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 B
Explanation
Choice A rationale
An average daily intake of about 3,000 calories is too high for a toddler. The recommended caloric intake for a toddler varies depending on age, size, and activity level, but it is generally much lower than 3,000 calories.
Choice B rationale
“The quality of food I provide him is more important than the quantity.”. This statement indicates an understanding of the teaching. It’s important to focus on providing nutrient-dense foods rather than just a large quantity of food.
Choice C rationale
Expecting an increased appetite in a toddler is not necessarily accurate. Toddlers often have variable appetites and may eat well one day and eat very little the next.
Choice D rationale
Giving a toddler an adult vitamin is not recommended. Toddlers have different nutritional needs than adults, and some vitamins and minerals can be harmful in large amounts. It’s better to focus on providing a balanced diet.
Correct Answer is ["A","B","E"]
Explanation
The nurse should include the following information in the teaching about home safety for a 10- month-old infant:
- Keep plastic bags and plastic grocery bags in a secure place. Plastic bags pose a choking hazard for young children who can easily put them over their heads and suffocate.
- Serve food in small pieces no larger than a cheerio. This reduces the risk of choking, as infants have limited chewing ability and can easily swallow large pieces of food whole.
E. Use plastic covers on all electrical outlets. This prevents the infant from sticking fingers or objects into the outlet, which could lead to electrical shock.
However, the following information is incorrect and should not be included:
C. Lower the crib rails to the lowest level. While lowering the crib rails might seem convenient, it actually increases the risk of the infant climbing out and potentially falling and injuring themselves. Crib rails should be kept at the highest level possible once the infant can sit up on their own.
D. Set the water heater to 65°C (149°F). This temperature is scalding hot and can cause severe burns in infants. The recommended safe water heater temperature is 120°F (48.9°C) or lower to prevent accidental scalding.
Therefore, the correct selections are A, B, and E. The nurse should emphasize the importance of creating a safe environment for the infant by keeping choking hazards out of reach, serving food in appropriate sizes, and preventing access to electrical outlets. Additionally, the nurse should educate parents about the safe water heater temperature to avoid scalding risks.
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