What is the best intervention for the nurse caring for a child experiencing an acute asthma attack?
Offer plenty of fluids, particularly carbonated beverages.
Place the child in a humidified cool mist tent with oxygen.
Administer sedatives as ordered to decrease anxiety.
Position the child with arms resting on the overbed table.
The Correct Answer is D
Choice A rationale
Offering plenty of fluids is important for hydration and thinning secretions in asthma, but carbonated beverages can cause gastric distension and worsen respiratory distress by pressing on the diaphragm, making them unsuitable. Furthermore, this intervention does not directly address the acute bronchoconstriction that defines an asthma attack.
Choice B rationale
While humidified oxygen might be indicated for hypoxemia, a cool mist tent is not the primary intervention for acute asthma. The core problem is bronchoconstriction, which requires bronchodilators to open the airways. A cool mist tent offers general comfort but does not provide specific therapeutic relief for the underlying pathophysiology.
Choice C rationale
Administering sedatives to a child experiencing an acute asthma attack is generally contraindicated. Sedation can depress respiratory drive, worsen hypoventilation, and mask signs of worsening respiratory distress, potentially leading to respiratory arrest, especially when the child's respiratory effort is already compromised.
Choice D rationale
Positioning the child with arms resting on the overbed table, often referred to as the "tripod position," allows for the use of accessory respiratory muscles (e.g., sternocleidomastoid, scalenes) to facilitate breathing. This position optimizes lung expansion and reduces the work of breathing by providing a stable base for shoulder girdle muscles to pull up the chest cage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Oral rinsing after fluticasone administration helps prevent oral candidiasis by removing residual corticosteroid, but if lesions are already present, this action alone is insufficient. It is a preventive measure, not a treatment for existing fungal or other infections causing lesions.
Choice B rationale
Oral lesions in a client on fluticasone, an inhaled corticosteroid, are highly suggestive of oral candidiasis (thrush) due to local immunosuppression. Obtaining a culture and sensitivity identifies the specific pathogen and its susceptibility to antifungal agents, guiding appropriate and effective treatment. Normal flora includes Candida albicans, but overgrowth leads to infection.
Choice C rationale
Starting a broad-spectrum antibiotic is inappropriate without identifying the causative agent. Oral lesions are more commonly fungal in origin in this context, not bacterial. Unnecessary antibiotic use can lead to antibiotic resistance and disrupt normal flora, potentially worsening a fungal infection.
Choice D rationale
While oral candidiasis is a known side effect of inhaled corticosteroids, simply documenting the finding without further action would be negligent. Prompt identification and treatment of the infection are necessary to prevent discomfort, spread, and potential complications, ensuring the client's well-being.
Correct Answer is A
Explanation
Choice A rationale
A sputum culture for acid-fast bacillus (AFB) is considered the gold standard for confirming the diagnosis of active pulmonary tuberculosis. This test directly identifies the presence of Mycobacterium tuberculosis in respiratory secretions, providing definitive evidence of infection and allowing for drug susceptibility testing, which is crucial for guiding treatment.
Choice B rationale
A chest X-ray can show abnormalities suggestive of pulmonary tuberculosis, such as infiltrates, cavitations, or effusions, but it is not definitive. Other respiratory conditions can present similarly, and a chest X-ray alone cannot confirm the presence of active Mycobacterium tuberculosis. It serves as a supportive diagnostic tool.
Choice C rationale
A sputum smear for acid-fast bacilli provides rapid presumptive evidence of active tuberculosis by visualizing AFB under a microscope. While helpful for early detection and isolation precautions, it does not confirm the species of mycobacteria and has lower sensitivity than culture. A positive smear needs confirmation with culture.
Choice D rationale
The Mantoux test, or tuberculin skin test, indicates exposure to Mycobacterium tuberculosis and the development of a cell-mediated immune response. A positive test signifies either latent TB infection or active disease but cannot differentiate between the two. It does not confirm active pulmonary tuberculosis and is not reliable for confirming active disease.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.