What measure at home could help a child with an upper respiratory infection breathe more easily?
Playing "rapid breathing" games.
Enforcing strict bed rest.
Limiting fluid intake.
Increasing room humidity.
The Correct Answer is D
Choice A rationale
Rapid breathing games would worsen the child's condition. Rapid breathing, or hyperventilation, can lead to respiratory alkalosis, which is an imbalance in the body's acid-base balance. It can also cause dehydration and further irritate the respiratory tract, increasing the child's discomfort and potentially exacerbating the symptoms of the upper respiratory infection.
Choice B rationale
Enforcing strict bed rest is generally not necessary and can sometimes be detrimental. While rest is important, complete immobility can increase the risk of complications such as pneumonia due to a lack of lung expansion. Moderate activity is often encouraged to prevent pooling of secretions and to maintain normal respiratory function.
Choice C rationale
Limiting fluid intake is contraindicated. Adequate hydration is crucial for a child with an upper respiratory infection. Fluids help to thin respiratory secretions, making them easier to clear from the airways, and prevent dehydration, which can be a significant risk, especially if the child has a fever.
Choice D rationale
Increasing room humidity is a beneficial measure. Humidified air helps to soothe inflamed respiratory passages and moisten secretions, making them less viscous and easier for the child to cough up. This can significantly reduce nasal congestion, cough, and throat irritation, improving the child's ability to breathe comfortably.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Methylergonovine is a vasoconstrictor that stimulates smooth muscle contraction in the uterus to control postpartum hemorrhage. However, this vasoconstrictive effect is not limited to the uterus and can cause a systemic increase in blood pressure. The medication is contraindicated in patients with hypertension, with a systolic blood pressure greater than 140 mm Hg or a diastolic blood pressure greater than 90 mm Hg, to prevent a hypertensive crisis or cerebrovascular accident.
Choice B rationale
Hematocrit is the percentage of red blood cells in the blood and is used to assess for anemia or polycythemia. A normal hematocrit range for women is 37-47%. While anemia is a common concern postpartum, and a low hematocrit may indicate significant blood loss, it is not a primary contraindication for methylergonovine administration. The drug's primary side effect is related to blood pressure, not hematological status.
Choice C rationale
Urine output is an indicator of renal perfusion and overall hydration status. A normal urine output is typically greater than 30 ml/hr. While decreased urine output could indicate hypovolemia or renal dysfunction, it is not a direct contraindication for methylergonovine. The medication's effect on blood pressure is the primary safety consideration, not its effect on renal function or urine output.
Choice D rationale
Dizziness or lightheadedness can be a sign of orthostatic hypotension or blood loss. Assessing for dizziness is an important part of a postpartum assessment, but it is not a specific contraindication for methylergonovine. The medication's primary risk is hypertension, which is not directly related to a client's baseline experience of dizziness. A baseline blood pressure measurement is a more specific and crucial assessment.
Correct Answer is D
Explanation
Choice A rationale
Applying butter to a burn is a harmful practice. Butter holds heat against the skin, which can worsen the tissue damage. Additionally, it can trap bacteria, increasing the risk of infection. The oil in the butter can also interfere with proper medical evaluation and treatment of the burn.
Choice B rationale
Wrapping the child in a blanket and rushing him to the hospital is not the first action. The immediate priority is to stop the burning process. The heat from the scalding tea continues to damage tissue. A blanket can also retain heat and worsen the burn. The priority is to cool the skin first.
Choice C rationale
Removing the shirt is a good idea to prevent the trapped heat from worsening the burn, but applying burn ointment is not the first action. Immediate cooling with water is the priority. Burn ointments can trap heat and complicate medical assessment, as they must be removed before the burn can be properly evaluated.
Choice D rationale
Pouring cool water over the affected skin is the immediate and most effective first action. The cool water stops the burning process by dissipating the heat from the skin, minimizing the depth and severity of the burn. This action prevents further tissue damage and reduces pain.
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