Ch 28: Respiratory

A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests which of the following? A. Asthma B. Pneumonia C. Bronchiolitis D. Foreign body in trachea

A. Asthma

An infant's parents ask the nurse about preventing otitis media (OM). Which of the following should be recommended? A. Avoid tobacco smoke. B. Use nasal decongestant. C. Avoid children with OM. D. Bottle- or breast-feed in supine position.

A. Avoid tobacco smoke.

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which of the following? A. Do not use for more than 3 days. B. Keep drops to use again for nasal congestion. C. Administer drops after feedings and at bedtime. D. Give two drops every 5 minutes until nasal congestion subsides.

A. Do not use for more than 3 days

What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? A. Meconium ileus B. History of poor intestinal absorption C. Foul-smelling, frothy, greasy stools D. Recurrent pneumonia and lung infections

A. Meconium ileus

The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic, since these symptoms are suggestive of which of the following? A. Pneumothorax B. Bronchodilation C. Carbon dioxide retention D. Increased viscosity of sputum

A. Pneumothorax

Which of the following is the most important consideration in managing tuberculosis (TB) in children? A. Skin testing B. Chemotherapy C. Adequate rest D. Adequate hydration

A. Skin testing

Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections? A. They are safer. B. They are less expensive. C. Respiratory secretions are dried by steam vaporizers. D. A more comfortable environment is produced.

A. They are safer

A child with asthma is having pulmonary function tests. Which of the following explains the purpose of the peak expiratory flow rate? A. To assess severity of asthma B. To determine cause of asthma C. To identify "triggers" of asthma D. To confirm diagnosis of asthma

A. To asses severity of asthma

When caring for a child after a tonsillectomy, the nurse should do which of the following? A. Watch for continuous swallowing. B. Encourage gargling to reduce discomfort. C. Apply warm compresses to the throat. D. Position the child on the back for sleeping.

A. Watch for continuous swallowing

The leading cause of chronic illness in children is: A. asthma. B. pertussis. C. tuberculosis. D. cystic fibrosis.

A. asthma

Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which of the following? A. Severe pain in the ear B. Anorexia and vomiting C. A feeling of fullness in the ear D. Fever as high as 40° C (104° F)

C. A feeling of fullness in the ear

The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate which of the following? A. Sore throat B. Inspiratory stridor C. Complete obstruction D. Respiratory tract infection

C. Complete obstruction

An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires the following isolation: A. reverse isolation. B. airborne isolation. C. Contact Precautions. D. Standard Precautions.

C. Contact Precautions

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent: A. otitis media. B. diabetes insipidus (DI). C. nephrotic syndrome. D. acute rheumatic fever.

D. acute rheumatic fever

Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39o C (102.2o F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner would instruct the parents to use: A. decongestants to ease stuffy nose. B. antihistamines to help the child sleep. C. aspirin for pain and fever management. D. benzocaine ear drops for topical pain relief.

D. benzocaine ear drops for topical pain relief.

The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. Which of the following statements by the parent would indicate a correct understanding of the teaching? A. "I can use an ice collar on my child for pain control along with analgesics." B. "My child should clear the throat frequently to clear the secretions." C. "I should allow my child be as active as tolerated." D. "My child should gargle and brush teeth at least three times per day."

A. "I can use an ice collar on my child for pain control along with analgesics."

An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. Instructions to the parent should include which of the following? A. Administer all of the prescribed medication. B. Continue medication until all symptoms subside. C. Immediately stop giving medication if hearing loss develops. D. Stop giving medication and come to the clinic if fever is still present in 24 hours.

A. Administer all of the prescribed medication.

An infant has been diagnosed with staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? A. Administration of antibiotics B. Frequent complete assessment of the infant C. Round-the-clock administration of antitussive agents D. Strict monitoring of intake and output to avoid congestive heart failure

A. Administration of antibiotics

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. Which of the following is essential in this child's care? A. Monitor pulse oximetry. B. Monitor arterial blood gases. C. Administer oxygen if respiratory distress develops. D. Administer oxygen if child's lips become bright, cherry-red in color.

B. Monitor ABG/s

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following? A. Force fluids. B. Monitor pulse oximetry. C. Institute seizure precautions. D. Encourage high-protein diet.

B. Monitor pulse oximetry.

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which of the following? A. Admit to the hospital and observe for impending epiglottitis. B. Provide fluids that the child likes and use comfort measures. C. Control fever with acetaminophen and call if cough gets worse tonight. D. Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement.

