Peds Respiratory Questions

50. The parent of a child with cystic fibrosis 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, because these symptoms are suggestive of which of the following? 1. Pneumothorax 2. Bronchodilation 3. Carbon dioxide retention 4. Increased viscosity of sputum

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52. In providing nourishment for a child with cystic fibrosis, which of the following factors should the nurse keep in mind? 1. Diet should be high in calories and protein. 2. Diet should be high in easily digested carbohydrates and fats. 3. Most fruits and vegetables are not well tolerated. 4. Fats and proteins must be greatly curtailed.

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8. When caring for a child following a tonsillectomy, the nurse should do which of the following? 1. Watch for continuous swallowing. 2. Encourage gargling to reduce discomfort. 3. Position the child on the back for sleeping. 4. Apply warm compresses to the throat.

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11. The most profound complication of prolonged middle ear disorders is: 1. visual impairment. 2. hearing loss. 3. tympanic membrane rupture. 4. enhanced auditory discrimination.

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12. When home compliance for antibiotic therapy is a concern, which of the following medication routes is recommended? 1. Oral 2. Intramuscular 3. Intravenous 4. Rectal

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17. The nurse is assessing a child with croup. Examining the child's throat using a tongue depressor might precipitate which of the following? 1. Inspiratory stridor 2. Complete obstruction 3. Sore throat 4. Respiratory tract infection

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18. Which of the following types of croup is always considered a medical emergency? 1. Laryngitis 2. Epiglottitis 3. Spasmodic croup 4. Laryngotracheobronchitis

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19. The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37°C. The nurse suspects croup and should recommend which of the following? 1. Control fever with acetaminophen and call if cough gets worse tonight. 2. Try a cool-mist vaporizer at night and watch for signs of difficulty breathing. 3. Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement. 4. Admit to the hospital and observe for impending epiglottitis.

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20. 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? 1. Mothers of hospitalized toddlers often experience guilt. 2. The mother's presence will reduce anxiety and ease child's respiratory efforts. 3. Separation from mother is a major developmental threat at this age. 4. The mother can provide constant observations of the child's respiratory efforts.

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27. Which of the following is the most important consideration in managing tuberculosis in children? 1. Skin testing 2. Chemotherapy 3. Adequate rest 4. Adequate hydration

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31. The nurse is caring for a child with adult respiratory distress syndrome associated with sepsis. Nursing actions should include which of the following? 1. Force fluids. 2. Monitor pulse oximetry. 3. Institute seizure precautions. 4. Encourage high-protein diet.

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32. The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which of the following is essential in this child's care? 1. Monitor pulse oximetry. 2. Monitor arterial blood gases. 3. Administer oxygen if respiratory distress develops. 4. Administer oxygen if child's lips become bright, cherry-red in color.

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34. Which of the following is a nonsedating antihistamine used to treat allergies in children? 1. Pseudoephedrine 2. Loratadine (Claritin) 3. Diphenhydramine (Benadryl) 4. Chlorpheniramine (Chlor Trimeton)

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35. Asthma is now classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include all of the following except: 1. lung function. 2. associated allergies. 3. frequency of symptoms. 4. frequency and severity of exacerbations.

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39. Which of the following types of asthma medications are considered quick-relief or rescue medications to treat acute symptoms and exacerbations? 1. Methylxanthines 2. Anticholinergics 3. Cromolyn sodium 4. Leukotriene modifiers

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40. Beta-adrenergic agonists and methylxanthines are often prescribed for a child suffering an asthma attack. What is their action? 1. Liquefy secretions 2. Dilate the bronchioles 3. Reduce inflammation of the lungs 4. Reduce infection

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49. A child with cystic fibrosis is receiving recombinant human deoxyribonuclease. This drug: 1. may cause mucus to thicken. 2. may cause voice alterations. 3. is given subcutaneously. 4. is not indicated for children younger than age 12.

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9. Which of the following statements best represents infectious mononucleosis? 1. Herpes virus hominis, type II, is the principal cause. 2. Herpes-like Epstein-Barr virus is the principal cause. 3. Diagnosis is established by a complete blood count, which reveals a characteristic leukopenia. 4. Diagnosis is established by clinical manifestations, since diagnostic tests cannot confirm diagnosis.

