AANP Family Nurse Practitioner (FNP) Certification ExamAssessmentMedium
A 5-year-old child is brought to the clinic with a 2-day history of sudden onset of high fever (103°F), severe sore throat, dysphagia, and drooling. The child appears anxious and is sitting in a 'tripod' position. What is the immediate priority for the Family Nurse Practitioner?
- AObtain a throat culture for bacterial pharyngitis.
- BSecure the airway and prepare for emergency transport.
- CPerform a rapid strep test and mononucleosis screen.
- DAdminister oral antibiotics and antipyretics.
Show answer & explanationAnswer & explanation
Correct answer: B. Secure the airway and prepare for emergency transport.
The symptoms of high fever, severe sore throat, dysphagia, drooling, and tripod position are classic signs of acute epiglottitis, a life-threatening airway emergency. The immediate priority is to secure the airway and prepare for emergency transport to a facility where intubation can be performed.
Why the other options are wrong
- A. Obtaining a throat culture is contraindicated in suspected epiglottitis due to the risk of precipitating acute airway obstruction.
- C. Rapid strep test and mononucleosis screen are inappropriate and dangerous in a child with suspected epiglottitis due to the risk of airway manipulation.
- D. Oral antibiotics and antipyretics are not the immediate priority for a potential airway emergency and would delay critical intervention.
Acute Epiglottitis
A rapidly progressive, life-threatening infection of the epiglottis and surrounding tissues that can lead to acute airway obstruction.
- Characterized by rapid onset of high fever, severe sore throat, dysphagia, drooling.
- Children often adopt a 'tripod' position.
- Requires immediate airway management and emergency medical intervention.
Memory trick: Don't Delay: Drooling, Dysphagia, Distress, and Danger!