what is the priority nursing intervention for a child with epiglottitis
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Nursing Elites

ATI RN

ATI Nursing Care of Children 2019 B

1. What is the priority nursing intervention for a child with epiglottitis?

Correct answer: B

Rationale: The correct answer is B: Maintain airway patency. When dealing with a child with epiglottitis, the priority nursing intervention is to ensure airway patency to prevent airway obstruction, which can lead to respiratory distress or failure. Administering antibiotics (choice A) is important to treat the infection, but airway management takes precedence. Providing hydration (choice C) and monitoring vital signs (choice D) are essential aspects of care but are secondary to securing the airway in a child with epiglottitis.

2. The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?

Correct answer: C

Rationale: Testicular torsion is a surgical emergency requiring immediate medical evaluation. Applying heat or elevating the legs will not alleviate the torsion, and delaying care can lead to testicular necrosis.

3. A new mom is ready to introduce solid foods to her infant. Which food would you recommend starting with?

Correct answer: B

Rationale: The correct answer is B: Rice cereal. Rice cereal is typically the first solid food introduced to infants because it is easy to digest and unlikely to cause an allergic reaction. Starting with rice cereal helps assess the baby's readiness for solid foods and reduces the risk of allergic responses. Choice A (Meat) is not recommended as the initial solid food due to its higher allergenic potential. Choices C (Fruits) and D (Vegetables) are also not usually recommended as the first solid food, as they may be more challenging for infants to digest compared to rice cereal.

4. What is the most frequent cause of hypovolemic shock in children?

Correct answer: B

Rationale: Hypovolemic shock in children is most frequently caused by blood loss, which can result from trauma, surgery, or gastrointestinal bleeding. Sepsis and anaphylaxis can lead to different types of shock (septic and anaphylactic), and heart failure is related to cardiogenic shock.

5. Why is knowledge of developmental theories useful for the nurse?

Correct answer: D

Rationale: The correct answer is D. Understanding developmental theories helps nurses anticipate and plan appropriate care based on the child’s developmental stage. Choice A is incorrect because developmental theories provide a framework but do not dictate exact actions. Choice B is incorrect as developmental processes are not entirely predictable and are not meant to control a child’s development. Choice C is incorrect as developmental theories are not a strict set of facts that all children follow in a prescribed manner, but rather guidelines for understanding and supporting a child's growth and development.

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