A 5-year-old is noted by the parents to snore at night. The child has also had problems staying awake in preschool and has had behavioral problems. The father also snores. Physical examination of the child reveals large, pink, nonexudative tonsils. The most appropriate next step is

Correct Answer: B

Rationale: The most appropriate next step in this scenario is option B, polysomnography. Polysomnography is a diagnostic test used to evaluate sleep patterns and diagnose sleep disorders, such as obstructive sleep apnea (OSA), which could be the underlying cause of the child's symptoms like snoring, daytime sleepiness, and behavioral issues. In this case, the child's symptoms, along with the presence of enlarged tonsils, are suggestive of OSA, making polysomnography the best choice for further evaluation. Option A, laryngoscopy, is not the most appropriate next step because it focuses on examining the larynx and may not provide comprehensive information about the child's sleep patterns and potential sleep disorder like OSA. Option C, ambulatory apnea monitor, is also not the most appropriate next step as it is used for monitoring breathing patterns at home and may not provide as detailed information as polysomnography in diagnosing sleep disorders. Option D, telemetry, is not relevant in this context as it is a method used for monitoring physiological parameters remotely and is not indicated for the evaluation of sleep disorders in pediatric patients. In an educational context, understanding the importance of appropriate diagnostic tests in pediatric patients with symptoms suggestive of sleep disorders is crucial for nurses working in pediatric settings. Recognizing the signs and symptoms of conditions like OSA in children and knowing the appropriate diagnostic steps can lead to timely interventions and improved outcomes for pediatric patients.

Correct Answer: A

Rationale: The correct answer is A) low in calories. Mushrooms are considered an ideal food choice for various reasons. They are low in calories, making them a great option for individuals looking to manage their weight or calorie intake. Mushrooms are also low in fat, which further contributes to their health benefits. Option B) high in calories is incorrect because mushrooms are not a calorie-dense food. Option C) high in fat is also incorrect as mushrooms are naturally low in fat content. Option D) low in fat is partially correct but not as comprehensive as option A, which specifically highlights the low-calorie aspect of mushrooms. From an educational perspective, understanding the nutritional content of different foods is essential for healthcare professionals, especially in pediatric nursing. Recommending low-calorie, nutritious foods like mushrooms can help promote healthy eating habits among children and their families. It is crucial to provide accurate information to support optimal growth and development in pediatric patients.

Correct Answer: B

Rationale: In this question, the correct answer is B) roving eye movements. Explanation: - Methamphetamine intoxication is associated with roving eye movements due to CNS stimulation. - Organophosphate poisoning can cause symptoms like paresthesias, cranial nerve dysfunction, and seizures. - Bark scorpion envenomation typically presents with localized symptoms like pain, swelling, and redness at the sting site. Educational Context: Understanding the distinctive clinical manifestations of various toxicological exposures is crucial for pediatric nurses. Recognizing specific signs and symptoms can aid in prompt diagnosis and appropriate management, ultimately improving patient outcomes. In this question, identifying roving eye movements as a hallmark of methamphetamine intoxication helps reinforce the importance of precise symptom recognition in pediatric nursing practice.

Correct Answer: C

Rationale: In the context of pediatric nursing, understanding the complications of allergic rhinitis is crucial for providing effective care to children. The most likely clue to a secondary bacterial infection like sinusitis in a child with allergic rhinitis is thick nasal secretions (Option C). Explanation of why Option C is correct: Thick nasal secretions are indicative of a bacterial infection as they suggest the presence of pus or mucus that is typically associated with a bacterial rather than a viral infection. In the case of allergic rhinitis complicated by sinusitis, the change in nasal secretions from clear and watery to thick and discolored is a key indicator of a secondary infection that requires medical attention. Explanation of why other options are wrong: A) Hyperemia: While hyperemia (redness of the nasal mucosa) can occur in both allergic rhinitis and sinusitis, it is a non-specific finding that can be present in various nasal conditions and does not specifically point towards bacterial infection. B) Swollen turbinates: Swollen turbinates are a common feature of allergic rhinitis due to inflammation but are not specific to bacterial infection. D) Bluish mucus membranes: Bluish discoloration indicates cyanosis, which is a sign of inadequate oxygenation and is not typically associated with bacterial sinusitis in the context of allergic rhinitis. Educational context: Understanding the clinical manifestations and potential complications of allergic rhinitis in pediatric patients is essential for nurses caring for children with respiratory conditions. Recognizing the signs of secondary bacterial infections like sinusitis is important for timely intervention and appropriate treatment to prevent further complications and improve patient outcomes. By differentiating between allergic rhinitis symptoms and those indicating a bacterial infection, nurses can provide targeted care and support to pediatric patients effectively.

Correct Answer: C

Rationale: In pediatric nursing, understanding the major risk factors for persistent asthma is crucial for providing effective care to children. The correct answer is C) wheezing apart from colds. This is because persistent asthma is characterized by ongoing symptoms such as wheezing, coughing, chest tightness, and shortness of breath that occur frequently, even in the absence of colds or respiratory infections. Option A) eczema is a common comorbidity with asthma, but it is not the major risk factor for persistent asthma. Option B) allergic rhinitis is also a common condition associated with asthma, but it is not the primary risk factor for persistent asthma. Option D) food allergen sensitization may contribute to asthma exacerbations in some children, but it is not considered the major risk factor for persistent asthma. Educationally, it is important to recognize the key indicators of persistent asthma to differentiate it from intermittent asthma and provide appropriate management and treatment. By understanding the major risk factors, nurses can help educate families on asthma triggers, symptom management, and the importance of adherence to asthma action plans for long-term control.