Family Nurse Practitioner Exam

An infant with both inspiratory and expiratory wheezing, fever, and clear nasal discharge is most likely experiencing what condition?

1. Tracheobronchitis

2. Bronchiolitis

3. Croup

4. A small foreign body lodged in the bronchus

The correct answer is: Bronchiolitis

The presence of both inspiratory and expiratory wheezing, coupled with fever and clear nasal discharge, strongly indicates bronchiolitis. This condition is typically caused by viral infections, most commonly respiratory syncytial virus (RSV), and it affects the small airways (bronchioles) in infants and young children. In bronchiolitis, wheezing occurs due to the inflammation and narrowing of the small airways, leading to difficulty in airflow during both phases of breathing, hence the presence of both inspiratory and expiratory wheezing. The fever suggests an underlying infectious process, which is frequently viral. Clear nasal discharge is also common in bronchiolitis, further supporting this diagnosis, as it indicates upper respiratory involvement that typically accompanies the condition. Other options may present with some overlapping symptoms but do not encapsulate the specific combination present in this case as well as bronchiolitis does. For instance, tracheobronchitis may produce cough and mucus but is less likely to show the specific wheezing pattern and symptom combination found in this scenario. Croup characteristically presents with a distinctive "barking" cough and stridor, primarily inspiratory, rather than both phases of wheezing. A small foreign body lodged in