B. Provide fluids that the child likes and use comfort measures.

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily which of the following? A. Mothers of hospitalized toddlers often experience guilt. B. The mother's presence will reduce anxiety and ease child's respiratory efforts. C. Separation from mother is a major developmental threat at this age. D. The mother can provide constant observations of the child's respiratory efforts

B. The mother's presence will reduce anxiety and ease child's respiratory efforts.

Which of the following statements is the most descriptive of asthma? A. It is inherited. B. There is heightened airway reactivity. C. There is decreased resistance in the airway. D. The single cause of asthma is an allergic hypersensitivity.

B. There is heightened airway reactivity.

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. This medication should be administered: A. after chest physiotherapy (CPT). B. before CPT. C. after receiving 100% oxygen. D. before receiving 100% oxygen.

B. before CPT.

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). This drug: A. is given subcutaneously. B. may cause voice alterations. C. may cause mucus to thicken. D. is not indicated for children younger than age 12 years.

B. may cause voice alterations.

One of the goals for children with asthma is to maintain the child's normal functioning. To accomplish this, one of the principles of treatment is to: A. limit participation in sports. B. reduce underlying inflammation. C. minimize use of pharmacologic agents. D. have yearly evaluations by health care provider.

B. reduce underlying inflammation

Which of the following tests aids in the diagnosis of cystic fibrosis (CF)? a. Sweat test, stool for fat, chest x-ray films b. Sweat test, bronchoscopy, duodenal fluid analysis c. Sweat test, stool for trypsin, biopsy of intestinal mucosa d. Stool for fat, gastric contents for hydrochloride, chest x-ray films

a. Sweat test, stool for fat, chest x-ray films

Which of the following diagnostic tests for allergies involves the injection of specific allergens? A. Phadiatop B. Skin testing C. Radioallergosorbent tests (RAST) D. Blood examination for total immunoglobulin E (IgE)

C. Radioallergosorbent tests (RAST)

Inhaled corticosteroids are currently the recommended first-line therapy for children with asthma over the age of 5 years. Children who are taking long-term inhaled steroids should be assessed frequently because which of the following may develop? A. Cough B. Osteoporosis C. Slowed growth D. Cushing syndrome

C. Slowerd growth

A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect: A. allergies. B. acute pharyngitis. C. foreign body in nose. D. acute nasopharyngitis.

C. foreign body in the nose

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant: A. has a cough. B. becomes fussy. C. shows signs of an earache. D. has a fever higher than 37.5° C (99° F).

C. shows signs of an earache

The nurse is preparing a staff education program about pediatric asthma. Which of the following concepts should the nurse include when discussing the asthma severity classification system? Select all that apply. A. Children with mild persistent asthma have nighttime symptoms less than two times a month. B. Children with moderate persistent asthma use a short-acting β-agonist more than two times per week. C. Children with severe persistent asthma have a peak expiratory flow (PFE) of 60% to 80% of predicted value. D. Children with mild persistent asthma have symptoms more than two times per week. E. Children with moderate persistent asthma have some limitations with normal activity. F. Children with severe persistent asthma have frequent nighttime symptoms.

D. Children with mild persistent asthma have symptoms more than two times per week. E. Children with moderate persistent asthma have some limitations with normal activity. F. Children with severe persistent asthma have frequent nighttime symptoms.

Which of the following statements best represents infectious mononucleosis? A. Herpes simplex type 2 is principal cause. B. A complete blood count shows a characteristic leukopenia. C. A short course of ampicillin is used when pharyngitis is present. D. Clinical symptoms and blood tests are both needed to establish the diagnosis.

D. Clinical symptoms and blood tests are both needed to establish the diagnosis.

Cystic fibrosis (CF) may affect single or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is which of the following? A. Hyperactivity of sweat glands B. Hypoactivity of autonomic nervous system C. Atrophic changes in mucosal wall of intestines D. Mechanical obstruction caused by increased viscosity of mucous gland secretions

D. Mechanical obstruction caused by increased viscosity of mucous gland secretions

A 4-year-old girl is brought to the emergency department. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should do which of the following? A. Make her lie down and rest quietly. B. Examine her oral pharynx and report to the physician. C. Auscultate her lungs and prepare for placement in a mist tent. D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation

D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include which of the following? A. Give pancreatic enzymes between meals if at all possible. B. Do not administer pancreatic enzymes if child is receiving antibiotics. C. Decrease dose of pancreatic enzymes if child is having frequent, bulky stools. D. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at beginning of meal.

D. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at beginning of meal.

Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? a. Ephedrine b. Theophylline c. Aminophylline d. Short-acting β2-agonists

d. Short-acting β2-agonists