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10. A child is diagnosed with influenza, probably type A disease. Management includes which of the following? 1. Clear liquid diet for hydration 2. Aspirin to control fever 3. Amantadine hydrochloride to reduce symptoms 4. Antibiotics to prevent bacterial infection

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15. Which of the following home care measures is advised for prevention of otitis externa? 1. Clean ear canal regularly with cotton swab. 2. Use 100% vinegar in ear canals. 3. Dry ears with towel after bathing or swimming. 4. Dry ears with conventional hair dryer on high heat.

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23. An infant with respiratory syncytial virus is started on ribavirin. The drug is nebulized by a small-particle aerosol generator into an oxygen tent. Which of the following is an important nursing consideration related to this medication? 1. Discontinue isolation precautions while medication is being administered. 2. Wear gown, mask, and gloves when opening the tent. 3. Temporarily stop aerosol administration when tent needs to be opened. 4. Temporarily increase aerosol administration when tent needs to be opened.

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53. Because the absorption of fat-soluble vitamins is decreased in cystic fibrosis, supplementation of which of the following vitamins is necessary? 1. C, D 2. A, E, K 3. A, D, E, K 4. C, folic acid

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54. An infant at high risk for bronchiolitis is to be given respiratory syncytial virus immunoglobulin. The nurse teaches the family that an injection is necessary: 1. once for permanent immunity. 2. in a series of three injections. 3. monthly from November to April. 4. only during hospitalization.

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7. It is generally recommended that a child with acute streptococcal pharyngitis can return to school: 1. when sore throat is better. 2. if no complications develop. 3. after being on antibiotics for 24 hours. 4. after being on antibiotics for 3 days.

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16. A 4-year-old girl is brought to the emergency room. 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? 1. Examine her oral pharynx and report to the physician. 2. Make her lie down and rest quietly. 3. Auscultate her lungs and make preparations for placement in a mist tent. 4. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

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2. A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because it: 1. liquefies secretions. 2. improves oxygenation. 3. promotes ventilation. 4. soothes inflamed mucous membrane.

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26. Skin testing for tuberculosis (Mantoux) is recommended: 1. every year for all children older than age 2. 2. every year for all children older than age 10. 3. every 2 years for all children starting at age 1. 4. every year for children with household contact with a person with human immunodeficiency virus.

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28. The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on which of the following? 1. Gagging 2. Coughing 3. Pulse higher than 100 beats/min 4. Inability to speak

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29. A toddler has a unilateral nasal discharge that is foul smelling and frequent sneezing. The nurse should suspect: 1. allergies. 2. acute pharyngitis. 3. acute nasopharyngitis. 4. foreign body in nose.

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38. A child with asthma is having pulmonary function tests. Which of the following explains the purpose of the peak expiratory flow rate? 1. Confirm diagnosis of asthma. 2. Determine cause of asthma. 3. Identify "triggers" of asthma. 4. Assess severity of asthma.

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4. What is an appropriate nursing intervention when caring for an infant with an upper respiratory infection and elevated temperature? 1. Give tepid water baths to reduce fever. 2. Encourage food intake to maintain caloric needs. 3. Have child wear heavy clothing to prevent chilling. 4. Give small amounts of favorite fluids frequently to prevent dehydration.

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41. Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? 1. Ephedrine 2. Theophylline 3. Aminophylline 4. Short-acting beta 2 agonists

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42. One of the goals for children with asthma is to prevent respiratory infection. This is because respiratory infection does which of the following? 1. Lessens effectiveness of medications 2. Encourages exercise-induced asthma 3. Increases sensitivity to allergens 4. Can trigger an episode or aggravate asthmatic state

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44. Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is which of the following? 1. Atrophic changes in mucosal wall of intestines 2. Hypoactivity of autonomic nervous system 3. Hyperactivity of sweat glands 4. Mechanical obstruction caused by increased viscosity of mucous gland secretions

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47. Cystic fibrosis is suspected in a toddler. Which of the following tests is essential in establishing this diagnosis? 1. Bronchoscopy 2. Serum calcium 3. Urine creatinine 4. Sweat chloride test

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5. The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant: 1. becomes fussy. 2. has a cough. 3. has a fever higher than 99°F. 4. shows signs of an earache.

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50. The parent of a child with cystic fibrosis 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, because these symptoms are suggestive of which of the following? 1. Pneumothorax 2. Bronchodilation 3. Carbon dioxide retention 4. Increased viscosity of sputum 51. Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include which of the following? 1. Do not administer pancreatic enzymes if child is receiving antibiotics. 2. Decrease dose of pancreatic enzymes if child is having frequent, bulky stools. 3. Administer pancreatic enzymes between meals if at all possible. 4. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at beginning of meal.

