The nurse is providing care to a 4-month-old infant in the emergency department. Upon assessment, the infant is noted to be experiencing tachypnea, wheezing, retractions, and nasal flaring. The infant has large amounts of nasal drainage. The infant is irritable, and the pulse ox reading is currently at 85% on room air. The parents state the symptoms have been consistent for about two days, but they brought the child in due to concerns for dehydration with decreased milk intake. Which diagnosis does the nurse anticipate for this infant?
Pneumonia
Active pulmonary tuberculosis
RSV
Croup
The Correct Answer is C
Choice A reason: Pneumonia could present with these symptoms, but it is less likely in this case due to the specific combination of symptoms described.
Choice B reason: Active pulmonary tuberculosis is less common in infants and does not typically present with these acute symptoms.
Choice C reason: This is the correct choice. The symptoms described are characteristic of Respiratory Syncytial Virus (RSV), especially in infants.
Choice D reason: Croup could cause some of these symptoms, but it is more commonly associated with a distinctive barking cough and stridor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Non-opioid analgesics are typically not strong enough to manage the severe pain associated with a sickle cell crisis.
Choice B reason: Guided imagery can be a helpful adjunct, but it is not the primary method of pain control during a crisis.
Choice C reason: Diversional activities may help distract from the pain but are not sufficient as the sole method of pain management.
Choice D reason: This is the correct choice. An IV PCA (patient-controlled analgesia) allows the child to manage pain effectively and is appropriate for severe pain during a sickle cell crisis.
Correct Answer is B
Explanation
Choice A reason: Discussing the child's previous history of injury is important, but it does not address the immediate concern of pain management.
Choice B reason: Consulting with a practitioner to determine safe analgesia options is crucial for managing pain while also monitoring the child's variable consciousness levels.
Choice C reason: While it is true that analgesia can mask neurological symptoms, it is essential to manage pain effectively, and the healthcare team can monitor for changes in consciousness.
Choice D reason: Teaching the family about specific medications like benzodiazepines is not the most immediate concern and should be left to the practitioner's discretion based on the child's condition. Pain management and safety are the priorities.
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