The MOST common non-infectious cause of inspiratory stridor in infants is

Correct Answer: D

Rationale: In pediatric respiratory assessment, knowing the causes of inspiratory stridor in infants is crucial for accurate diagnosis and appropriate intervention. The correct answer is D) Laryngomalacia. Laryngomalacia is the most common cause of inspiratory stridor in infants, characterized by the inward collapse of the supraglottic structures during inspiration. Subglottic stenosis (A) is a narrowing of the airway below the vocal cords and typically presents with biphasic stridor. Laryngeal web (B) is a congenital anomaly where a membrane partially obstructs the airway, leading to stridor. Airway hemangioma (C) is a vascular growth that can cause airway obstruction and stridor, but it tends to present with a different quality of stridor. Educationally, understanding these distinctions is vital for nurses caring for pediatric patients. Recognizing laryngomalacia as a common cause of inspiratory stridor in infants helps in prompt identification and management, ensuring optimal respiratory outcomes for these vulnerable patients. Nurses should be adept at differentiating various causes of stridor through comprehensive assessments to provide timely and effective interventions.

Correct Answer: C

Rationale: The correct answer is C) Adenovirus type 21. Swyer-James syndrome, or unilateral hyperlucent lung, is a condition characterized by focal or unilateral hyperlucency of the lung due to pulmonary vascular hypoplasia, air trapping, and reduced bronchial size following severe necrotizing pneumonia in childhood. Adenovirus type 21 is specifically associated with the development of this syndrome due to its propensity to cause severe necrotizing pneumonia, leading to the described radiographic findings. Option A) Influenza virus is incorrect because although influenza can cause severe respiratory infections, it is not specifically linked to Swyer-James syndrome. Option B) Parainfluenza virus is also incorrect as it primarily causes upper respiratory tract infections and is not a known cause of this syndrome. Option D) Rhinovirus is incorrect as it is a common cause of the common cold and generally does not lead to the severe necrotizing pneumonia associated with Swyer-James syndrome. Understanding the specific viral etiology associated with Swyer-James syndrome is crucial for pediatric nurses as it informs their assessment, management, and education of patients and families. Recognizing the link between Adenovirus type 21 and this syndrome can aid in early identification and appropriate interventions to prevent long-term complications. This knowledge enhances the nurse's ability to provide comprehensive care and support to pediatric patients with respiratory conditions.

Correct Answer: A

Rationale: In pediatric respiratory assessment, sweat testing is a crucial diagnostic tool for conditions like cystic fibrosis. False negative results on sweat testing can occur in conditions that impact the sweat production or composition. The correct answer, "A) Edema," can lead to false negative results as it causes swelling and accumulation of fluid in the interstitial spaces, affecting the sweat secretion and composition. Option B) Eczema does not directly affect sweat production or composition, so it would not result in false negatives on sweat testing. Option C) Hypothyroidism and Option D) Dehydration may affect sweat quantity but not significantly alter the composition to cause false negatives on sweat testing for cystic fibrosis. In an educational context, understanding the factors that can influence sweat testing results is vital for nurses and healthcare providers who care for pediatric patients. This knowledge ensures accurate interpretation of diagnostic tests, leading to timely and appropriate interventions. Nurses must be able to differentiate conditions that can impact test results to provide optimal care for children undergoing respiratory assessments.

Correct Answer: C

Rationale: In this scenario, the most likely diagnosis for the adolescent presenting with sudden onset respiratory distress, cyanosis, retractions, and markedly decreased breath sounds over the left lung is C) Pneumothorax. A pneumothorax occurs when air enters the pleural space, leading to lung collapse. The sudden onset of symptoms like respiratory distress, cyanosis, and decreased breath sounds are indicative of a pneumothorax, especially in a healthy adolescent with no significant medical history. Now, let's analyze why the other options are incorrect: A) Empyema: This is an accumulation of pus in the pleural space, usually due to a bacterial infection. While it can cause respiratory symptoms, it typically presents with fever, cough, and chest pain, which are not described in the case. B) Chylothorax: This is a condition where lymphatic fluid (chyle) accumulates in the pleural space. It is more commonly seen in conditions like thoracic duct injury or lymphatic malformations and does not typically present with the sudden onset of symptoms described. D) Staphylococcal pneumonia: This is a bacterial infection of the lung tissue caused by Staphylococcus aureus. While pneumonia can present with respiratory distress and decreased breath sounds, the sudden onset and unilateral nature of the symptoms described in the case are more indicative of a pneumothorax. In an educational context, understanding the differential diagnosis of respiratory distress in pediatric patients is crucial for nurses to provide timely and appropriate care. Recognizing the signs and symptoms of various respiratory conditions, like pneumothorax, empowers healthcare providers to initiate prompt interventions and prevent potential complications.

Correct Answer: B

Rationale: In pediatric respiratory assessment, understanding streptococcal pharyngitis is crucial for accurate diagnosis and treatment. The correct answer, B) once-a-day amoxicillin is ineffective therapy, is right because the standard treatment for streptococcal pharyngitis is a 10-day course of penicillin or amoxicillin given multiple times a day to maintain therapeutic levels. Once-a-day dosing may not achieve the necessary sustained levels for effective treatment. Option A is incorrect because reculturing is indeed necessary to confirm eradication of the bacteria, even if signs have improved, to prevent recurrence or complications. Option C is incorrect as the carrier state of streptococcal pharyngitis can increase the risk of rheumatic fever due to ongoing exposure to the bacteria. Option D is incorrect because treatment within 10 days of onset of symptoms helps prevent rheumatic fever, but it does not guarantee prevention. In an educational context, it is essential to emphasize the importance of appropriate antibiotic selection, dosing regimen, and duration in the treatment of streptococcal pharyngitis to prevent complications like rheumatic fever. Educating healthcare providers on evidence-based guidelines for diagnosis and management of pediatric respiratory infections is crucial for optimal patient outcomes.