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55. The leading cause of chronic illness in children is: 1. cystic fibrosis. 2. pertussis. 3. tuberculosis. 4. asthma.

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6. It is important that a child with acute streptococcal pharyngitis be treated with antibiotics in order to prevent: 1. otitis media. 2. diabetes insipidus. 3. nephrotic syndrome. 4. acute rheumatic fever.

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3. 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? 1. Do not use drops for any other children. 2. Keep drops to use again for nasal congestion. 3. Administer drops until nasal congestion subsides. 4. Administer drops after feedings and at bedtime.

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30. A father calls the emergency room (ER) nurse, because his 2-year-old son has ingested lighter fluid. The nurse should recommend which of the following? 1. Transport the child to the ER. 2. Observe the child closely for respiratory symptoms. 3. Give ipecac to induce vomiting before transporting to the ER. 4. Give milk to protect the gastrointestinal tract before transporting the child to the ER.

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36. Which of the following statements is the most descriptive of bronchial asthma? 1. There is heightened airway reactivity. 2. There is decreased resistance in the airway. 3. The single cause of asthma is an allergic hypersensitivity. 4. It is inherited. 1

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37. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests which of the following? 1. Asthma 2. Pneumonia 3. Bronchiolitis 4. Foreign body in trachea

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43. Which statement expresses accurately the genetic implications of cystic fibrosis? 1. If it is present in a child, both parents are carriers of this defective gene. 2. It is inherited as an autosomal dominant trait. 3. It is a genetic defect found primarily in nonwhite population groups. 4. There is a 50% chance that siblings of an affected child will also be affected.

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45. What is the earliest recognizable clinical manifestation(s) of cystic fibrosis? 1. Meconium ileus 2. History of poor intestinal absorption 3. Foul-smelling, frothy, greasy stools 4. Recurrent pneumonia and lung infections

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46. Which of the following tests aid in the diagnosis of cystic fibrosis? 1. Sweat test, stool for fat, chest x-ray films 2. Stool for fat, gastric contents for HCL, chest x-ray films 3. Sweat test, bronchoscopy, duodenal fluid analysis 4. Sweat test, stool for trypsin, biopsy of intestinal mucosa

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48. A child with cystic fibrosis receives aerosolized bronchodilator medication. This medication should be administered: 1. before chest physiotherapy. 2. after chest physiotherapy. 3. before receiving 100% oxygen. 4. after receiving 100% oxygen.

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25. An appropriate nursing intervention when caring for a child with pneumonia is which of the following? 1. Encourage rest. 2. Avoid lying on affected side. 3. Administer analgesics. 4. Place in Trendelenburg position.

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1. Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections? 1. They are safer. 2. They are less expensive. 3. Respiratory secretions are dried. 4. A more comfortable environment is produced.

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13. An 18-month-old child is seen in the clinic with acute otitis media. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Instructions to the parent should include which of the following? 1. Administer all of the prescribed medication. 2. Continue medication until all symptoms subside. 3. Immediately stop giving medication if hearing loss develops. 4. Stop giving medication and come to the clinic if fever is still present in 24 hours.

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14. An infant's parents ask the nurse about preventing otitis media. Which of the following should be recommended? 1. Avoid tobacco smoke. 2. Use nasal decongestant. 3. Avoid children with otitis media. 4. Bottle or breast-feed in supine position.

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21. An important nursing consideration when caring for a 10-month-old infant with respiratory syncytial virus/bronchiolitis would be which of the following? 1. Place in a mist tent. 2. Administer antibiotics. 3. Administer cough syrup. 4. Encourage to drink 8 ounces of formula every 4 hours.

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22. An infant is receiving respiratory syncytial virus (RSV) immune globulin (RespiGam). The purpose of this is to: 1. prevent RSV infection. 2. make isolation of infant with RSV unnecessary. 3. prevent secondary bacterial infection. 4. decrease toxicity of antiviral agents.

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24. A young child's parents tell the nurse that the child had "double pneumonia" last spring. The nurse should recognize that this term means which of the following? 1. Both lungs are affected. 2. Bronchial tubes and one lung are affected. 3. Pulmonary infection is both viral and bacterial. 4. Pulmonary infection is twice as severe as would be normally expected.

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