Peds Chapter 40; The Child With Respiratory Dysfunction

Apnea of infancy has been diagnosed in an infant scheduled for discharge with home monitoring. Part of the infant's discharge teaching plan should include A. Cardiopulmonary resuscitation (CPR) B. Administration of intravenous (IV) fluids C. Foreign airway obstruction removal using the Heimlich maneuver D. Advice that the infant not be left with caretakers other than the parents

A. Cardiopulmonary resuscitation (CPR)

Asthma is classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include (Select all that apply) A. lung function. B. associated allergies. C. frequency of symptoms. D. frequency and severity of exacerbations.

A. lung function. D. frequency and severity of exacerbations.

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 A. pneumothorax. B. bronchodilation. C. carbon dioxide retention. D. increased viscosity of sputum.

A. pneumothorax.

An infant with a congenital heart defect is receiving palivizumab (Synagis). Based on the nurse's knowledge of medication, the purpose of this medication is to A. prevent respiratory syncytial virus (RSV) infection. B. make isolation of the infant with RSV unnecessary. C. prevent secondary bacterial infection. D .decrease toxicity of antiviral agents.

A. prevent respiratory syncytial virus (RSV) infection.

A 4-year-old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate the breathing to use it effectively. The nurse should suggest that he use a A. spacer. B. nebulizer. C. peak expiratory flow meter. D. trial of chest physiotherapy.

A. spacer.

The most appropriate nursing intervention for a child following a tonsillectomy is to A. watch for continuous swallowing. B. encourage gargling to reduce discomfort. C. position the child on the back for sleeping. D. apply warm compresses to the throat.

A. watch for continuous swallowing.

The most appropriate time to perform bronchial postural drainage is A. immediately before all aerosol therapy. B. before meals and at bedtime. C. Immediately on arising and at bedtime. D. thirty minutes after meals and at bedtime

B. before meals and at bedtime.

An immediate intervention to teach parents for when an infant chokes on a piece of food would be to A. have infant lie quietly while a call is placed for emergency help. B. position infant in a head-down, face-down position and administer five quick back slaps. C. administer mouth-to-mouth resuscitation. D. give some water by a cup to relieve the obstruction.

B. position infant in a head-down, face-down position and administer five quick back slaps.

The mother of a 20-month-old tells the nurse that the child has a barking cough at night. The child's temperature is 37ºC (98.6ºF). The mother states the child is not having difficulty breathing. The nurse suspects croup and should recommend A. controlling the fever with acetaminophen (Tylenol) and call the primary care provider if the cough gets worse tonight. B. trying a cool-mist vaporizer at night and watching for signs of difficulty breathing. C. trying over-the-counter cough medicine and coming to the clinic tomorrow if there is no improvement. D. bringing the child to the hospital to be admitted and to be observed for impending epiglottitis.

B. trying a cool-mist vaporizer at night and watching for signs of difficulty breathing.

A child with asthma is having pulmonary function tests. What explains the purpose of the peak expiratory flow rate (PEFR)? A. Confirms the diagnosis of asthma B. Determines the cause of asthma C. Identifies the "triggers" of asthma D. Assesses the severity of asthma

D. Assesses the severity of asthma

What clinical manifestation would the nurse expect when a pneumothorax occurs in a neonate who is undergoing mechanical ventilation? A. Barrel chest B. Wheezing C. Thermal instability D. Nasal flaring and retractions

D. Nasal flaring and retractions

The nurse is interviewing the parents of a 4-month-old infant brought to the hospital emergency department. The infant is dead on arrival, and no attempt at resuscitation is made. The parents state that the baby was found in the crib with a blanket over the head, lying face down in bloody fluid from the nose and mouth. The parents indicate no problems when the infant was placed in the crib asleep. Which of the following causes of death does the nurse suspect? A. Suffocation B. Child abuse C. Infantile apnea D. Sudden infant death syndrome (SIDS)

D. Sudden infant death syndrome (SIDS)

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

D. acute rheumatic fever

One of the goals for children with asthma is to prevent respiratory tract infection because infections A. lessen effectiveness of medications. B. encourage exercise-induced asthma. C. increase sensitivity to allergens. D. can trigger an episode or aggravate asthmatic state.

