It may be difficult to differentiate asthma from bronchiolitis by physical examination, but all the following may be helpful EXCEPT

Correct Answer: B

Rationale: In the context of pediatric respiratory disorders, it is crucial for nursing students to be able to differentiate between asthma and bronchiolitis, as their management and treatment strategies differ. In this question, the correct answer is option B) Wheezing. Wheezing is a common symptom seen in both asthma and bronchiolitis, so it may not be helpful in distinguishing between the two conditions. Option A) Age of presentation is helpful in differentiating asthma (common in older children) from bronchiolitis (common in infants). Option C) Personal history of asthma is relevant as a child with a known history of asthma is more likely to have an asthma exacerbation rather than bronchiolitis. Option D) Family history of asthma may also be helpful in diagnosing asthma in a child presenting with respiratory symptoms. Educationally, understanding these distinctions is vital for nurses caring for pediatric patients with respiratory conditions. By knowing the key differences and similarities between asthma and bronchiolitis, nurses can provide more accurate assessments, interventions, and education to patients and their families.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Mycoplasma pneumoniae. When cold agglutinins are present in peripheral blood samples, it suggests atypical pneumonia, which is commonly caused by Mycoplasma pneumoniae. Mycoplasma pneumoniae is known to cause primary atypical pneumonia, especially in school-aged children and young adults. Option A) Pseudomonas aeruginosa is less likely because it is more commonly associated with nosocomial infections or infections in immunocompromised individuals. Option B) Staphylococcus aureus typically causes bacterial pneumonia in infants and young children, often associated with a more rapid onset and more severe symptoms. Option C) Chlamydia trachomatis is more commonly associated with neonatal conjunctivitis or genitourinary infections rather than pneumonia in pediatric patients. Understanding the specific pathogens associated with different types of pneumonia is crucial for nurses caring for pediatric patients with respiratory disorders. Recognizing the clinical presentations and common etiologies of pneumonia helps in providing timely and appropriate interventions to improve patient outcomes.

Correct Answer: A

Rationale: In the context of nursing care for pediatric respiratory disorders, understanding the diagnostic tests used is crucial for providing effective care. In the case of pulmonary embolism, the diagnostic test of choice is a CT angiogram of the chest (Option A). A CT angiogram is preferred for diagnosing pulmonary embolism because it is non-invasive, readily available, and provides detailed images of the pulmonary vasculature, allowing for accurate detection of blood clots in the lungs. Ventilation-perfusion scans (Option B) are commonly used in adults but are less reliable in pediatric patients due to their developing lung physiology. Doppler or compression ultrasonography (Option C) is not the first-line diagnostic test for pulmonary embolism as it is more commonly used to detect deep vein thrombosis. Pulmonary angiography (Option D) is an invasive procedure and is typically reserved for cases where CT angiogram results are inconclusive or when immediate treatment is needed. Educationally, understanding the rationale behind choosing the appropriate diagnostic test for pulmonary embolism in pediatric patients ensures that nursing professionals can advocate for the most effective and least invasive diagnostic approach, leading to timely and accurate diagnosis and treatment, ultimately improving patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) Hyponatremia, hypochloremia, metabolic alkalosis. Cystic Fibrosis (CF) is a genetic disorder that primarily affects the respiratory and digestive systems. In infants with CF, the pancreas does not secrete enough enzymes for proper digestion, leading to failure to thrive. Respiratory symptoms such as chronic cough and wheezing are also common due to thick mucus buildup in the airways. Electrolyte abnormalities in CF result from excessive salt loss in sweat, leading to hyponatremia (low sodium) and hypochloremia (low chloride). Metabolic alkalosis occurs due to loss of chloride and dehydration. Option A) Hypernatremia, hypochloremia, metabolic alkalosis is incorrect because CF typically presents with hyponatremia, not hypernatremia. Option C) Hyponatremia, hyperchloremia, metabolic alkalosis is incorrect because CF leads to hypochloremia, not hyperchloremia. Option D) Hyponatremia, hypochloremia, metabolic acidosis is incorrect as CF typically results in metabolic alkalosis, not acidosis. Understanding these electrolyte imbalances in CF is crucial for nurses caring for pediatric patients with this condition. Recognizing these key manifestations can lead to early diagnosis and appropriate management, ultimately improving patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Parainfluenza virus. In pediatric respiratory disorders, upper airway infections are commonly caused by viral agents like Parainfluenza virus. This virus is known to cause croup, a condition characterized by barking cough and inspiratory stridor. Option B) Staphylococcus aureus is a bacterial pathogen, not typically associated with upper airway infections in pediatrics. It is more commonly linked to skin and soft tissue infections. Option C) Persistent fetal circulation is a cardiovascular condition seen in newborns, not related to upper airway infections. Option D) Croup is a condition caused by viral infections, particularly by the Parainfluenza virus. It presents with symptoms like barking cough and inspiratory stridor. Educationally, understanding the etiology of pediatric respiratory disorders is crucial for nurses caring for children. Knowing the common pathogens involved in upper airway infections helps in accurate diagnosis and appropriate management. Nurses should be able to differentiate between viral and bacterial causes to provide effective care and educate families on preventive measures.