ESTUDYR
NCLEX-Style Case Study: Pediatric Bronchiolitis
Client Scenario (Applies to all items)
The nurse in the pediatric emergency department cares for a 3-month-old male client.
Health History, Assessment, and Vital Signs:
A 3-month-old male presents with his mother who reports the child had a fever of 102.2°F
(39.0°C) at home. He has had nasal congestion and a cough for the past 2–3 days. His
mother states that he was feeding normally until today; however, he has not shown interest
in feeding today. She attempted to feed him 1 hour ago, but he fell asleep at the breast. His
last diaper change was 5 hours ago.
The client was born at 42 weeks with an uncomplicated labor and delivery. Birth weight was
8 lb 7 oz (3.83 kg). The client has a past medical history of slow weight gain and newborn
jaundice. Current weight is 13 lb 2 oz (5.95 kg). Immunizations are up to date.
Item 1 of 6
Question:
Click to select the findings that require immediate follow-up by the nurse.
(Select all that apply)
Temperature
Wheezing
Nasal flaring
Pulse oximetry
Respiratory rate
Born at 42 weeks
History of jaundice
Intercostal retractions
Hypoactive bowel sounds
Hands and feet cool to touch
Correct Answers:
, ESTUDYR
Wheezing
Nasal flaring
Pulse oximetry
Respiratory rate
Intercostal retractions
Rationale:
These findings indicate respiratory distress and require immediate intervention. Signs such
as wheezing, nasal flaring, increased respiratory rate, decreased oxygen saturation, and
intercostal retractions reflect increased work of breathing and impaired oxygenation.
Other findings such as temperature or past history are important but do not require
immediate priority intervention.
Item 2 of 6
Question:
For each client finding below, indicate whether it is most consistent with gastroesophageal
reflux disease (GERD), asthma, or bronchiolitis.
(Each row must have at least one selection)
Client Finding GERD Asthma Bronchiolitis
Fever ☐ ☐ ☐
Cough ☐ ☐ ☐
Nasal congestion ☐ ☐ ☐
Expiratory wheezing ☐ ☐ ☐
Intercostal retractions ☐ ☐ ☐
Correct Answers:
Fever → Bronchiolitis
Cough → Asthma, Bronchiolitis
Nasal congestion → Bronchiolitis
Expiratory wheezing → Asthma, Bronchiolitis
Intercostal retractions → Asthma, Bronchiolitis
Rationale:
Bronchiolitis is a viral infection commonly associated with fever, nasal congestion, and
respiratory distress. Asthma is characterized by airway hyperreactivity and wheezing. GERD
is associated with feeding difficulties and regurgitation, not respiratory distress signs such as
retractions.
NCLEX-Style Case Study: Pediatric Bronchiolitis
Client Scenario (Applies to all items)
The nurse in the pediatric emergency department cares for a 3-month-old male client.
Health History, Assessment, and Vital Signs:
A 3-month-old male presents with his mother who reports the child had a fever of 102.2°F
(39.0°C) at home. He has had nasal congestion and a cough for the past 2–3 days. His
mother states that he was feeding normally until today; however, he has not shown interest
in feeding today. She attempted to feed him 1 hour ago, but he fell asleep at the breast. His
last diaper change was 5 hours ago.
The client was born at 42 weeks with an uncomplicated labor and delivery. Birth weight was
8 lb 7 oz (3.83 kg). The client has a past medical history of slow weight gain and newborn
jaundice. Current weight is 13 lb 2 oz (5.95 kg). Immunizations are up to date.
Item 1 of 6
Question:
Click to select the findings that require immediate follow-up by the nurse.
(Select all that apply)
Temperature
Wheezing
Nasal flaring
Pulse oximetry
Respiratory rate
Born at 42 weeks
History of jaundice
Intercostal retractions
Hypoactive bowel sounds
Hands and feet cool to touch
Correct Answers:
, ESTUDYR
Wheezing
Nasal flaring
Pulse oximetry
Respiratory rate
Intercostal retractions
Rationale:
These findings indicate respiratory distress and require immediate intervention. Signs such
as wheezing, nasal flaring, increased respiratory rate, decreased oxygen saturation, and
intercostal retractions reflect increased work of breathing and impaired oxygenation.
Other findings such as temperature or past history are important but do not require
immediate priority intervention.
Item 2 of 6
Question:
For each client finding below, indicate whether it is most consistent with gastroesophageal
reflux disease (GERD), asthma, or bronchiolitis.
(Each row must have at least one selection)
Client Finding GERD Asthma Bronchiolitis
Fever ☐ ☐ ☐
Cough ☐ ☐ ☐
Nasal congestion ☐ ☐ ☐
Expiratory wheezing ☐ ☐ ☐
Intercostal retractions ☐ ☐ ☐
Correct Answers:
Fever → Bronchiolitis
Cough → Asthma, Bronchiolitis
Nasal congestion → Bronchiolitis
Expiratory wheezing → Asthma, Bronchiolitis
Intercostal retractions → Asthma, Bronchiolitis
Rationale:
Bronchiolitis is a viral infection commonly associated with fever, nasal congestion, and
respiratory distress. Asthma is characterized by airway hyperreactivity and wheezing. GERD
is associated with feeding difficulties and regurgitation, not respiratory distress signs such as
retractions.
