Which clinical presentation is most indicative of a patient with mild persistent asthma?
Daily symptoms with nighttime episodes more than once a week.
Symptoms occur more than twice a week but not daily, with nighttime episodes three to four times a month.
Symptoms occur less than twice a week, with nighttime episodes less than twice a month.
Symptoms occur continually with frequent exacerbations.
The Correct Answer is B
Asthma classification is based on the frequency of daytime symptoms and nocturnal awakenings. Knowledge of the National Asthma Education and Prevention Program guidelines is required to correctly categorize severity, which dictates the pharmacological "step" therapy for pediatric patients.
Choice A rationale
Daily symptoms with nighttime episodes occurring more than once a week characterize moderate persistent asthma. This level of severity requires a higher dose of inhaled corticosteroids and potentially long-acting beta-agonists to maintain adequate pulmonary function.
Choice B rationale
Mild persistent asthma is defined by symptoms occurring more than twice weekly but less than daily. Nighttime awakenings happen three to four times per month. This classification necessitates the daily use of a low-dose anti-inflammatory controller.
Choice C rationale
Symptoms less than twice a week and nighttime episodes less than twice a month define intermittent asthma. This category typically only requires a rescue inhaler, such as albuterol, for as-needed use during acute bronchospasm episodes.
Choice D rationale
Continual symptoms throughout the day and frequent nighttime awakenings are indicative of severe persistent asthma. This reflects significantly limited physical activity and requires high-intensity therapy to prevent life-threatening exacerbations and maintain airway patency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This question involves pediatric cardiology and the long-term sequelae of autoimmune responses. Knowledge of the inflammatory process triggered by Group A Streptococcus and its specific affinity for endocardial tissue is required to identify the most significant chronic health complication.
Choice A rationale
Rheumatic fever causes permanent scarring and thickening of the heart valves, particularly the mitral valve. This inflammatory damage leads to stenosis or regurgitation, necessitating long-term monitoring and potentially surgical valve replacement later in life to prevent heart failure.
Choice B rationale
While viral infections cause myocarditis, rheumatic fever is an autoimmune reaction following a bacterial infection. The primary pathology is not a direct viral invasion of the muscle but a cross-reactive immune response against the heart's own connective tissues.
Choice C rationale
Hypertension is typically associated with genetics, renal issues, or lifestyle factors like diet and inactivity. It is not a direct pathological consequence of the acute inflammatory process or the autoimmune mechanisms characterized by rheumatic fever or its cardiac involvement.
Choice D rationale
Myocardial infarction in pediatrics is rare and usually linked to congenital coronary anomalies or Kawasaki disease. Rheumatic fever specifically targets the valves and endocardium rather than the coronary arteries, making ischemia a less likely direct risk than valvular destruction.
Correct Answer is C
Explanation
This scenario involves a potential pediatric abuse situation requiring immediate nursing intervention. Application of the nursing process (assessment before action) and legal mandates for reporting suspected maltreatment is necessary to determine the priority step when physical indicators of injury are observed.
Choice A rationale
Discussing bruises with a parent may be necessary later, but it is not the immediate priority. If abuse is occurring, confronting the parent before completing a thorough assessment or ensuring child safety could potentially put the child at further risk.
Choice B rationale
Reporting to protective services is mandatory, but the nurse must first gather all clinical evidence. A complete physical exam provides the detailed data needed for an accurate and comprehensive report, ensuring all injuries are documented before the report is filed.
Choice C rationale
The nurse must first assess the child to identify the full extent of injuries and ensure physical stability. Systematic assessment allows for the discovery of hidden bruises or fractures, which is essential for both medical treatment and legal documentation.
Choice D rationale
Documentation is essential for legal and clinical purposes but follows the actual assessment. The nurse cannot document the full clinical picture accurately without performing a head-to-toe examination first to find all potential markers of physical trauma.
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