What should the nurse’s first action be with a child who has a high fever, dysphagia, drooling, tachycardia, and tachypnea?

Correct Answer: D

Rationale: The correct answer is D) Lateral neck x-ray of the soft tissue. The presenting symptoms of high fever, dysphagia, drooling, tachycardia, and tachypnea are indicative of a possible case of epiglottitis, a serious condition that requires immediate medical attention. A lateral neck x-ray is crucial in diagnosing epiglottitis as it can show the characteristic "thumb sign" caused by an enlarged epiglottis. Option A) Immediate IV placement may be necessary but is not the first action to take in this situation. The priority is to diagnose the condition accurately before initiating treatment. Option B) Immediate respiratory treatment may be needed eventually, but the first step is to confirm the diagnosis through diagnostic testing. Option C) Thorough physical assessment is important, but in this case, time is of the essence, and a prompt diagnostic test like a lateral neck x-ray is crucial for timely intervention. In an educational context, it is essential for nurses to recognize the signs and symptoms of pediatric respiratory emergencies like epiglottitis. Quick and accurate assessment followed by appropriate diagnostic testing can make a significant difference in the outcome for the child. This question highlights the importance of prioritizing actions in emergency situations to provide safe and effective care.

Correct Answer: C

Rationale: The correct answer is C) Lateral neck x-ray of the soft tissue. Epiglottitis is a serious condition characterized by inflammation and swelling of the epiglottis, which can lead to airway obstruction. A lateral neck x-ray of the soft tissue is diagnostic for epiglottitis as it can show the classic "thumb sign," indicating a swollen epiglottis. Option A) Blood test is not typically used as a diagnostic tool for epiglottitis. While some blood tests may show signs of inflammation or infection, they are not specific for diagnosing epiglottitis. Option B) Throat swab may be used to test for bacterial infections like streptococcus, but it is not specific for diagnosing epiglottitis. Option D) Signs and symptoms are important in the clinical assessment of a patient suspected of having epiglottitis, but they are not diagnostic on their own. Diagnostic imaging such as a lateral neck x-ray is necessary to confirm the diagnosis. In an educational context, understanding the diagnostic tools for conditions like epiglottitis is crucial for nurses, especially those preparing for exams like the NCLEX. Knowing which tests are appropriate for specific conditions helps nurses provide timely and accurate care to pediatric patients with respiratory issues.

Correct Answer: C

Rationale: The correct answer is C) Administer the amoxicillin until all of the medication is finished. This instruction is crucial to ensure that the infection is completely treated and to prevent the development of antibiotic resistance. It is essential for the parent to understand the importance of completing the full course of antibiotics as prescribed by the healthcare provider. Option A) Continue the amoxicillin until your child's symptoms subside is incorrect because although symptoms may improve before the full course is completed, stopping the antibiotic prematurely can result in incomplete treatment and a higher risk of recurrence or resistance. Option B) Administer an over-the-counter antihistamine with the antibiotic is incorrect as antihistamines are not typically indicated for ear infections and should not be given without specific instructions from a healthcare provider. Option D) Allow your child to administer his own dose of amoxicillin is incorrect as medication administration should always be supervised by an adult to ensure the correct dosage and timing. In an educational context, it is important to emphasize to parents the importance of completing the full course of antibiotics to effectively treat infections and prevent the spread of antibiotic resistance. Parents should be encouraged to ask healthcare providers any questions they may have about the prescribed treatment to ensure proper administration and adherence to the treatment plan.

Correct Answer: B

Rationale: In this question, the correct answer is B) Children with bacterial pneumonia are usually sicker than children with viral pneumonia. This statement is accurate because bacterial pneumonia tends to cause more severe symptoms and complications compared to viral pneumonia in children. Option A is incorrect because while bacterial agents can cause pneumonia, viral agents are actually more common, especially in children. Option C is incorrect as viral pneumonia is generally associated with milder symptoms compared to bacterial pneumonia. Option D is incorrect because viral pneumonia does not require treatment with antibiotics as they are not effective against viruses. Educationally, understanding the differences between bacterial and viral pneumonia is crucial for nurses as it guides appropriate treatment decisions. Nurses must be able to differentiate between the two types of pneumonia based on symptomatology, severity, and causative agents to provide optimal care for pediatric patients with respiratory infections.