When caring for a child diagnosed with bronchiolitis, what is the priority nursing intervention?

Correct Answer: B

Rationale: The priority nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention aims to maintain airway patency, optimize oxygenation, and support effective breathing. Administering bronchodilators, though important, may not be the initial priority as respiratory therapy takes precedence in ensuring adequate oxygenation and ventilation. Monitoring oxygen saturation is crucial but is usually part of the ongoing assessment following the initiation of respiratory therapy. Encouraging fluid intake is essential for hydration but is not the priority intervention when addressing the respiratory distress associated with bronchiolitis.

Correct Answer: A

Rationale: The correct answer is to rotate injection sites. This practice helps prevent lipodystrophy, a localized loss of fat tissue that can affect insulin absorption. By rotating sites, the child can avoid developing lumps or indentations in the skin where insulin is repeatedly injected. Administering insulin before meals (choice B) may be necessary for certain types of insulin but is not the priority when teaching about insulin administration. Storing insulin in the refrigerator (choice C) is important for maintaining its potency, but it is not the primary emphasis when teaching about insulin administration. Administering insulin at bedtime (choice D) may be necessary based on the child's insulin regimen but is not the primary consideration for teaching injection techniques and site rotation.

Correct Answer: A

Rationale: The priority nursing intervention when caring for a child with cystic fibrosis is administering pancreatic enzymes. Cystic fibrosis is a genetic disorder that affects the digestive and respiratory systems. Administering pancreatic enzymes is crucial in aiding digestion as patients with cystic fibrosis often have pancreatic insufficiency. While providing respiratory therapy and encouraging physical activity are important aspects of care for individuals with cystic fibrosis, administering pancreatic enzymes takes precedence in addressing the malabsorption issues associated with the condition. Encouraging frequent handwashing is also essential in infection control, but it is not the priority intervention specifically related to managing cystic fibrosis.

Correct Answer: B

Rationale: The priority nursing intervention for a 5-year-old child admitted to the hospital with bacterial meningitis is to isolate the child. Isolating the child is crucial to prevent the spread of infection to others, as bacterial meningitis is highly contagious. Administering antibiotics (Choice A) is important in the treatment of bacterial meningitis, but isolating the child takes precedence to protect others. Monitoring vital signs (Choice C) and administering fluids (Choice D) are essential aspects of care for a child with meningitis but are not the priority intervention to prevent the spread of the infection.

Correct Answer: D

Rationale: In this scenario, the priority nursing action for the adolescent with diabetes and a fasting blood glucose level of 180 mg/dL at 6:30 AM is to tell the adolescent that the prescribed dose of rapid-acting insulin should be administered (Option D). Administering insulin is crucial to help lower the elevated blood glucose level and prevent potential complications of hyperglycemia. Option A, encouraging exercise, is not appropriate as the immediate focus should be on addressing the high blood glucose level. Exercise may further elevate blood glucose levels in this situation. Option B, asking for an immediate glucometer reading, is not the priority because the fasting blood glucose level is already known to be high. Immediate intervention is needed rather than just obtaining another reading. Option C, suggesting a complex carbohydrate such as cheese, is not appropriate as this would not effectively address the high blood glucose level. Insulin administration is needed to bring the blood glucose level down quickly and effectively. In an educational context, it is essential for pediatric nurses to understand the critical importance of timely intervention in managing diabetes in adolescents. This scenario highlights the significance of prioritizing insulin administration to address hyperglycemia promptly and prevent potential complications. Nurses should be knowledgeable about appropriate interventions and understand the impact of different actions on blood glucose levels in diabetic patients.