What classic sign would the nurse, auscultating breath sounds of a child hospitalized for an asthma attack, expect to find?
Expiratory Wheezing
Fine Crackles
Coarse rhonchi
Decreased breath sounds at the lung bases
The Correct Answer is A
A. Expiratory Wheezing: Expiratory wheezing is a classic sign of an asthma attack. It occurs due to narrowing and inflammation of the airways, which causes turbulent airflow during exhalation. Wheezing typically gets louder during expiration as the airways are more constricted during this phase of breathing.
B. Fine Crackles: Fine crackles are often heard in conditions like pneumonia or heart failure, where fluid is present in the lungs. They are not a hallmark of asthma.
C. Coarse Rhonchi: Coarse rhonchi are low-pitched sounds often associated with mucous secretions in the larger airways, but they are not the classic finding in asthma, where wheezing predominates.
D. Decreased Breath Sounds at the Lung Bases: Decreased breath sounds can indicate severe respiratory distress or a condition like pleural effusion or atelectasis. However, in asthma, breath sounds are usually more prominent during wheezing and are not typically decreased in the absence of complications.
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Related Questions
Correct Answer is C
Explanation
A. Inhaled steroid: Inhaled corticosteroids are used for long-term control of asthma and are not typically used during an acute asthma attack. They work by reducing inflammation, but they do not provide immediate relief of bronchoconstriction.
B. Oral leukotriene modifiers: Leukotriene modifiers are used for long-term asthma management, but they are not effective in providing quick relief during an acute asthma attack.
C. Inhaled beta agonist: Beta agonists (e.g., albuterol) are the first-line treatment for quick relief during an asthma attack. They work by relaxing the muscles around the airways to improve airflow and relieve symptoms like chest tightness and coughing.
D. Oral steroids: Oral steroids (e.g., prednisone) are used for severe asthma exacerbations, but they are not used as the first-line treatment for quick relief of symptoms like tight chest and cough. They take time to reduce inflammation.
Correct Answer is D
Explanation
A. Keep the child home from school for at least 1 week: The child should stay home for at least 24 hours after starting antibiotics, not 1 week, to prevent spreading the infection.
B. Intramuscular injections will be required monthly: This is incorrect. Monthly intramuscular injections of penicillin are used for prophylaxis to prevent rheumatic fever, not for the treatment of acute group A β-hemolytic streptococcal infections.
C. Avoid the use of warm compresses around the head or neck: Warm compresses are not contraindicated for sore throats associated with group A strep infections unless there is an abscess or specific complication. This statement is not relevant.
D. Replace the child's toothbrush after 24 hours of taking antibiotics: The toothbrush should be replaced after 24 hours to prevent re-infection, as the child may still have bacteria in their mouth that can reintroduce the infection.
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