What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find?

Fine crackles.

Coarse rhonchi.

Expiratory wheezing.

Decreased breath sounds at lung bases.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Fine crackles are typically associated with fluid in the small airways or alveoli, as seen in conditions like pneumonia or heart failure, rather than the bronchoconstriction characteristic of asthma. During an acute asthma attack, the primary issue is narrowing of the bronchioles, leading to different adventitious sounds.

Choice B rationale

Coarse rhonchi are often indicative of secretions in larger airways, which can be cleared by coughing. While some mucus production can occur in asthma, coarse rhonchi are not the classic or primary auscultatory finding during an acute asthma attack, where airway smooth muscle constriction is the dominant pathology.

Choice C rationale

Expiratory wheezing is the hallmark auscultatory finding in an acute asthma attack. It is produced by the turbulent flow of air through narrowed lower airways, particularly during exhalation, as the bronchial smooth muscles constrict, and the airways become obstructed due to inflammation and mucus plugging.

Choice D rationale

Decreased breath sounds at the lung bases can indicate poor air entry into those areas, often due to atelectasis, pleural effusion, or severe airway obstruction. While severe asthma can lead to diminished breath sounds if airflow is severely compromised, expiratory wheezing is the more specific and classic initial finding during an acute exacerbation.

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Correct Answer is A

Explanation

Choice A rationale

Oseltamivir, an antiviral neuraminidase inhibitor, is most effective when administered within 48 hours of influenza symptom onset. It works by inhibiting the viral neuraminidase enzyme, preventing the release of new virions from infected cells, thereby reducing viral spread and shortening the duration and severity of illness, if given early.

Choice B rationale

Rest is indeed important for recovery from influenza, as it conserves energy and allows the immune system to combat the infection. However, decreasing fluid intake is contraindicated; adequate hydration is crucial to prevent dehydration, especially with fever, and to help thin respiratory secretions, facilitating their clearance.

Choice C rationale

Influenza is a viral infection; therefore, antibiotics, which target bacterial pathogens, are ineffective against the influenza virus itself. Administering antibiotics would be inappropriate and could contribute to antibiotic resistance without providing therapeutic benefit for the viral illness, unless a secondary bacterial infection is suspected.

Choice D rationale

Admission to an acute care facility is generally reserved for severe cases of influenza, such as those with respiratory distress, hypoxemia, or significant comorbidities. For a patient whose symptoms started only 24 hours prior and without severe complications, outpatient management with antiviral therapy is typically sufficient.

A. Before exercise to prevent attacks. B. At the initial onset of the attack. C. During the attack to relieve symptoms. D. As often as 4 times a day.

Correct Answer is A

Explanation

Choice A rationale

Cromolyn is a mast cell stabilizer that works by inhibiting the release of inflammatory mediators (e.g., histamine, leukotrienes) from mast cells. Its mechanism of action is prophylactic, meaning it prevents the cellular cascade leading to bronchospasm when administered before exposure to a trigger, such as exercise. It has no bronchodilatory effect.

Choice B rationale

Administering cromolyn at the initial onset of an attack is ineffective because it does not have acute bronchodilatory properties. Once the inflammatory cascade is initiated and bronchoconstriction has begun, cromolyn cannot reverse the symptoms. Rescue inhalers like albuterol are needed for acute symptom relief.

Choice C rationale

Cromolyn is a prophylactic medication and does not provide symptomatic relief during an acute asthma attack. Its role is to stabilize mast cells to prevent the release of inflammatory mediators that cause bronchoconstriction and inflammation. Therefore, it is not used to alleviate symptoms once an attack is in progress.

Choice D rationale

While cromolyn can be prescribed for regular daily use, the specific instruction for exercise-induced asthma is to take it before exercise. Taking it as often as 4 times a day without considering the timing relative to triggers may not be optimal for preventing exercise-induced symptoms, as its effect is primarily preventive.

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What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who presents with symptoms of influenza that started 24 hours ago is seen by the health care provider. Which intervention does the nurse expect for this patient?

Correct Answer is A

Explanation

What should the nurse explain to the parent of a child with exercise-induced asthma about when to inhale Cromolyn?

Correct Answer is A

Explanation

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