Blood cultures should be performed on hospitalized children to attempt to diagnose a bacterial cause of pneumonia. Blood cultures are positive in

Correct Answer: A

Rationale: Blood cultures are an essential diagnostic tool in identifying the bacterial cause of pneumonia in hospitalized children. The correct answer is A) 10% to 20% of bacterial pneumonia. This range represents the typical positivity rate of blood cultures in bacterial pneumonia cases. Blood cultures help identify the specific bacterial pathogen responsible for the infection, guiding appropriate antibiotic therapy. Option B) 20% to 30% is incorrect because blood cultures are generally positive in a lower percentage of cases than this range. Option C) 30% to 40% and Option D) 40% to 50% are also incorrect as they overestimate the positivity rate of blood cultures in bacterial pneumonia cases. Educationally, understanding the diagnostic procedures for pneumonia, such as blood cultures, is crucial for nurses caring for pediatric patients. This knowledge helps in timely and accurate identification of the causative organism, leading to effective treatment and improved patient outcomes. Nurses need to be familiar with the expected positivity rates of diagnostic tests to interpret results correctly and collaborate with healthcare providers in providing optimal care for pediatric patients with pneumonia.

Correct Answer: B

Rationale: The correct answer is B) 20%. In Cystic Fibrosis (CF), approximately 20% of patients are born with intestinal obstruction caused by inspissated meconium, known as meconium ileus. This is a key feature of CF due to the thick, sticky mucus that affects various organs in the body, including the intestines. Option A) 10% is incorrect because the prevalence of meconium ileus in CF is higher than 10%. Option C) 30% and Option D) 40% are also incorrect as they overestimate the percentage of CF patients born with meconium ileus. Educationally, understanding the prevalence of meconium ileus in CF is crucial for nurses caring for pediatric patients with this condition. Recognizing this early sign can lead to prompt intervention and management, improving outcomes for these patients. It also highlights the multisystem nature of CF and the importance of a comprehensive approach to care.

Correct Answer: D

Rationale: In this scenario, the most likely diagnosis is choanal atresia (Option D). Choanal atresia is a congenital condition where there is a blockage of the posterior nasal passage, leading to respiratory distress, especially in newborns. In this case, the infant's initial ability to cry vigorously and then sudden onset of cyanosis and respiratory distress point towards a possible airway obstruction, which aligns with choanal atresia. Option A, tracheoesophageal fistula, would typically present with symptoms such as choking, coughing, and respiratory distress immediately after birth due to abnormal connection between the trachea and esophagus. Option B, pneumothorax, would present with sudden onset respiratory distress, but the inability to pass a nasogastric tube is not consistent with this diagnosis. Option C, persistent fetal circulation, would not typically present with sudden respiratory distress and cyanosis after an initial period of normalcy. Educationally, this question highlights the importance of recognizing the signs and symptoms of choanal atresia in newborns, as prompt diagnosis and intervention are critical for the infant's well-being. Understanding common respiratory conditions in newborns is essential for pediatric nurses to provide timely and appropriate care in emergent situations.

Correct Answer: C

Rationale: The correct answer is C) a pulmonary embolism. In this case, the clinical presentation of an 18-year-old female with chest pain, tachypnea, cyanosis, and a Pao2 of 60 mm Hg on 40% oxygen suggests a pulmonary embolism. This condition occurs when a blood clot travels to the lungs, obstructing blood flow and causing respiratory distress. Option A) pre-eclampsia is unlikely as the symptoms described are more indicative of a pulmonary issue rather than a hypertensive disorder related to pregnancy. Option B) Legionella pneumonia is less likely as the symptoms and presentation do not align with typical pneumonia symptoms such as fever and productive cough. Option D) hysterical hyperventilation is improbable given the severity of the symptoms and the presence of objective findings like low Pao2 levels. Educationally, this question highlights the importance of recognizing the signs and symptoms of a pulmonary embolism, especially in young adults with risk factors like recent childbirth. Understanding the clinical manifestations and appropriate diagnostic steps is crucial in the timely management of this life-threatening condition. This scenario also emphasizes the significance of differentiating between various respiratory conditions based on clinical presentations to provide optimal patient care.

Correct Answer: D

Rationale: The correct answer for the treatment of the 3-year-old in Question 11 being D) catheter snare removal is based on the scenario presented, which likely involves a foreign body being lodged in the airway. In pediatric respiratory emergencies, prompt removal of the obstruction is crucial to ensure adequate oxygenation. Catheter snare removal is a method commonly used to extract foreign bodies from the airway in pediatric patients, as it allows for precise and controlled retrieval. Option A) amoxicillin is an antibiotic and not appropriate for the immediate treatment of an airway obstruction. Option B) hydrogen peroxide is a disinfectant and should not be used in the airway. Option C) local anesthesia followed by suction is not suitable for acute airway obstruction in a pediatric patient. In an educational context, it is essential for nurses to be well-versed in pediatric respiratory emergencies, including the appropriate interventions for airway obstructions. Understanding the correct treatment modalities can make a significant difference in the outcomes of pediatric patients experiencing respiratory distress. Nurses must be prepared to act quickly and decisively in such critical situations to ensure the safety and well-being of their young patients.