability

Answer and Explanation

Correct Answer : A,B,C,D

Rationale:

A. Cool and dry skin: The toddler’s skin was previously flushed and warm due to fever. The change to cool, dry skin reflects that the fever has subsided and perfusion has stabilized, indicating overall improvement in the child’s condition.

B. Temperature: The axillary temperature decreased from 102.6° F to 99.1° F after administration of antipyretics, showing that the inflammatory response is resolving and the child is responding to treatment for infection.

C. Behavioral characteristic: Earlier, the toddler was fussy, irritable, and had poor sleep. Now he is playing with a stuffed animal and interacting appropriately, which demonstrates increased comfort, energy, and improved neurological and emotional status.

D. Pain assessment: The FLACC pain score decreased from 4/10 to 0/10, indicating effective analgesia from the lidocaine ear drops and ibuprofen, as well as relief from discomfort associated with the ear infection.

E. Increased irritability: Persisting or worsening irritability would suggest ongoing discomfort or unresolved infection and is not consistent with clinical improvement, making it an irrelevant indicator for positive change.

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Correct Answer is C

Explanation

Rationale:

A. Apply zinc oxide to perineum with each diaper change: Zinc oxide can help treat diaper rash and protect skin integrity, but it does not address the systemic allergic reaction symptoms such as sneezing, urticaria, or watery eyes.

B. Auscultate the lungs for respiratory pneumonia: Lung assessment is important in children with chronic conditions, but the symptoms described (sneezing, urticaria, watery eyes, and rash) indicate an allergic reaction rather than a respiratory infection.

C. Change to latex-free gloves when handling infant: The symptoms are indicative of a latex allergy, which is common in children with myelomeningocele who have frequent catheterizations and medical device exposure. Switching to latex-free gloves is the most important intervention to prevent further allergic reactions and potential anaphylaxis.

D. Draw blood to analyze for streptococcal infection: Streptococcal infections typically present with fever, sore throat, or systemic illness. The child’s symptoms are consistent with an allergic reaction rather than infection, so immediate lab testing for strep is not the priority.

A. Flaring of the nares. B. Diaphragmatic respirations. C. Resting respiratory rate of 35 breaths/minute. D. Bilateral bronchial breath sounds.

Correct Answer is A

Explanation

Rationale:

A. Flaring of the nares: Flaring of the nares occurs when the infant is working harder to breathe and indicates increased respiratory effort. In the context of RSV with poor feeding and frequent coughing, this is a key sign of respiratory distress that requires prompt attention.

B. Diaphragmatic respirations: Diaphragmatic (abdominal) breathing is normal in infants and reflects typical respiratory mechanics. It does not indicate respiratory distress unless accompanied by other abnormal signs like retractions or nasal flaring.

C. Resting respiratory rate of 35 breaths/minute: A respiratory rate of 35 is within the normal range for a 4-month-old (30–60 breaths/minute). Alone, it does not signify distress, though trends or additional signs should be monitored.

D. Bilateral bronchial breath sounds: Bilateral bronchial breath sounds can be normal over the central airways. This finding does not indicate respiratory distress and may reflect normal auscultatory findings in infants.

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Patient Data Exhibits Which findings indicate an improvement in the client’s condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A 4-month-old has been admitted to the pediatric medical unit with respiratory syncytial virus (RSV). The infant demonstrates poor feeding and begins coughing frequently. Which additional finding should alert the nurse that the child is experiencing respiratory distress?

Correct Answer is A

Explanation

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Patient Data Exhibits The nurse is evaluating the infant's progress and the parents' understanding of the condition. For each finding, click to indicate if it supports the interventions were effective or does not support the interventions were effective.

Patient Data

Exhibits
Which findings indicate an improvement in the client’s condition?