Predisposing risk factors for obstructive sleep apnea and hypoventilation include all of the following EXCEPT

Correct Answer: D

Rationale: In pediatric respiratory nursing, understanding predisposing risk factors for conditions like obstructive sleep apnea and hypoventilation is crucial for providing effective care. In this question, the correct answer is D) Hashimoto disease. Hashimoto disease is an autoimmune condition affecting the thyroid gland and is not typically associated with an increased risk of obstructive sleep apnea or hypoventilation. On the other hand, options A, B, and C are known risk factors for these respiratory issues in children. Obesity is a well-established risk factor for obstructive sleep apnea as excess weight can lead to airway obstruction during sleep. Trisomy 21 (Down syndrome) is also associated with a higher risk of obstructive sleep apnea due to anatomical factors such as a smaller airway. Sickle cell anemia can result in hypoventilation due to chronic lung disease and respiratory muscle weakness. Educationally, this question highlights the importance of recognizing specific risk factors for respiratory conditions in pediatric patients. By understanding these predisposing factors, nurses can implement appropriate screening, monitoring, and interventions to optimize respiratory health in children.

Correct Answer: D

Rationale: In the context of a post-tonsillectomy assessment in a child, the most concerning observation is option D) Swallowing excessively. This is because excessive swallowing could indicate bleeding, which is a critical post-operative complication that requires immediate medical attention. Bleeding after a tonsillectomy is a serious concern due to the rich blood supply to the tonsil area. Option A) Elevated heart rate and blood pressure could be expected in the immediate post-operative period due to the stress of surgery, anesthesia, and pain; however, it is not the most concerning observation in this context. Option B) Complaining of a sore throat is a common and expected symptom after a tonsillectomy due to the surgical removal of the tonsils, so it is not the most concerning observation. Option C) Refusing to eat solid foods is also a common occurrence after a tonsillectomy due to throat discomfort, so it is not as concerning as the potential sign of bleeding indicated by excessive swallowing. Educationally, this question highlights the importance of recognizing and prioritizing critical assessment findings in pediatric post-operative care. It underscores the need for nurses to be vigilant in monitoring for signs of complications, especially in procedures with potential risks like tonsillectomies. Nurses must be prepared to intervene promptly and effectively to ensure the safety and well-being of pediatric patients in the post-operative period.

Correct Answer: C

Rationale: The correct answer is C) Change the child to a higher-calorie formula. In pediatric cystic fibrosis (CF), there is a higher metabolic demand due to increased work of breathing and poor nutrient absorption. Therefore, meeting the nutritional needs of infants with CF is crucial for growth and development. Choosing a higher-calorie formula helps ensure that the infant receives adequate calories to support growth despite potential malabsorption issues common in CF. Option A) Increasing the number of fresh fruits and vegetables is not sufficient to meet the high caloric needs of infants with CF. While fruits and vegetables are nutritious, they may not provide the necessary calorie density required. Option B) Advancing the child's diet to whole cow's milk is not recommended for infants with CF because whole cow's milk is difficult to digest and may exacerbate gastrointestinal symptoms common in CF, such as malabsorption and diarrhea. Option D) Increasing the child's carbohydrate intake alone may not address the overall increased caloric needs of infants with CF. While carbohydrates are an essential energy source, focusing solely on carbohydrates may not provide the necessary nutrients and calories required for optimal growth in CF. Educationally, it is important to understand the specific nutritional needs of children with chronic conditions like CF to provide appropriate care and support. By choosing a higher-calorie formula, healthcare providers can better ensure that infants with CF receive the necessary nutrients to thrive despite the challenges posed by the disease.

Correct Answer: A

Rationale: The correct answer is option A) A 2-month-old born at 32 weeks' gestation is at the highest risk for requiring hospitalization to treat respiratory syncytial virus (RSV). Rationale: 1. Premature infants, especially those born before 35 weeks' gestation, are at higher risk for severe RSV infections due to their immature immune systems and underdeveloped lungs. This places them at increased risk for respiratory distress and complications requiring hospitalization. 2. Option B) A 16-month-old with a tracheostomy is at risk for respiratory complications; however, the highest risk for severe RSV infection leading to hospitalization lies with premature infants due to their vulnerability. 3. Option C) A 3-year-old with a congenital heart defect is at increased risk for respiratory infections, but the highest risk for severe RSV infection requiring hospitalization is in premature infants. 4. Option D) A 4-year-old born at 30 weeks' gestation is also at risk for RSV infection, but the highest risk remains with the 2-month-old born at 32 weeks' gestation due to their younger age and corresponding vulnerability. Educational Context: Understanding the risk factors for severe RSV infection leading to hospitalization is crucial for pediatric nurses. Knowledge of high-risk populations allows nurses to provide targeted education to parents, implement preventative measures, and recognize early signs of respiratory distress in vulnerable infants. This knowledge is essential for delivering optimal care and improving outcomes for pediatric patients with RSV infections.

Correct Answer: B

Rationale: In the context of a child with an acute asthma exacerbation, the most important laboratory result is an Arterial Blood Gas (ABG). ABG provides crucial information about the child's respiratory status by measuring oxygenation, acid-base balance, and carbon dioxide levels in the blood. In acute asthma, ABG helps assess the severity of respiratory distress, the effectiveness of oxygenation, and the need for interventions like oxygen therapy or ventilatory support. The other options (A) Complete Blood Count (CBC), (C) Blood Urea Nitrogen (BUN), and (D) Partial Thromboplastin Time (PTT) are not as relevant in assessing respiratory status during an acute asthma exacerbation. A CBC provides information about the child's overall health and immune system but does not directly assess respiratory function. BUN is a measure of kidney function and hydration status, while PTT evaluates blood clotting factors, neither of which directly indicate respiratory status in asthma. In an educational context, understanding the rationale behind choosing the correct laboratory test (ABG) is crucial for nurses caring for pediatric patients with respiratory conditions. It enables nurses to interpret results accurately, make informed clinical decisions, and provide timely interventions to optimize patient outcomes in acute situations like asthma exacerbations.