The caregivers of a 2-year-old who has had a common cold for 4 days calls the nurse in the emergency department at 2 AM on a cold winter night to say that the child has awakened with a barking cough and an elevated temperature. The caregiver reports she has taken the child into the bathroom and ran hot water for 15 minutes and now the child seems blue around her mouth The nurse would most appropriately recommend what action to the caregiver?

“Bring the child to the emergency room immediately.”

“Bundle the child up and take her out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”

“Take the child into the steam-filled room for an additional 15 minutes. If there is no relief, bring the child to the emergency room.”

“Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there’s no relief in an hour.”

Answer and Explanation

The Correct Answer is A

A. “Bring the child to the emergency room immediately.”

This is the most appropriate recommendation given the symptoms described, including the barking cough, elevated temperature, and blueness around the mouth. These signs may indicate respiratory distress, and immediate medical attention is needed.

B. “Bundle the child up and take her out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”

Taking a child out into the cold is not a recommended intervention for respiratory distress. This action may exacerbate the child's breathing difficulties. The symptoms described require urgent evaluation in a healthcare setting.

C. “Take the child into the steam-filled room for an additional 15 minutes. If there is no relief, bring the child to the emergency room.”

While steam may provide temporary relief for mild respiratory symptoms, the presence of blueness around the mouth suggests a more severe condition. Delaying care by waiting for an additional 15 minutes may not be appropriate in this situation.

D. “Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there’s no relief in an hour.”

Using a cool mist humidifier may be helpful for mild respiratory symptoms, but the severity of the symptoms described, especially blueness around the mouth, indicates a need for immediate medical attention. Waiting for an hour could lead to worsening of the child's condition.

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Correct Answer is D

Explanation

A. “My child has a vocabulary of approximately 20 words.”

This statement indicates language development, and an 18-month-old with a vocabulary of approximately 20 words is within the expected range. It's a positive indicator of language acquisition.

B. “My child is still thumb sucking.”

Thumb sucking is a common self-soothing behavior in infants and toddlers. While it's a normal behavior, it typically decreases with age. Thumb sucking alone may not necessarily be a cause for concern unless it persists significantly and interferes with other aspects of development.

C. “My child seems to be quite wary of strangers.”

Stranger anxiety is a normal developmental stage, and many children exhibit wariness or fear of unfamiliar people around the age of 18 months. It is considered a typical response and not necessarily indicative of developmental delay.

D. “My child is able to stand but is not yet taking steps independently.”

At 18 months, most children are expected to be walking independently. The inability to take independent steps might be a concern for gross motor skill development. While some variation is normal, a delay in achieving this milestone might prompt further evaluation to rule out any underlying developmental issues.

A. Mother sets aside afternoon time for the toddler while the baby naps. B. Mother sleeps while newborn is sleeping. C. Mother asks if the toddler likes the new baby. D. Mother suggests family not bring gifts to the toddler until behavior changes.

Correct Answer is A

Explanation

A. Mother sets aside afternoon time for the toddler while the baby naps.

Setting aside dedicated time for the older sibling when the newborn is napping demonstrates a proactive approach to ensuring the older child receives attention and feels valued, reducing the likelihood of resentment or rivalry.

B. Mother sleeps while newborn is sleeping:

While rest is important for the mother, this doesn't directly address the dynamics of sibling rivalry. It's essential to focus on positive interactions and attention for the toddler when the newborn is not requiring immediate care.

C. Mother asks if the toddler likes the new baby:

While communication is important, simply asking if the toddler likes the new baby may not be sufficient to prevent sibling rivalry. Actions and dedicated time are often more impactful.

D. Mother suggests family not bring gifts to the toddler until behavior changes:

Delaying gifts based on behavior may create an association between gifts and behavior change, which might not be the most effective approach. Positive reinforcement and attention are often more beneficial in preventing rivalry.

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Naxlex Comprehensive Predictor Exams

Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay?

Correct Answer is D

Explanation

The nurse instructs a mother on actions to prevent sibling rivalry between a toddler and a newborn. Which observation indicates that instruction has been effective?

Correct Answer is A

Explanation

When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction?

A breast-feeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother’s concerns?

The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing?

The pediatric nurse is meeting with a group of preschoolers family members to discuss various health topics. The nurse determines the sexual development session is successful after overhearing which comment by one of the participants?

The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers?

The nurse is assessing a child with acute epiglottitis. Examining the child’s throat by using a tongue depressor might precipitate which symptom or condition?

An infant weighing 6 pounds 3 ounces has morphine 0.5 mg IV q 2 hours prn ordered for post op pain. The recommended dosage for a child is 0.1-0.2 mg/kg/dose q2-4 hours prn. Prove mathematically the ordered dose by the physician (mg/kg/dose) and is it safe to give.

Nursing care of the child who is postoperative from a tonsillectomy should include: (Select All That Apply)?