The sweat chloride test, which is still the standard diagnostic test for cystic fibrosis (CF), is positive if sweat chloride more than

Correct Answer: D

Rationale: The correct answer is D) 70 mEq/L for the sweat chloride test to be considered positive for cystic fibrosis (CF). This test is used to measure the amount of chloride in sweat, as individuals with CF have higher levels of chloride due to the dysfunctional CFTR gene. A result of 70 mEq/L or higher indicates a positive test for CF. Option A) 40 mEq/L is incorrect because this level is below the threshold for a positive result in the sweat chloride test for CF. Option B) 50 mEq/L is also below the threshold. Option C) 60 mEq/L is closer but still below the critical value of 70 mEq/L that indicates a positive test for CF. Educational context: Understanding the diagnostic tests for cystic fibrosis, such as the sweat chloride test, is crucial for pediatric nurses working with children who may have this genetic condition. By knowing the correct threshold for a positive result, nurses can assist in the early identification and management of CF in pediatric patients. This knowledge is essential for providing optimal care and support to children and families affected by cystic fibrosis.

Correct Answer: D

Rationale: The most likely diagnosis for the l-year-old presenting with acute cough, choking, and respiratory distress after playing with sunflower seeds is foreign body aspiration, making option D the correct answer. Foreign body aspiration occurs when a solid or liquid object is inhaled into the airway, leading to airway obstruction and respiratory symptoms like wheezing and rapid breathing. In this scenario, the history of playing with sunflower seeds and the sudden onset of symptoms are classic indicators of foreign body aspiration in pediatric patients. Option A, anaphylaxis, is less likely in the absence of a known allergen exposure or typical allergic symptoms like hives or swelling. Bronchiolitis (option B) typically presents with viral respiratory symptoms like cough and wheezing, but in this case, the history of foreign body ingestion is more compelling. Cystic fibrosis (option C) is a genetic disorder with chronic respiratory issues, but it is less likely in the absence of a family history and with the acute presentation described. Educationally, understanding the common presentations and risk factors for foreign body aspiration in pediatric patients is crucial for nurses caring for children. Prompt recognition and intervention are essential to prevent complications and ensure positive outcomes in cases of airway obstruction. Nurses must be vigilant in assessing for foreign body aspiration in children who present with sudden respiratory distress, especially after playing with small objects like seeds.

Correct Answer: D

Rationale: The correct answer is D) foreign body. In a pediatric patient with unilateral nasal discharge that is malodorous and blood tinged, a foreign body lodged in the nasal passage should be suspected. Young children are curious and tend to put objects in their noses, leading to such symptoms. Option A) tertiary syphilis is unlikely in a 3-year-old with these symptoms as it is a rare presentation in this age group. Option B) unilateral choanal atresia would present with bilateral nasal obstruction, not unilateral discharge. Option C) chronic rhinovirus infection typically presents with more generalized upper respiratory symptoms rather than unilateral discharge. In an educational context, it is important for nurses to recognize common pediatric respiratory conditions and their presentations to provide appropriate care. Understanding the significance of unilateral symptoms in children, along with the need for prompt assessment and intervention in cases of foreign body aspiration, is crucial for pediatric nursing practice.

Correct Answer: C

Rationale: In this question, the correct answer is C) juvenile nasopharyngeal angiofibroma. A mass in the same nostril as the epistaxis is a key indicator of this condition. Juvenile nasopharyngeal angiofibroma is a benign but locally aggressive vascular tumor that commonly presents with unilateral nasal obstruction and recurrent epistaxis in adolescent males. Option A) encephalocele is a congenital defect where brain tissue protrudes through a defect in the skull, not related to the nasal mass or epistaxis. Option B) neuroepithelioma is a malignant tumor that typically presents in soft tissues, not in the nasal cavity. Option D) Hodgkin disease is a type of lymphoma that does not typically present with a mass in the nasal cavity or epistaxis. In an educational context, understanding the specific signs and symptoms of pediatric respiratory conditions is crucial for nurses, especially when preparing for exams like the NCLEX. This question reinforces the importance of recognizing key clinical manifestations to differentiate between various pediatric respiratory conditions and provide appropriate care.

Correct Answer: C

Rationale: The correct answer is C) laryngomalacia. Laryngomalacia is the most likely diagnosis based on the presentation of noisy breathing since birth, worsened supine position, retractions, mild thoracic deformity, and inspiratory stridor. Laryngomalacia is a common cause of stridor in infants due to the floppiness of the supraglottic structures, leading to airway obstruction during inspiration. Option A) diaphragmatic hernia is unlikely because it typically presents with respiratory distress shortly after birth, not noisy breathing since birth. Option B) tracheoesophageal fistula typically presents with choking, coughing, and cyanosis during or after feeding, not noisy breathing since birth. Option D) choanal atresia usually presents with nasal obstruction and respiratory distress, not necessarily noisy breathing and stridor since birth. Educationally, understanding the different respiratory conditions in pediatric patients is crucial for nurses taking the NCLEX. Recognizing the unique presentations of each condition helps in accurate diagnosis and timely intervention, which can be life-saving in pediatric respiratory emergencies.