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 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.

A. Painting pictures in the art corner of the room B. Watching a movie with other children their age C. Playing a board game D. Pretending to be mommies and daddies in the playhouse

Correct Answer is D

Explanation

A. Painting pictures in the art corner of the room:

Painting pictures in the art corner can be a fun and creative activity for preschoolers. It allows them to express themselves through art and develop fine motor skills. However, it might not be a group activity unless they are sharing materials and ideas.

B. Watching a movie with other children their age:

Watching a movie can be an enjoyable activity for preschoolers, especially if the content is age-appropriate. However, it is a passive activity, and group interactions might be limited during the movie.

C. Playing a board game:

Playing a board game can be a good group activity that involves turn-taking, following rules, and social interaction. However, some board games may be more suitable for older children who have developed certain cognitive and social skills.

D. Pretending to be mommies and daddies in the playhouse:

Pretend play, such as pretending to be mommies and daddies in a playhouse, is a developmentally appropriate and common activity for preschoolers. It encourages imaginative play, role-playing, and social interaction, helping with emotional and social development.

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Naxlex Comprehensive Predictor Exams

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

The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in?

Correct Answer is D

Explanation

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