D. can trigger an episode or aggravate asthmatic state.

The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. The first action by the nurse is to A. determine what the child has eaten. B. administer diphenhydramine (Benadryl) PO stat. C. move the child to the nurse's office or hallway. D. have someone call for an ambulance and paramedic rescue squad or 9-1-1.

D. have someone call for an ambulance and paramedic rescue squad or 9-1-1.

A 4-year-old child is brought to the emergency department. The child has a "froglike" croaking sound on inspiration, is agitated, and is drooling. The child insists on sitting upright. The priority action by the nurse is to A. examine the child's oropharynx and report the assessment to the healthcare provider. B. make the child lie down and rest quietly. C. auscultate the child's lungs and make preparations for placement in a mist tent. D. notify the healthcare provider immediately and be prepared to assist with a tracheostomy or intubation

D. notify the healthcare provider immediately and be prepared to assist with a tracheostomy or intubation

A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because it A. liquefies secretions. B. improves oxygenation. C. promotes ventilation. D. soothes inflamed mucous membrane

D. soothes inflamed mucous membrane

The Heimlich maneuver is recommended for airway obstruction in children older than _____ year(s). a. 1 b. 4 c. 8 d. 12

a. 1

Abdominal thrusts are recommended for airway obstruction in children older than a. 1 year b. 4years. c. 8 years. d. 12 years

a. 1 year

An 11-month-old infant is experiencing their first acute otitis media (AOM). What should the nurse include in the discharge teaching to the infant's parents? Select all that apply. a. A follow-up visit should occur after the antibiotic treatment is completed. b. Antibiotic ear drops will be administered in conjunction with the oral antibiotics to decrease pain. c. Tylenol should not be given because it may mask symptoms of mastoiditis. d. All prescribed medication should be completed even if the infant appears to be feeling better. e. Tylenol or Ibuprofen may be administered to assist in controlling the infant's fevers.

a. A follow-up visit should occur after the antibiotic treatment is completed. d. All prescribed medication should be completed even if the infant appears to be feeling better. e. Tylenol or Ibuprofen may be administered to assist in controlling the infant's fevers.

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests which respiratory condition? a. Asthma b. Pneumonia c. Bronchiolitis d. Foreign body in the trachea

a. Asthma

An infant's parents ask the nurse about preventing otitis media (OM). What intervention 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. Avoid tobacco smoke.

Instructions for decongestant nose drops should include what recommendation? 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. Avoiding use for more than 3 days

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. Before chest physiotherapy (CPT)

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 assessment is most suggestive of what respiratory airway disorder? a. Bronchitis b. Bronchiolitis c. Viral-induced asthma d. Acute spasmodic laryngitis

a. Bronchitis

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which interventions? (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

a. Cluster care to conserve energy d. Administration of antibiotics

A school-age child has been admitted with an acute asthma episode. The child is receiving oxygen by nasal prongs at 2 liters. How often should the nurse plan to monitor the child's pulse oximetry status? a. Continuous b. Every 30 minutes c. Every hour d. Every 2 hours

a. Continuous

Which of the following signs is an early indication of hemorrhage in a child who has had a tonsillectomy? a. Continuous swallowing b. Decreasing blood pressure c. Irritability d. Nasal drainage

a. Continuous swallowing

In providing nourishment for a child with cystic fibrosis (CF), what diet consideration should be stressed to both the child and caregivers? 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. Diet should be high in carbohydrates and protein.

The parents of a newly diagnosed 5-year-old female with CF ask the nurse what time to begin the child's airway clearance therapies (ACT) each day. Which is the nurse's best response? a. Do the ACTs 30 minutes before meals. b. Do the ACTs before any nebulized aerosol treatments. c. Do the ACTs 30 minutes after meals. d. Do the ACTs when you notice your daughter has a cold or congestion

a. Do the ACTs 30 minutes before meals.

