Which child requires urgent care?

An 18-month-old who has high fever, coughs hard, and has a runny nose.

A one-year-old who has a slight fever, a rash, and green secretions.

Answer and Explanation

The Correct Answer is A

Choice A rationale

An 18-month-old who has a high fever, coughs hard, and has a runny nose requires urgent care. High fever in a child can be a sign of a serious infection or other medical condition. The hard coughing could indicate a respiratory issue such as bronchitis or pneumonia, which can be serious in young children. The runny nose is another symptom of a possible respiratory infection.

Choice B rationale

A one-year-old who has a slight fever, a rash, and green secretions may not require urgent care but should still be seen by a healthcare provider. A slight fever can be a sign of a minor infection, which may resolve on its own or with over-the-counter remedies. However, a rash

and green secretions could indicate a bacterial infection, which may require antibiotic treatment.

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Correct Answer is D

Explanation

Choice A rationale

While providing oxygen can be important in the care of a newborn with esophageal atresia, it is not the first priority. These babies often have difficulty breathing, but this is usually due to the abnormal connection between the esophagus and the trachea (tracheoesophageal fistula), which allows stomach acid to enter the lungs. Oxygen therapy alone does not address this underlying problem.

Choice B rationale

Placing the infant in an isolette or radiant warmer is not the first priority. While maintaining the baby’s body temperature is important, it does not address the immediate risks associated with esophageal atresia.

Choice C rationale

Obtaining a stat chest X-ray can be part of the diagnostic process for esophageal atresia, but it is not the first priority. The diagnosis is usually suspected based on symptoms such as frothy bubbles in the mouth and nose, coughing or choking when feeding, and difficulty breathing.

Choice D rationale

Elevating the head of the bed 30 to 35 degrees is the first priority. This position helps to prevent aspiration of gastric contents into the lungs, which can occur due to the abnormal connection between the esophagus and the trachea (tracheoesophageal fistula) that is often present in babies with esophageal atresia.

A. These therapies will decrease our child’s resistance to respiratory infections. B. These therapies will only be done when our child is showing signs of illness. C. These therapies will help to loosen our child’s secretions and allow for better expectoration. D. These therapies will allow for the removal of mucus from our child’s GI tract that blocks digestion.

Correct Answer is C

Explanation

Choice A rationale

These therapies will decrease our child’s resistance to respiratory infections. This statement is incorrect. The therapies mentioned - chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine - do not directly decrease a child’s resistance to respiratory infections.

Instead, they help manage the symptoms of cystic fibrosis by helping to clear mucus from the lungs, which can improve lung function and reduce the risk of lung infections.

Choice B rationale

These therapies will only be done when our child is showing signs of illness. This statement is incorrect. These therapies are part of the daily management of cystic fibrosis and are typically done regularly, not just when the child is showing signs of illness.

Choice C rationale

These therapies will help to loosen our child’s secretions and allow for better expectoration. This statement is correct. The goal of these therapies is to help clear thick, sticky mucus from the lungs, which can improve breathing and reduce the risk of lung infections.

Choice D rationale

These therapies will allow for the removal of mucus from our child’s GI tract that blocks digestion. This statement is incorrect. While cystic fibrosis can affect the digestive system by causing thick mucus to block the tubes that carry digestive enzymes from your pancreas to your small intestine, the therapies mentioned are primarily used to help clear mucus from the lungs.

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Which child requires urgent care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a newborn suspected to have esophageal atresia. Which of the following interventions must be the FIRST priority?

Correct Answer is D

Explanation

The parents of a 7-year-old recently diagnosed with cystic fibrosis have received discharge instructions for chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine.Which of the following statements by the parents indicates understanding of the discharge instructions?

Correct Answer is C

Explanation

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