Chapter 40
Abdominal thrusts (the Heimlich maneuver) are recommended for airway obstruction in children older than: a. 1 year b. 4 years c. 8 years d. 12 years
a
The earliest recognizable clinical manifestation of cystic fibrosis (CF) is: a. Meconium ileus. b. History of poor intestinal absorption. c. Foul-smelling, frothy, greasy stools. d. Recurrent pneumonia and lung infections.
a
The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup? a. Wheezing is heard audibly. b. it has a harsh, bark cough. c. it is bacterial in nature d. the child has a high fever
b
The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the infant: a. Becomes fussy. b. has a cough c. has a fever of 99*F d. show signs of an earache
d
Which statement is characteristic of acute otitis media (AOM)? a. The etiology is unknown. b. Permanent hearing loss often results. c. It can be treated by intramuscular antibiotics. d. It is treated with a broad range of antibiotics
d
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: a. gagging b. coughing c. pulse over 100 BPM d. inability to speak
d
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? a. Before chest physiotherapy (CPT) b. After CPT c Before receiving 100% oxygen d. After receiving 100% oxygen
a
A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing? a. Dyspnea b. tachypnea c. hypopnea d. orthopnea
a
An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply). a. Cluster care to conserve energy b. Round-the-clock administration of antitussive agents c. Strict intake and output to avoid congestive heart failure d. Administration of antibiotics e. Placement in a mist tent
a,d
A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests: a. Asthma. b. pneumonia c. bronchiolitis d. foreign body in the trachea
a
A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma? a. There is heightened airway reactivity. b. There is decreased resistance in the airway. c. The single cause of asthma is an allergic hypersensitivity. d. It is inherited.
a
A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is human immunodeficiency virus (HIV) positive. Which induration size indicates a positive result for this child 48 to 72 hours after the test? a. 5mm b. 10 mm c. 15 mm d. 20 mm
a
A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of: a. bronchitis b. bronchiolitis c. viral-induced asthma d. acute spasmodic laryngitis
a
An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of the instructions? a. I should administer all the prescribed medication. b. I should continue medication until the symptoms subside. c. I will immediately stop giving medication if I notice a change in hearing. d. I will stop giving medication if fever is still present in 24 hours.
a
An appropriate nursing intervention when caring for a child with pneumonia is to: a. Encourage rest. b. Encourage the child to lie on the unaffected side. c. Administer analgesics. d. Place the child in the Trendelenburg position.
a
An infants parents ask the nurse about preventing otitis media (OM). What should the nurse recommend? a. Avoid tobacco smoke. b. Use nasal decongestant. c. Avoid children with OM. d. Bottle-feed or breastfeed in supine position.
a
Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include: a. Avoiding use for more than 3 days. b. Keeping drops to use again for nasal congestion. c. Administering drops until nasal congestion subsides. d. Administering drops after feedings and at bedtime.
a
In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind? a. Diet should be high in carbohydrates and protein. b. Diet should be high in easily digested carbohydrates and fats. c. Most fruits and vegetables are not well tolerated. d. Fats and proteins must be greatly curtailed.
a
Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? a. If it is present in a child, both parents are carriers of this defective gene. b. It is inherited as an autosomal dominant trait. c. It is a genetic defect found primarily in non-Caucasian population groups. d. There is a 50% chance that siblings of an affected child also will be affected.
a
Which information should the nurse teach families about reducing exposure to pollens and dust (Select all that apply)? a. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses. d. Keep humidity in the house above 60%. e. Keep pets outside.
a,b,c
A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug: a. May cause mucus to thicken. b. May cause voice alterations. c. Is given subcutaneously. d. Is not indicated for children younger than 12 years
b
Asthma in infants is usually triggered by: a. Medications. b. a viral infection c. exposure to cold air d. allergy to dust or dust mites
b
Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible? a. radial b. carotid c. femoral d. brachial
b
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurses rationale for this action is primarily that: a. Mothers of hospitalized toddlers often experience guilt. b. The mothers presence will reduce anxiety and ease the childs respiratory efforts. c. Separation from the mother is a major developmental threat at this age. d. The mother can provide constant observations of the childs respiratory efforts.