A nurse is charting that a hospitalized child has labored breathing. Which medical term describes labored breathing? a. Dyspnea b. Tachypnea c. Hypopnea d. Orthopnea

a. Dyspnea

A 17-year-old female with cystic fibrosis is hospitalized for a "tune-up." Which documentation in the chart would indicate the need for counseling regarding nutrition? a. Five to six frothy, foul-smelling stools. b. Weight unchanged from 3 days ago. c. Consumed 50% of her breakfast this morning. d. Eats three snacks a day

a. Five to six frothy, foul-smelling stools.

In the child who is suspected of having epiglottitis, the nurse should: a. Have intubation equipment available. b. Visually inspect the child's oropharynx with a tongue blade. c. Obtain a throat culture. d. Prepare to immunize the child for Haemophilus influenzae.

a. Have intubation equipment available.

An 18-month-old child is seen in the clinic is diagnosed with acute otitis media (AOM). Oral amoxicillin 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. I should administer all the prescribed medication.

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? a. If it is present in a child, both parents can be 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. If it is present in a child, both parents can be carriers of this defective gene.

The use of palivizumab (Synagis), for RSV is given because: a. It helps prevent RSV in high-risk populations. b. It is an antiviral agent. c. It helps treat patients at low risk for mortality. d. It can be used for any infant.

a. It helps prevent RSV in high-risk populations.

A quantitative sweat chloride test has been done on a 6-month-old child. What value should be most indicative of cystic fibrosis (CF)? a. Less than 18 mEq/L b. 18-40 mEq/L c. 40-60 mEq/L d. Greater than 60 mEq/L

a. Less than 18 mEq/L

What are the earliest recognizable clinical manifestations of cystic fibrosis (CF)? a. Meconium ileus b. History of poor intestinal abso1ption c. Foul-smelling, frothy, greasy stools d. Recurrent pneumonia and lung infections

a. Meconium ileus

The nurse examines a 6-year-old child with asthma and finds that there is hyperresonance on percussion. Breath sounds are coarse and loud with sonorous crackles throughout the lung fields. Expiration is prolonged; crackles can be heard. There is generalized inspiratory and expiratory wheezing. The child has these symptoms two times a week, with nighttime episodes a few times per month. He uses a short-acting β agonist daily and his FEV1 is 80%. Based on these findings, the nurse suspects that there is: a. Moderate persistent asthma. b. Severe persistent asthma. c. Mild persistent asthma. d. Mild intermittent asthma

a. Moderate persistent asthma.

What nursing intervention should be included in the plan of care for a young child diagnosed with pneumonia? a. Monitor for abdominal pain. b. Encourage the child to lie on the unaffected side. c. Administer analgesics. d. Place the child in the Trendelenburg position.

a. Monitor for abdominal pain.

A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis? a. Nonproductive cough, wheezing b. Fever, general malaise c. Productive cough, rales d. Stridor, substernal retractions

a. Nonproductive cough, wheezing

A 4-year-old child is 12 hours status post a tonsillectomy. The child is taking some clear liquids; however, the child "spit up" a small amount of fresh red blood. What is the most appropriate action to take? a. Notify the health care provider immediately. b. Ask the parents to let you know if the child vomits anymore. c. Give the child pain medication and a popsicle. d. Give the child an ice pack to promote vasoconstriction and decrease/stop the bleeding.

a. Notify the health care provider immediately.

An 18-month-old is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which of the following? a. Racemic epinephrine nebulized treatments and corticosteroids b. Intravenous (IV) and oxygen c. Antibiotics and albuterol d. Chest physiotherapy (CPT) and oxygen

a. Racemic epinephrine nebulized treatments and corticosteroids

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. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses.

Which of the following is not a typical clinical manifestation of the influenza virus? a. Stridor and lymphadenopathy b. Fever and chills c. Sore throat and dry mucous membranes d. Photophobia and myalgia

a. Stridor and lymphadenopathy

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. There is heightened airway reactivity.

