Practice Question
A nurse is reviewing assessment findings for a 2-year-old toddler who has bronchitis. For which of the following findings should the nurse anticipate a prescription for a chest x-ray?
Answer Choices:
Correct Answer:
Axillary temperature 40°C (104°F)
Rationale:
🌼 A temperature of 40°C (104°F) in a 2-year-old is a high fever and raises concern for a more serious infection, such as pneumonia, rather than simple bronchitis.
🌼 High fever, especially with respiratory symptoms, may prompt the provider to order a chest x-ray to evaluate for consolidation or infiltrates.
🌼 Bronchitis often presents with cough, wheeze, and mild fever, but a very high fever can suggest complications or alternative diagnoses.
🌼 The nurse should anticipate that such a fever will likely lead to further diagnostic imaging to clarify the extent and location of infection.
🌼 Therefore, among the listed findings, the very elevated temperature is the best trigger for anticipating a chest x-ray prescription.
Fatigue
🌼 Fatigue is a nonspecific symptom and is common in many illnesses, including viral bronchitis, colds, and mild infections.
🌼 While it indicates the child is not feeling well, it does not specifically point toward a need for imaging of the lungs.
🌼 Fatigue alone, without signs like very high fever, significant respiratory distress, or focal lung findings, is usually managed with supportive care.
🌼 It does not help distinguish between simple bronchitis, viral infection, or minor illnesses that do not require x-ray evaluation.
🌼 Therefore, fatigue is insufficient by itself to anticipate a chest x-ray prescription.
Coryza
🌼 Coryza refers to nasal inflammation with runny nose and congestion, typical of upper respiratory infections.
🌼 This symptom is generally associated with viral URIs and is common in conditions like the common cold, often coexisting with bronchitis.
🌼 Coryza does not specifically indicate lower respiratory tract involvement severe enough to require imaging.
🌼 Most children with coryza are treated supportively and do not need a chest x-ray, unless other red-flag signs are present.
🌼 So, while common, coryza alone does not warrant anticipation of a chest x-ray.
Wheezing
🌼 Wheezing in a 2-year-old with bronchitis can result from airway inflammation and narrowing, which is typical in lower respiratory infections.
🌼 Wheeze is often managed with bronchodilators, observation, and supportive care, especially if the child is otherwise stable.
🌼 Wheezing alone is not a definitive indicator of pneumonia or structural lung changes that require imaging.
🌼 A chest x-ray is more strongly indicated when wheezing is accompanied by significant distress, hypoxia, or high persistent fever.
🌼 Thus, wheezing by itself does not automatically signal the need for a chest x-ray, compared to a very high fever like 40°C.
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This question is from Custom PNSG Respiratory Cardiac Exam Fall 2025 which contains 42 questions.
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From Exam
Custom PNSG Respiratory Cardiac Exam Fall 2025
42 Questions
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- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: 💫PN Custom Exam(s)
- Answer Choices: 4