Chapter 24

Which of the following makes children prone to tonsillitis and pharyngitis?

frequent upper respiratory tract infections and being around other children who may be infected

The nurse is talking with parents about the prevention of otitis media. Which of the following would the nurse identify as preventive measures?

immunizations and breastfeeding

In assessing a client with allergic rhinitis and in teaching the caregivers, the nurse will keep in mind that perennial allergic rhinitis is most often related to sensitivity to which of the following allergens?

indoor allergens such as dust mites and mold

During which of the following age periods does a child have the most limited alveolar surface for gas exchange in relation to height and weight?

infancy

35.Which of the following body structures is infected then a child has croup?

larynx, trachea, and large bronchi

The nurse is assigned to care for a child who had a tonsillectomy yesterday. The child complains of a sore throat and wants something cool. Which of the following cool drinks or foods would be acceptable to offer the child?

lime sherbet

The nurse working with a child with laryngotracheobronchitis is offering the child tiny medicine cups of fluid and giving stickers and prizes for meeting goals related to intake of fluid. All this effort on the part of the nurse to get the child to drink more fluid is because the fluid is needed to:

loosen secretions

Which of the following is an herbal substance that is mixed with water and taken orally to soothe and relax the airway and relieve cough?

mullein

Which of the following outcomes is the most important for a child who has had a tonsillectomy?

no postoperative bleeding

The nurse who is teaching a caregiver about avoiding triggers of asthma for a child. The nurse will evaluate the caregiver as having understood the instruction when the caregiver comes back in 2 weeks and gives which of the following reports?

I launder the bed linens and clothing in water that is at least 54.4 degrees C (130 degrees F).

The nurse is assessing a child with croup. Which of the following signs or symptoms would the nurse associate with croup and most expect to find?

bark-like cough, hoarseness, inspiratory stridor

Which of the following outcomes is the primary criterion for evaluating the resolution of ineffective airway clearance?

clear airway sounds

Which of the following respiratory alterations is the same as nasopharyngitis?

common cold

Which of the following is the primary complication of otitis media?

conductive hearing loss

Examination of the throat of a child with acute epiglottis by depressing the tongue is:

contraindicated due to the possibility of causing complete airway obstruction

The nurse is assessing the skin moisture of a child with laryngotracheobronchitis. Which of the following explains why the nurse assessed the skin moisture in this case?

diaphoresis is associated with increased respiratory effort

A child with acute otitis media is put on antibiotics. The caregivers ask when the child will be better. The nurse will explain that, then treated with antibiotics, an acute otitis media will begin to resolve in how many days?

2 to 3

Compared to that of an adult, which of the following percentages represents a childs oxygen consumption?

200%

Chronic otitis media is an inflammation of the middle ear that persists beyond which of the following time periods?

3 months

Which of the following represents the life-expectancy of a child with cystic fibrosis?

30 years +

The nurse explains to parents why an adenoidectomy is sometimes indicated with the tonsillectomy. Which of the following is the nurses best explanation?

An adenoidectomy is justified when a childs enlarged adenoids block the flow of air through the nasal passages.

The pediatric nurse is assessing a child with nasopharyngitis. The parents ask about the possibility of the child getting an antibiotic. Which of the following is the nurses best answer?

Antibiotics are not effective in the treatment of nasopharyngitis.

Which of the following instructions is the most important discharge teaching for the caregivers of a child who is postoperative from a tonsillectomy?

Between 4 and 10 days postoperatively, a membrane that formed over the surgical site may hemorrhage and require immediate medical attention.

The school nurse encourages the parents of a student who has a severe sore throat to take the child to the pediatrician. The nurse is especially concerned about the possibility of streptococcal tonsillitis mainly because of which of the following?

If streptococcal tonsillitis is not treated adequately it may lead to scarlet fever, otitis media, or more serious complications.

Which of the following is the nurses best course of action when he or she finds out that a family is using herbal remedies?

Question the caregiver about the herb(s) because some herbs are not safe or have adverse interactions with prescribed medications.

When a premature newborn is showing signs of developing respiratory distress syndrome or bronchopulmonary dysplasia, which of the following treatments is most likely given to reduce the chance of the infant having these problems?

exogenous surfactant therapy

A child who is in the first postoperative day after a tonsillectomy starts to cough and wants to blow his nose. Which of the following actions by the nurse would be best?

Remind the child not to cough or blow his nose.

A nurse working in the health clinic is performing the initial history for an adopted Chinese child who has recently immigrated to the United States. The nurse anticipates exploring which of the following priority questions with the childs parents? Select all that apply.

