HESI Registered Nurse EXIT Practice Exam

While caring for a toddler with croup, which initial sign requires immediate nurse attention?

1. Respiratory rate of 42

2. Lethargy for the past hour

3. Apical pulse of 54

4. Coughing up copious secretions

The correct answer is: Respiratory rate of 42

In the context of caring for a toddler with croup, the key factor that requires immediate nurse attention is the lethargy observed in the child. Lethargy can indicate a significant deterioration in the child's respiratory status or overall condition. In children, especially toddlers, changes in alertness or energy levels can signal an inadequate gas exchange or worsening airway obstruction, both of which may put the child at risk for serious complications. Lethargy is often one of the earliest signs of hypoxia or respiratory distress, and in conjunction with croup, it suggests that the child may not be handling the illness well. It is essential to address this issue promptly, as immediate assessment and potential interventions could be critical to the child's well-being. While other findings, like respiratory rate, apical pulse, and coughing up secretions are important to monitor, they do not reflect an immediate life-threatening condition in the same way lethargy does, especially in the context of a toddler who may decompensate rapidly. Therefore, recognizing lethargy as an urgent sign allows for timely medical intervention, which can be lifesaving.