Which of the following are common symptoms seen in a foreign body aspiration of children? a. Wheezing b. Diaphoresis c. Drooling d. Nasal congestion

a. Wheezing

A toddler has been diagnosed with S. pneumonia. Nursing care of the child with pneumonia includes which intervention? a. Administration of antibiotics. b. Administration of oseltamivir (Tamiflu). c. Round-the-clock administration of antitussive agents. d. Strict monitoring of intake and output to avoid congestive heart failure.

b. Administration of oseltamivir (Tamiflu).

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratroy tract infection

b. Complete obstruction

Beta Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack for what resulting action? a. Liquefaction of secretions b. Dilation of the bronchioles c. Reduction of inflammation of the lungs d. Reduction of existing infection

b. Dilation of the bronchioles

Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis c. Spasmodic croup d. Laryngotracheobronchitis (LTB)

b. Epiglottitis

Since the advent of immunization for Haemophilus influenzae, there has been a decrease in the incidence of: a. Laryngotracheobronchitis. b. Epiglottitis. c. Influenza (seasonal). d. Croup

b. Epiglottitis.

The best technique to prevent spread of nasopharyngitis is: a. Prompt immunization. b. Frequent hand washing and use of a tissue or their elbow to cover their mouth or nose when they cough or sneeze. c. Mist vaporization. d. To ensure adequate fluid intake.

b. Frequent hand washing and use of a tissue or their elbow to cover their mouth or nose when they cough or sneeze.

An 8-year-old child diagnosed with asthma is being taught how to use a spacer with an albuterol inhaler. What is the best way for the nurse to evaluate the child's understanding of how to use the spacer? a. Guide the child step by step through the process. b. Have the child attach the spacer to the inhaler and use it. c. Have the child verbalize how to use the spacer. d. Attach the spacer to the inhaler, then have the child to use it.

b. Have the child attach the spacer to the inhaler and use it.

Nursing care management of the 6-month-old infant with RSV bronchiolitis should include: a. Supplemental oxygen to keep oxygen saturation levels greater than 94%. b. IV fluids during the acute phase of the illness. c. Appropriate bronchodilation therapy. d. Chest physiotherapy (CPT) every 4 hours and as needed.

b. IV fluids during the acute phase of the illness.

What distinguishing manifestation of spasmodic croup should parents be taught to identify? a. Wheezing is heard audibly. b. It has a harsh, barkey cough. c. It is bacterial in nature. d. The child has a high fever

b. It has a harsh, barkey cough.

Which of the following is the best choice for the child with acute respiratory disorder? a. IV fluid restriction b. Maintenance of patient comfort c. Insist that the child play quietly in bed. d. Use tidal volumes of 10 ml/kg

b. Maintenance of patient comfort

A child diagnosed with cystic fibrosis is prescribed recombinant human deoxyribonuclease (rhDNase). What information should be included in the medication education provided the child and family? a. May cause mucus to thicken. b. May cause minor voice alterations. c. Is given subcutaneously. d. Is not indicated for children younger than 12 years.

b. May cause minor voice alterations.

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this child's care? a. Monitor pulse oximetry. b. Monitor arterial blood gases (ABGs). c. Administer oxygen if respiratory distress develops. d. Administer oxygen if the child's lips become bright, cherry red.

b. Monitor arterial blood gases (ABGs).

The nurse is caring for a child diagnosed with acute respiratory distress syndrome (ARDS) associated with sepsis. What nursing intervention should be included in the plan of care? a. Force fluids. b. Monitor pulse oximetry. c. Institute seizure precautions. d. Encourage a high-protein diet

b. Monitor pulse oximetry.

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. Repeated exposure to organisms causes increased immunity.

During influenza epidemics, it is generally believed the age group that provides a major source of transmission is the: a. Infant. b. School-age child. c. Adolescent. d. Preschool-age child.

b. School-age child.

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse's prima1y rationale for this action? a. Mothers of hospitalized toddlers often experience guilt. b. The mother's presence will reduce anxiety and ease the child's respirato1y efforts. c. Separation from the 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 the child's respiratory efforts.

Most respiratory infections in children are caused by: a. Pneumococci. b. Viruses. c. Streptococci. d. Haemophilus influenzae.

b. Viruses.

