Who should address organ donation first at the bedside?

The primary nurse caring for the client.

The social worker.

The organ procurement coordinator.

The attending physician.

Answer and Explanation

The Correct Answer is C

Choice A rationale

The primary nurse, while having a close relationship with the client and family, is not typically the first professional to address organ donation. Their role involves providing direct medical care and support, and discussing organ donation could introduce a conflict of interest or compromise the therapeutic relationship during a sensitive time.

Choice B rationale

The social worker provides psychosocial support and resource navigation. While they may be involved in discussions about end-of-life care, initiating the organ donation conversation is a specialized role requiring specific training and adherence to legal and ethical guidelines, which typically falls outside their initial scope.

Choice C rationale

The organ procurement coordinator is specifically trained and legally authorized to discuss organ donation with families. They possess the necessary knowledge about the donation process, ethical considerations, and legal requirements, ensuring the conversation is handled sensitively and accurately, minimizing distress for the family.

Choice D rationale

The attending physician’s primary responsibility is the medical care of the patient. Introducing the topic of organ donation could potentially be perceived as abandoning care or create a conflict of interest. While they may support the coordinator, direct initiation by the physician is generally avoided to maintain trust and focus on patient care.

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Correct Answer is []

Explanation

Condition: Spasmodic croup
2 actions: Administer a single dose of oral dexamethasone; Position the child upright and provide humidified air
2 parameters: Respiratory rate and oxygen saturation; Stridor and work of breathing

Rationale for correct condition
Spasmodic croup presents in toddlers with sudden onset of nighttime barking cough without fever. It is often associated with atopy, such as eczema. The child is playful and afebrile with no daytime distress. Lungs are clear with normal oxygen saturation (98%) and respiratory rate (28/min; normal 20–40/min for toddlers). No infectious signs are present, supporting a diagnosis of spasmodic croup.

Rationale for correct actions
Oral dexamethasone reduces airway inflammation in croup and decreases symptom duration through corticosteroid-mediated cytokine inhibition. A single dose is effective in mild-to-moderate cases, reducing subglottic edema.
Positioning the child upright and using humidified air improves airflow by decreasing upper airway narrowing and soothing inflamed mucosa. It is a first-line supportive measure to alleviate nocturnal symptoms.

Rationale for correct parameters
Monitoring respiratory rate and oxygen saturation assesses oxygenation and ventilation status. Tachypnea or desaturation may signal worsening airway obstruction.
Stridor and work of breathing are key signs of upper airway compromise. Increased inspiratory effort or stridor at rest requires escalation of care.

Rationale for incorrect conditions
Respiratory syncytial virus causes wheezing, fever, and lower respiratory symptoms, which are absent here.
Epiglottitis presents with high fever, drooling, and toxic appearance, not seen in this playful child.
Acute laryngitis lacks the barking cough and is uncommon in toddlers.

Rationale for incorrect actions
Preparing for intubation is reserved for airway obstruction, which is not present.
Broad-spectrum antibiotics are ineffective in non-bacterial etiologies like croup.
Ribavirin targets RSV, which this child does not have.

Rationale for incorrect parameters
Swallowing ability and drooling assess epiglottitis, not croup.
Fever and WBC count are normal and nonspecific.
Wheezing and lung sounds assess lower airway disease, not upper airway croup.

Take-home points:

Spasmodic croup causes nighttime barking cough without fever in toddlers.
Differentiate from RSV (wheezing), epiglottitis (drooling), and laryngitis (hoarseness).
Steroids and humidified air reduce symptoms in mild croup.
Key assessments include stridor and respiratory status, not fever or wheezing.

A. You should allow your child to play any sport they want to play. B. You should allow your child to participate in age-appropriate activities, such as riding a bike using proper protective gear. C. You should not allow your child to play any sport due to the risk of injury. D. You should not allow your child to ride a bike or go skateboarding with their classmates.

Correct Answer is B

Explanation

Choice A rationale

Allowing a child with hemophilia to participate in any sport without restriction significantly increases the risk of severe bleeding episodes, especially in contact sports. Hemophilia involves a deficiency in clotting factors, making even minor trauma potentially life-threatening due to uncontrolled hemorrhage, which can lead to joint damage, organ damage, or intracranial bleeding, severely impacting their long-term health and mobility.

Choice B rationale

Encouraging participation in age-appropriate, low-impact activities like cycling with proper protective gear promotes physical activity and psychosocial development. This approach minimizes the risk of traumatic injuries that could trigger bleeding while still fostering a sense of normalcy and social integration. Regular physical activity also helps maintain muscle strength and joint integrity, which can be beneficial in managing hemophilia.

Choice C rationale

Completely restricting a child with hemophilia from all sports or physical activity can negatively impact their physical and psychological well-being. While safety is paramount, total avoidance can lead to muscle atrophy, obesity, and social isolation. A balanced approach that allows for modified, safe activities is crucial for holistic development, promoting self-esteem and peer interaction.

Choice D rationale

Discouraging activities like bike riding or skateboarding even with classmates, implies excessive restriction. While high-risk activities should be avoided, moderate-risk activities can be managed with appropriate precautions, such as helmets and padding. This extreme limitation can hinder the child's physical development, social integration, and mental health, leading to feelings of difference and isolation from peers.

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Who should address organ donation first at the bedside?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

Correct Answer is B

Explanation

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