ATI NCLEX-RN Practice Questions Practice Question

Which of the following nursing orders has the highest priority for a child with epiglottitis?

Correct Answer: B

Rationale: Because of the possibility of fever or respiratory failure, vital signs should be done more often than every eight hours. If the epiglottitis worsens, the edema and laryngospasm may close the airway and an emergency tracheostomy may be necessary. Although intake and output are a part of the nursing care of a child with epiglottitis, it is not as important as the safety measure of keeping the tracheostomy set at the bedside. Specific gravity will indicate hydration status, but it is not as important as keeping the tracheostomy set at the bedside.

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