Which child requires urgent emergency medical intervention?
A 6-month-old who has a high fever, dysphagia, stridor, and a muffled cry.
A 13-year-old who has a high fever, stridor, and purulent secretions.
A 2-year-old who has a barky cough, is afebrile, and has mild intercostal retractions.
A 5-year-old who has an abrupt onset of moderate respiratory distress, a mild fever, and a barky cough.
The Correct Answer is A
Choice A rationale
A 6-month-old who has a high fever, dysphagia, stridor, and a muffled cry. This child is showing signs of epiglottitis, a severe and life-threatening condition that requires immediate medical attention. Epiglottitis is characterized by inflammation and swelling of the epiglottis, the flap at the base of the tongue that keeps food from going into the windpipe. Symptoms include high fever, difficulty swallowing (dysphagia), stridor (a high-pitched wheezing sound caused by disrupted airflow), and a muffled or hoarse voice. In severe cases, it can lead to complete blockage of the airway, which is a medical emergency.
Choice B rationale
A 13-year-old who has a high fever, stridor, and purulent secretions. While these symptoms are concerning and require medical attention, they are not as immediately life-threatening as the symptoms presented in Choice A. The presence of purulent secretions suggests a bacterial infection, which while serious, can typically be treated with antibiotics.
Choice C rationale
A 2-year-old who has a barky cough, is afebrile, and has mild intercostal retractions. These symptoms suggest croup, a common childhood condition that causes a barky cough and mild breathing difficulties. While croup can be distressing, it is usually not life-threatening and can often be managed at home with supportive care.
Choice D rationale
A 5-year-old who has an abrupt onset of moderate respiratory distress, a mild fever, and a barky cough. These symptoms also suggest croup. While this child is experiencing moderate respiratory distress, which requires medical attention, it is not as immediately life-threatening as the symptoms presented in Choice A2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Seizures, confusion, and weakness are symptoms that a nurse should anticipate when assessing a child suffering from hypotonic hyponatremia with a sodium level below 114
mEq/L2. Severe hyponatremia can lead to cerebral edema, resulting in neurologic symptoms such as seizures and confusion.
Choice B rationale
Mild tingling and numbness in fingers are not typically associated with hyponatremia. These symptoms are more commonly associated with conditions affecting the nervous system or with electrolyte imbalances such as hypocalcemia.
Choice C rationale
Frequent urination and fluid retention are not typical symptoms of hyponatremia. They are more commonly associated with conditions such as kidney disease or heart failure.
Choice D rationale
A temperature of 96°F orally and drowsiness are not specific symptoms of hyponatremia. While drowsiness can occur with severe hyponatremia due to cerebral edema, a low body temperature is not typically associated with this condition.
Correct Answer is A
Explanation
Choice A rationale
Supervising the child in outdoor, fenced play areas is a key safety measure for toddlers. At this age, children are exploring their environment and may not be aware of potential dangers.
Fenced play areas provide a safe space for the child to play while still being under the watchful eye of the parents. This demonstrates an understanding of the child’s safety needs.
Choice B rationale
Allowing a toddler to cross the street with a 6-year-old sibling is not a safe practice. Children at this age do not have the cognitive ability to understand the dangers of traffic and cannot make safe decisions about when to cross the street. Therefore, this action does not demonstrate an understanding of the child’s safety needs.
Choice C rationale
Using an automobile booster seat with a lap belt is not appropriate for an 18-month-old toddler. According to safety guidelines, children under the age of 2 should be in a rear-facing car seat, and children between the ages of 2 and 4 should be in a forward-facing car seat with a harness. Booster seats are typically used for older children who have outgrown their forward- facing car seats. Therefore, this action does not demonstrate an understanding of the child’s safety needs.
Choice D rationale
Teaching a toddler about swimming and water safety is important, but it is not enough to ensure the child’s safety. Toddlers should always be supervised around water, even if they have had swimming lessons. Drowning is a leading cause of death in toddlers, and it can happen quickly and silently. Therefore, while teaching water safety is a good step, it needs to be combined with other safety measures.
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