The nurse in the emergency department is caring for a child who appears extremely ill with a high fever, unable to control their oral secretions. with voice hoarseness and inspiratory stridor and inspiratory sternal retractions while breathing. The nurse suspects epiglottitis. Which would the nurse do next?

Contact the assigned emergency room physician to evaluate the need for an advanced airway

Administer intravenous corticosteroids

Obtain a throat culture

inspect the throat to obtain further data to support the diagnosis

Answer and Explanation

The Correct Answer is A

A. Contact the assigned emergency room physician to evaluate the need for an advanced airway
Explanation:
Epiglottitis is a medical emergency that can rapidly progress to airway obstruction. The classic signs and symptoms include a high fever, difficulty swallowing, voice hoarseness, inspiratory stridor, and sternal retractions. Immediate intervention may be necessary to secure the airway. Therefore, contacting the emergency room physician to evaluate the need for an advanced airway (such as intubation) is a priority.
B. Administer intravenous corticosteroids
Explanation: While corticosteroids may be used in the management of epiglottitis to reduce airway inflammation, securing the airway is the priority in the acute phase. Corticosteroids would typically be administered after securing the airway.
C. Obtain a throat culture
Explanation: Obtaining a throat culture is not the immediate priority in the case of suspected epiglottitis. Prompt intervention to secure the airway takes precedence over diagnostic tests.
D. Inspect the throat to obtain further data to support the diagnosis
Explanation: Direct visualization of the throat (inspection) may exacerbate the airway obstruction and is not recommended in the acute management of suspected epiglottitis. The priority is to secure the airway while minimizing agitation and discomfort for the child. Diagnostic procedures, such as obtaining a throat culture, can be considered after the airway is stabilized.

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Correct Answer is ["A","D","F"]

Explanation

A.Move furniture away from the child.
Explanation: Creating a safe environment is important during a seizure. Moving furniture away from the child helps prevent injury.
B.Place the child in a prone position.
Explanation: Placing the child in a prone position (face down) is not recommended. The child should be placed on their side to allow for drainage of oral secretions and to prevent aspiration.
C. Restrain the child.
Explanation: Restraint is generally not recommended during a seizure, as it may cause injury to the child or the person providing care. Allow the seizure to run its course, and focus on keeping the environment safe.
D.Time the seizure.
Explanation: Timing the duration of the seizure is important for medical evaluation and management. Note the start and end times of the seizure.
E. Insert a padded tongue blade in the child's mouth.
Explanation: Inserting any object, including a padded tongue blade, into the child's mouth during a seizure is not recommended. This can lead to oral and dental injuries. Maintaining a clear airway and protecting the child from injury are priorities.
F. Stay with the child.
Explanation: Staying with the child provides support and ensures the child's safety during the seizure. It also allows the caregiver to observe and provide information to healthcare professionals.

A. A urinary output of 30 mL/hr B. A white blood cell (WBC) count of 10.000 mm3 (10×109/L) C. Decreased breath sounds in the lung bases D. A weight gain

Correct Answer is C

Explanation

A. A urinary output of 30 mL/hr
Explanation: While decreased urinary output may indicate dehydration, it is not a specific finding related to pertussis. Dehydration can occur due to inadequate fluid intake or loss through vomiting or sweating.
B. A white blood cell (WBC) count of 10,000 mm3 (10×10^9/L)
Explanation: An elevated white blood cell count is a common finding in infections, including pertussis. It reflects the body's immune response to the infection. A WBC count of 10,000 mm3 is within the normal range, and while it indicates an inflammatory response, it does not specifically point to a complication.
C. Decreased breath sounds in the lung bases
Explanation:
Pertussis is a respiratory infection caused by the bacterium Bordetella pertussis. Complications can arise, including pneumonia. Decreased breath sounds in the lung bases may suggest the presence of pneumonia, which is a serious complication of pertussis. Pneumonia can lead to respiratory distress and requires prompt medical attention.
D. A weight gain
Explanation: Weight gain is not typically associated with pertussis. In fact, respiratory distress and difficulty feeding during coughing paroxysms can lead to weight loss in infants with pertussis. Weight gain may be indicative of other unrelated factors.

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Naxlex Comprehensive Predictor Exams

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply.

Correct Answer is ["A","D","F"]

Explanation

The nurse performs an assessment of a child with pertussis (whooping cough). Which finding would the nurse identify as indicative of a potential complication?

Correct Answer is C

Explanation

The nurse is assessing a child admitted with a diagnosis of rheumatic fever. Which significant question would the nurse ask the child's parent during the assessment?

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A nurse is caring for a child who is experiencing a seizure. Which of the following actions should the nurse take?

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