When is it generally recommended that a child being treated for acute streptococcal pharyngitis may return to school?

The correct answer is choice C. Dyspnea.

Choice A rationale:

Orthopnea. Orthopnea refers to difficulty in breathing that occurs when lying flat. It is not the term used to describe labored breathing, which is the main concern in this question.

Choice B rationale:

Hypopnea. Hypopnea is a term used to describe shallow or slow breathing, usually during sleep. It is not the term used to describe the labored breathing mentioned in the question.

Choice C rationale:

Dyspnea. This is the correct term to describe labored breathing, which is characterized by a subjective sensation of discomfort or difficulty in breathing. In this context, the nurse is charting that the hospitalized child has labored breathing, indicating the need for further assessment and intervention to address this breathing difficulty.

Choice D rationale:

Tachypnea. Tachypnea refers to abnormally fast breathing. While it is a concern, especially in the context of a hospitalized child, it does not specifically describe labored breathing, which is the main focus of this question.

The correct answer is choice C. Asthma.

Choice A rationale:

A foreign body in the trachea can cause acute respiratory distress and a sudden cough, but it is unlikely to cause chronic nonproductive cough and diffuse wheezing during the expiratory phase of respiration. The symptoms in the scenario are more suggestive of a chronic condition.

Choice B rationale:

Bronchiolitis primarily affects infants and young children, causing symptoms such as fever, rhinorrhea, and wheezing. While wheezing can be present, the diffuse wheezing during the expiratory phase described in the scenario is more characteristic of asthma.

Choice C rationale:

Asthma is characterized by chronic inflammation of the airways, leading to episodes of bronchoconstriction and increased airway reactivity. The chronic, nonproductive cough and diffuse wheezing during the expiratory phase are classic signs of asthma. Expiratory phase wheezing occurs due to the narrowing of the smaller airways during expiration.

Choice D rationale:

Pneumonia is an infection of the lung tissue and can cause productive cough, fever, and crackles on auscultation. While wheezing might occur in pneumonia due to inflammation and narrowing of the airways, it's not the most likely cause of the symptoms described in the scenario.