A nurse is admitting an infant with asthma. The nurse understands that 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. a viral infection.

Which of the following questions would be most important for the nurse to ask the parents of a child admitted to the hospital with a diagnosis of reactive airway disease? a. "What brings you to the hospital?" b. "What is your ethnic background?" c. "Do you have a history of asthma in your family?" d. "Were your pregnancy and delivery uneventful?"

c. "Do you have a history of asthma in your family?"

A nurse is teaching an adolescent how to use the peak expiratory flowmeter. The adolescent has understood the teaching if which statement is made? a. "I will record the first reading I get." b. "I should be sitting comfortably when I perform the readings." c. "I will record the readings at the same time every day." d. "I will repeat the routine two times."

c. "I will record the readings at the same time every day."

Respiratory syncytial virus (RSV) is: a. An uncommon virus that causes severe bronchiolitis. b. An uncommon virus that usually does not require hospitalization. c. A common virus that usually occurs primarily in winter and early spring. d. A common virus that usually does not require hospitalization.

c. A common virus that usually occurs primarily in winter and early spring.

The primary concern of the nurse when giving tips for how to increase humidity in the home of a child with a respiratory infection should be to make sure the child has: a. Continuous contact with the humidification source. b. A warm humidification source. c. A humidification source that is safe. d. A cool humidification source.

c. A humidification source that is safe.

The nurse should suspect epiglottitis if the child has: a. Cough, sore throat, and agitation. b. Cough, drooling, and retractions. c. Absence of cough in the presence of drooling and agitation. d. Absence of cough, hoarseness, and retractions.

c. Absence of cough in the presence of drooling and agitation.

When it is generally recommended that a child being treated for acute streptococcal pharyngitis may return to school? a. When the sore throat is better b. If no complications develop c. After taking antibiotics for 24 hours d. After taking antibiotics for 3 days

c. After taking antibiotics for 24 hours

Of the foods listed, the most appropriate selection to offer first to an alert child who is in the postoperative period following a tonsillectomy is: a. Strawberry ice cream. b. Red cherry-flavored gelatin. c. An apple-flavored ice pop. d. Cold diluted orange juice.

c. An apple-flavored ice pop.

An abnormal otoscopic examination would reveal: a. Visible landmarks. b. A light reflex. c. An erythematous bulging tympanic membrane. d. A mobile tympanic membrane

c. An erythematous bulging tympanic membrane.

Group A β-hemolytic streptococcal (GABHS) infection is usually a. Serious infection of the upper airway. b. Common cause of pharyngitis in children over the age of 15 years. c. Brief illness that places the child at risk for serious sequelae. d. Disease of the heart, lungs, joints, and central nervous system.

c. Brief illness that places the child at risk for serious sequelae.

Children with mild croup syndrome (no stridor): a. Require hospitalization. b. Will need to be intubated. c. Can be cared for at home. d. Are over 6 years old.

c. Can be cared for at home.

General signs of bacterial pneumonia include: a. Low fever and nausea. b. Clear breath sounds and brown sputum. c. Cough, tachypnea, and fever. d. Nasal flaring and tympany with percussion.

c. Cough, tachypnea, and fever.

The nurse is caring for a 10-month-old infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? (Select all that apply.) a. Administer antibiotics. b. Administer cough syrup. c. Encourage infant to drink 8 ounces of fo1mula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.

c. Encourage infant to drink 8 ounces of fo1mula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.

In an 8-month-old infant admitted to the hospital with pertussis, the nurse should inquire about the: a. Living conditions of the infant and family. b. Labor and delivery history of the mother. c. Immunization status of the infant. d. Alcohol and drug intake of the mother

c. Immunization status of the infant.

The most likely reason that the respiratory infection rate increases drastically in the age range from 3 to 6 months is that the: a. Infant's exposure to pathogens is greatly increased during this time. b. Viral agents that are mild in older children are extremely severe in infants. c. Maternal antibodies have decreased and the infant's own antibody production is immature. d. Diameter of the airways is smaller in the infant than in the older child.

c. Maternal antibodies have decreased and the infant's own antibody production is immature.