b
The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. complete obstruction c. sore throat d. respiratory tract infection
b
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include: a. force fluids b. monitor pulse ox c. institute seizure precautions d. encourage a high-protein diet
b
The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this childs care? a. Monitor pulse oximetry. b. Monitor arterial blood gases. c. Administer oxygen if respiratory distress develops. d. Administer oxygen if childs lips become bright, cherry red.
b
Which consideration is the most important in managing tuberculosis (TB) in children? a. Skin testing annually b. pharmacotherapy c. adequate nutrition d. adequate hydration
b
Which statement best describes why children have fewer respiratory tract infections as they grow older? a. The amount of lymphoid tissue decreases. b. Repeated exposure to organisms causes increased immunity. c. Viral organisms are less prevalent in the population. d. Secondary infections rarely occur after viral illnesses.
b
Which type of croup is always considered a medical emergency? a. laryngitis b. epiglottitis c. spasmodic croup d. laryngotracheobronchitis (LTB)
b
b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? a. Liquefy secretions b. dilate the bronchioles c. reduce inflammation of the lungs d. reduce infection
b
A child is diagnosed with influenza, probably type A disease. Management includes: a. Clear liquid diet for hydration. b. Aspirin to control fever. c. Amantadine hydrochloride to reduce symptoms. d. Antibiotics to prevent bacterial infection.
c
It is generally recommended that a child with acute streptococcal pharyngitis can return to school: a. When the sore throat is better b. if no complications develop c. after taking antibiotics for 24 hrs d. after taking antibiotics for 3 days
c
It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop: a. Cough. b. osteoporosis c. slow growth d. Cushings syndrome
c
Which intervention for treating croup at home should be taught to parents? a. Have a decongestant available to give the child when an attack occurs. b. Have the child sleep in a dry room. c. Take the child outside. d. Give the child an antibiotic at bedtime.
c
parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend: a. Soccer. b. running c. swimming d. basketball
c
The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the childs care (Select all that apply)? a. Administer antibiotics. b. Administer cough syrup. c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.
c,d,e
A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition? a. allergic rhinitis b. bronchitis c. asthma d. sinusitis
d
Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by: a. fever as high as 104*F b. severe pain in the ear c. n/v d. a feeling of fullness in the ear
d
Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? a. Bronchoscopy b. serum calcium c. urine creatinine d. sweat chloride test
d
Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include: a. Do not administer pancreatic enzymes if the child is receiving antibiotics. b. Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools. c. Administer pancreatic enzymes between meals if at all possible. d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
d
Parents have understood teaching about prevention of childhood otitis media if they make which statement? a. We will only prop the bottle during the daytime feedings. b. Breastfeeding will be discontinued after 4 months of age. c. We will place the child flat right after feedings. d. We will be sure to keep immunizations up to date.
d
Skin testing for tuberculosis (the Mantoux test) is recommended: a. Every year for all children older than 2 years. b. Every year for all children older than 10 years. c. Every 2 years for all children starting at age 1 year. d. Periodically for children who reside in high-prevalence regions.
d
When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to: a. Give tepid water baths to reduce fever. b. Encourage food intake to maintain caloric needs. c. Have child wear heavy clothing to prevent chilling. d. Give small amounts of favorite fluids frequently to prevent dehydration.
d
Which information should the nurse teach workers at a day care center about respiratory syncytial virus (RSV)? a. RSV is transmitted through particles in the air. b. RSV can live on skin or paper for up to a few seconds after contact. c. RSV can survive on nonporous surfaces for about 60 minutes. d. Frequent hand washing can decrease the spread of the virus.
d
Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C and calcium b. Vitamin B12 and B6 c. Magnesium d. Vitamins a,d,e,k
d
Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system? a. They have a widened, shorter airway. b. There is a defect in their sucking ability. c. The gag reflex increases mucus production. d. Mucus and edema obstruct small airways.
d