A nurse is assessing a child with asthma. Which of the following signs or symptoms would indicate that the child's asthma is poorly controlled?

Correct Answer: C

Rationale: In the context of assessing a child with asthma, frequent nighttime awakenings due to coughing would indicate that the child's asthma is poorly controlled. This is because nighttime coughing is a common symptom of asthma exacerbation and indicates increased airway inflammation and constriction during the night. Option A, the child using a peak flow meter daily, is actually a sign of good asthma management as it helps monitor lung function and detect early signs of worsening asthma. Option B, the child being able to perform normal activities without limitations, could be misleading as asthma symptoms can vary throughout the day and may not be reflective of the overall control of the condition. Option D, the child having no difficulty breathing during physical activity, does not specifically address nighttime symptoms, which are crucial indicators of asthma control. Educationally, understanding the signs of poorly controlled asthma in children is essential for nurses caring for pediatric patients with asthma. Recognizing nighttime symptoms is particularly important as they can impact a child's sleep quality and overall health. Nurses must be vigilant in assessing and monitoring asthma symptoms to provide timely interventions and prevent exacerbations.

Correct Answer: B

Rationale: In the initial treatment of a burn injury in a child, the priority intervention is to remove the child from the heat source (Option B). This is because stopping the burning process is crucial to prevent further injury and tissue damage. By removing the child from the heat source, the burn can be contained and further injury minimized. Applying cold compresses (Option A) is not recommended as it can lead to vasoconstriction and further damage to the skin. Covering the burn with butter or oil (Option C) is also contraindicated as it can trap heat and increase the risk of infection. Cleaning the burn with soap and water (Option D) is not recommended initially as it can cause further damage and increase the risk of infection. Educationally, it's important for nurses to understand the appropriate first aid measures for burn injuries in children to provide safe and effective care. Teaching this information to nursing students prepares them to respond promptly and effectively in emergency situations involving burn injuries in pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) Using prescribed medications as directed. In managing a child with chronic asthma, using prescribed medications as directed is crucial for controlling and preventing asthma exacerbations. Medications such as bronchodilators and anti-inflammatory drugs help to reduce airway inflammation, open up airways, and decrease the frequency of asthma attacks. Educating parents about the importance of medication adherence empowers them to effectively manage their child's condition and improve their quality of life. Option A) Limiting the child's physical activity is incorrect because regular physical activity is beneficial for children with asthma as it helps to improve lung function and overall health. Option C) Reducing fluid intake during asthma attacks is incorrect as maintaining proper hydration is important, especially during asthma exacerbations, to help thin mucus and keep airways moist. Option D) Encouraging exposure to allergens to build immunity is incorrect as it can trigger asthma symptoms and exacerbate the condition. Avoiding allergen exposure is essential in asthma management. In an educational context, it is crucial for nurses to provide comprehensive asthma management education to parents, including proper medication use, recognizing asthma triggers, and when to seek medical help. This empowers parents to play an active role in managing their child's asthma and promoting better health outcomes.

Correct Answer: A

Rationale: Educational Rationale: The correct answer is A) Clean and dry. This is because moisture and dirt in the ears can create a breeding ground for bacteria, leading to ear infections. By keeping the child's ears clean and dry, the risk of developing infections is reduced. Educating parents on proper ear hygiene practices is crucial in preventing recurrent ear infections in children with a history of such issues. Option B) Covered with earplugs when swimming is incorrect because while it is important to prevent water from entering the ears during swimming to avoid swimmer's ear, covering the ears with earplugs all the time can also trap moisture and lead to infections. Option C) Rinsed with a vinegar solution is incorrect as this practice is not recommended for routine ear care in children. While vinegar can be used in specific cases under healthcare provider guidance, it is not a general preventive measure for ear infections. Option D) Exposed to cold air to prevent infection is incorrect as exposing the ears to cold air does not prevent ear infections. In fact, sudden exposure to cold air can sometimes cause discomfort and may not be beneficial in preventing infections. In an educational context, it is essential for nurses to provide parents with accurate information and guidance on how to maintain good ear hygiene practices for their children. By explaining the rationale behind the correct answer and debunking misconceptions related to other options, nurses can empower parents to take proactive measures in preventing ear infections in their children.

Correct Answer: D

Rationale: The correct answer is D) Infection. When caring for a child who has received a solid organ transplant, monitoring for infection is crucial due to the immunosuppressive medications these children are typically on to prevent organ rejection. These medications weaken the immune response, making the child more susceptible to infections. Infections can quickly become life-threatening in immunocompromised individuals, so vigilant monitoring and early intervention are essential. Option A) Rejection of the transplanted organ is a possible complication but typically presents with more specific signs and symptoms like organ dysfunction rather than being a common immediate concern post-transplant. Option B) Hyperglycemia is a potential complication post-transplant due to the effects of immunosuppressive medications, but infection poses a more immediate and serious threat to the child's health. Option C) Fluid overload is a concern in some cases after transplant due to changes in kidney function or medication side effects, but infection is a more urgent and critical issue to monitor for in the immediate post-transplant period. Educational context: Understanding the unique challenges faced by pediatric patients who have undergone organ transplants is crucial for nurses. Recognizing the potential complications and knowing how to prioritize and respond to them effectively can significantly impact the outcomes for these vulnerable patients. By focusing on infection prevention and early detection, nurses can help ensure the best possible care and outcomes for these children.