The nurse is caring for a child diagnosed with an acute respiratory infection. What nursing intervention should be included in the plan of care? Select one: a. Encourage at least 4 ounces of fluid per hour b. Assess respiratory rate once per shift c. Monitor pulse oximetry continuously d. Instruct the patient to eat a high-protein diet

c. Monitor pulse oximetry continously

An 8-year-old child is diagnosed with influenza, probably type A disease. What intervention should be included in the plan of care? a. Clear liquid diet for hydration b. Aspirin to control fever c. Oseltamivir to reduce symptoms d. Antibiotics to prevent bacterial infection

c. Oseltamivir to reduce symptoms

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently to monitor for what increased risk? a. Cough b. Osteoporosis c. Slowed growth d. Cushing's syndrome

c. Slowed growth

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 which of the following types of isolation would be appropriate? a. Standard and droplet b. Droplet and contact c. Standard, droplet, and contact d. Standard, contact, and airborne

c. Standard, droplet, and contact

A parent whose two school-age children diagnosed with exercise-induced bronchospasm (EIB) asks the nurse in what sports, if any, they can participate. The nurse should recommend which sport? a. Soccer b. Running c. Swimming d. Basketball

c. Swimming

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 if air is cool and moist. d. Give the child an antibiotic at bedtime.

c. Take the child outside if air is cool and moist.

A nurse providing care to a child diagnosed with chronic otitis media with effusion (OME) will assess for which sign/symptom? a. Fever as high as 40°C (104°F) b. Severe pain in the ear c. Nausea and vomiting d. A feeling of fullness in the ear

d. A feeling of fullness in the ear

What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? a. Magnesium sulfate b. Theophylline c. Atrovent d. Albuterol

d. Albuterol

The principal treatment for the pancreatic insufficiency which occurs in cystic fibrosis is the administration of: a. Enemas. b. Corticosteroids. c. Antibiotics. d. Enzymes.

d. Enzymes.

The nurse should prepare for an impending emergency situation to care for the child with suspected: a. Spasmodic croup. b. Laryngotracheobronchitis. c. Acute spasmodic laryngitis. d. Epiglottitis.

d. Epiglottitis.

Which information should the nurse stress to 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. Frequent hand washing can decrease the spread of the virus.

When caring for an infant with an upper respiratory tract infection and elevated temperature, which appropriate nursing intervention should the nurse implement? 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. Give small amounts of favorite fluids frequently to prevent dehydration.

Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? a. Hyperactivity of sweat glands b. Hypoactivity of autonomic nervous system c. Atrophy in the mucosal walls of all body systems d. Increased thickness of mucous gland secretions

d. Increased thickness of mucous gland secretions

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 then sucking ability. c. The gag reflex increases mucus production. d. Mucus and edema obstruct small airways.

d. Mucus and edema obstruct small airways.

Pancreatic enzymes are administered to the child with cystic fibrosis. What infornation should be included in patient education concerning the administration of these enzymes? 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. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

In the postoperative period following a tonsillectomy, the child should be: a. Placed in the Trendelenburg position. b. Encouraged to cough and deep breathe. c. Suctioned vigorously to clear the airway. d. Positioned to facilitate drainage of secretions

d. Positioned to facilitate drainage of secretions

When should the parent of an infant with nasopharyngitis be instructed to notify the health care professional? a. Becomes fussy. b. Has a cough. c. Has a fever over 99°F. d. Shows signs of an earache.

d. Shows signs of an earache.

Which of the following is the most common bacterial pathogen responsible for community-acquired pneumonia in children 5 years or older? a. Haemophilus pneumoniae b. Mycoplasma pneumoniae c. Staphylococcal aureus pneumoniae d. Streptococcal pneumoniae

d. Streptococcal pneumoniae

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. Sweat chloride test

Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C and calcium b. Vitamins B6 and B12 c. Magnesium d. Vitamins A, D, E, and K

d. Vitamins A, D, E, and K

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. We will be sure to keep immunizations up to date