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 C

Explanation

A. A highly pruritic profuse macule to papule rash on the trunk.
Explanation: This description does not align with the typical presentation of erythema infectiosum. The rash in fifth disease is not highly pruritic, and the initial characteristic is the "slapped face" appearance.
B. A discrete pinkish red maculopapular rash that is spreading to the trunk.
Explanation: While erythema infectiosum can involve a discrete rose-pink maculopapular rash on the trunk and limbs, the key initial characteristic is the "slapped face" appearance.
C. An erythema on the face that has a "slapped face appearance."
Explanation:
Erythema infectiosum, caused by the parvovirus B19, is commonly known as fifth disease. The initial rash often presents with a distinctive "slapped face" appearance, characterized by erythema (redness) on the cheeks, resembling a slapped appearance. Subsequently, a discrete rose-pink maculopapular rash may develop on the trunk and limbs.
D. A discrete rose-pink maculopapular rash on the trunk.
Explanation: This description aligns with the later stages of the rash in erythema infectiosum. However, the initial characteristic is the "slapped face" appearance on the face.

A. when a parent is holding the infant B. During sleep C. When changing the infant's diapers D. When drawing blood for electrolyte level testing

Correct Answer is D

Explanation

A. When a parent is holding the infant
Explanation: Being held by a parent is generally a comforting and calming experience for an infant, and it is unlikely to significantly increase oxygen demand. In fact, the presence of a familiar caregiver may help reduce stress.
B. During sleep
Explanation: During sleep, an infant's oxygen demand may decrease, and oxygen supplementation may not be necessary unless there are specific indications or concerns about oxygen saturation levels.
C. When changing the infant's diapers
Explanation: Changing a diaper is a routine care activity that is not likely to significantly increase oxygen demand. It is not typically associated with stress or increased metabolic activity that would necessitate additional oxygen.
D. When drawing blood for electrolyte level testing
Explanation:
Drawing blood for electrolyte level testing is a potentially stressful procedure that may cause distress and anxiety in the infant. Stress and anxiety can increase the metabolic rate and oxygen demand. In a situation where an infant is already prescribed oxygen as needed for heart failure, additional stressors like blood drawing may necessitate the administration of oxygen to ensure an adequate oxygen supply

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

On assessment, the school nurse notes that the child has a rash. The nurse suspects that the child has erythema infectiosum (fifth disease). because the skin assessment revealed a rash that has which characteristics?

Correct Answer is C

Explanation

A pediatrician has prescribed oxygen as needed for an infant with heart failure. Which situation would likely increase the oxygen demand. requiring the nurse to administer oxygen to the infant?

Correct Answer is D

Explanation

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse would make which response?

A nurse is admitting a child who has suspected epiglottitis. Which of the following actions should the nurse take first?

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?

A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?

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