Tell me about the childs immunization history. Has the child been exposed to any known communicable illnesses?

The nurse will teach parents of a young infant who has nasopharyngitis to modify the feedings. Which modification would be most important and helpful?

With a calm and patient approach, feed the infant with frequent rest periods during each feeding.

A parent asks the nurse to explain why children under the age of 3 are more vulnerable to otitis media. The nurse explains that this is mainly due to which of the following?

Young children have wider, shorter, and straighter eustachian tubes than older children and adults.

Which of the following is the primary function of the respiratory system?

facilitate gas exchange

The mother of a 2-1/2-year old child who has had tonsillitis asks about the possibility of a tonsillectomy for the child. The nurse informs the mother that tonsillectomies are usually performed when the child is over 3 years old. The mother wants to know why children younger than 3 have to wait for a tonsillectomy. Which of the following is the nurses best answer?

Younger children are more prone to excessive blood loss and the tonsils growing back.

Which of the following statements best describes croup?

a common viral syndrome

The nurse assessing a child with a respiratory problem finds stridor, which is best described by which of the following?

a high-pitched sound produced by an obstruction of the trachea or larynx

The nurse assessing a child with nasopharyngitis would most likely find the child to have which of the following signs or symptoms?

a normal white blood cell count (WBC), stuffy nose, nasal discharge, cough, sore throat, and malaise

Otitis media can occur with or without an effusion. Which of the following best describes an effusion?

accumulation of fluid such as in the middle ear or pleural cavity

The nurse is assessing a child with a diagnosis of pneumonia. The child is taking shallow respirations. Which of the following is the most likely explanation?

an attempt to minimize pain

Which of the following statements best defines cystic fibrosis?

an autosomal recessive disorder that mainly affects the exocrine glands and does multiple system damage

The nurse who is teaching the caregivers of children who are going to be skin tested for allergies will teach them to avoid giving the child which of the following medications for several days to weeks before the test?

antihistamines

Pneumonia in children appears:

as a primary disease or a complication of another disease

Which of the following conditions is the leading cause of pediatric chronic illness?

asthma

Which of the following types of pneumonia would be treated with antibiotics?

bacterial

Which of the following signs or symptoms is the earliest manifestation of bleeding in a child who has had a tonsillectomy?

frequent swallowing

Which of the following positions does the nurse use for the child who has just returned to the room from a tonsillectomy?

on the abdomen or side

The nurse is assessing a preverbal child who keeps pulling on his ear. The nurse knows that this behavior is one way that children express:

pain

The treatment of chronic fluid collections in the middle ear that take more than 3 or 4 months to resolve are treated with antibiotics or which of the following procedures?

placement of tubes

The nurse is caring for a child who is on ribavirin. Which of the following people most need to be discouraged from visiting?

pregnant health care workers

The nurse is caring for a child with a diagnosis of bronchiolitis who is being managed at home. Which of the following strategies to foster adequate ventilation would be best for the nurse to suggest to the family?

raising the head of the childs bed

The nurse inspecting the tympanic membrane of a child with acute otitis media will find a tympanic membrane that is best described as:

red and bulging with full or absent light reflex

The nurse assessing a child with acute epiglottitis looks up the disorder as a review and is most likely to find which of the following classic symptoms associated with this disorder?

respiratory distress, drooling, fever, agitation, and lethargy

Which of the following therapies is the only specific therapy for respiratory syncytial virus (RSV) bronchiolitis?

ribavirin (Virazole)

When the nurse is teaching the parents how to relieve nasal congestion in their infant, the nurse will recommend which of the following?

saline nasal drops instilled every 3 to 4 hours

The nurse who is teaching parents about reducing risk factors for otitis media in children would mention which of the following as putting children most at risk for otitis media?

secondhand smoke

Which of the following factors are age-related physical differences in infants that most increase this populations risks for developing a respiratory system dysfunction?

small airways and fewer alveoli

When an infant is in respiratory distress and having retractions, what causes the retractions?

soft tissue surrounding the ribs and sternum are drawn inward during inspiration

Which of the following characterizes the course of acute otitis media?

sudden onset and short duration

What is meant by the ventilation/perfusion ratio?

the comparison of alveolar ventilation to capillary perfusion

The treatment of pneumonia most depends on:

the etiologic agent

The nurse is making home visits to a child who is being treated for a diagnosis of pneumonia. The nurse notices that the family has a large amount of garlic on hand. Which of the following most likely explains why the garlic is present?

to be eaten raw to treat the cough and to serve as an antibiotic

What is the major cause of nasopharyngitis?

viruses

Which of the following pathogens causes bronchiolitis?

viruses