Pediatrics Exam I (Pediatric Success Ch. 4 Respiratory Disorders)

An 8-month-old male twin is in the hospital with RSV. The nurse educated the parent on how to prevent the healthy twin at home from contracting RSV. Which statement indicates the parent needs further teaching?

"I should make sure that both my children receive Synagis injections for the remainder of this year."

A pediatric client is admitted in status asthmaticus. The parent reports that the child is currently taking Singulair, albuterol, and Flovent. What is the most important piece of information that the nurse must ask the parent in order to best treat the patient?

"When was your child's last dose of medication?"

The parent of a pediatric client with asthma is talking to the nurse about administering the child's albuterol inhaler. Which statement by the parent leads the nurse to believe that the parent needs further education on how to administer the medication?

"I should administer two quick puffs of the albuterol inhaler using a spacer."

A 3-year-old female is admitted to the hospital with asthma. The nurse is trying to work with the child on breathing exercises to increase her expiratory phase. What should the nurse have the child do?

Blow a pinwheel.

A 6-month-old is admitted to the hospital with RAD. The nurse is assessing the child. Which of the following physical findings should be of most concern?

The baby is grunting.

Which of the following statements about pneumonia is accurate?

Children with bacterial pneumonia are usually sicker than children with viral pneumonia.

A 6-year-old presents to the ER with respiratory distress and stridor. The child is diagnosed with RSV. The parent asks the child's nurse how the child will be treated. Which is the nurse's best response?

"We will treat your child with nebulized racemic epinephrine."

Which of the following is the highest priority for receiving the flu vaccine?

A healthy 8-month-old who attends day care.

A 3-year-old is admitted to the hospital with a diagnosis of epiglottitis. The child is in severe distress and needs to be intubated. The mother is crying and tells the nurse that she should have brought her son in yesterday when he said his throat was sore. Which is the nurse's best response?

"Epiglottitis is rapidly progressive; you could not have predicted that his symptoms would worsen so quickly."

A 2-month-old is seen in the pediatrician's office for his 2-month well-child checkup. The nurse is assessing the patient and reports to the physician that the child is exhibiting early signs of respiratory distress. Which of the following would indicate an early sign of distress?

The infant has tachypnea.

The nurse is caring for a 22-month-old male who has had repeated bouts of otitis media. The nurse is educating the parents about otitis media. Which of the following statements from the parents indicates they need additional teaching?

"My child will have fewer ear infections if he has his tonsils removed."

The parent of a 4-month-old with CF asks the nurse what time to begin the child's first CPT each day. Which is the nurse's best response?

"You should do the first CPT 30 minutes before feeding the child breakfast."

A 7-year-old female with asthma is playing a soccer game in gym class. During the game the child begins to cough, wheeze, and have difficulty catching her breath. The school nurse is called to the soccer field. Which of the following should the nurse administer to provide quick relief?

Albuterol.

A 3-year-old is seen in the physician's office for a dry, hacking cough that is preventing the child from sleeping. The child is diagnosed with a URI. Which of the following interventions is most appropriate for this patient?

The child should be given 1/2 teaspoon honey four to five times per day.

The parent of a pediatric client calls the ER. The parent reports that the child has had a barky cough for the last 3 days and it always gets worse at night. The parent asks the nurse what to do. Which is the nurse's best response?

"Take your child outside in the night air for 15 minutes."

A 2-month-old is diagnosed with otitis. The parent asks the nurse if the otitis will have any long-term effects for the child. Understanding the complications that can occur with otitis, which is the nurse's best response?

"The child could suffer recurrent ear infections."

Which of the following children is in the greatest need of emergency medical treatment?

A 6-year-old who has high fever, no spontaneous cough, and frog-like croaking.

The nurse caring for a female pediatric client with CF sends a stool for analysis. The results show an excessive amount of azotorrhea and steatorrhea. What does the nurse realize about the laboratory values?

They reflect that the patient is not compliant with taking her enzymes.

A school-age child has been diagnosed with nasopharyngitis. The parent is concerned because the child has had little or no appetite for the last 24 hours. The parent asks the nurse if this is a concern. Which is the nurse's best response?

"Be sure your child is taking an adequate amount of fluid. The appetite should return soon."

The parent of a 10-month-old male brings the child to the pediatrician's office with URI symptoms and a fever. The parent asks the nurse what can be done at home to improve the child's current condition. Which is the nurse's best response?

"Give your child small amounts of fluid every hour to prevent dehydration."

A pediatric client had a tonsillectomy 24 hours ago. The nurse is reviewing discharge instructions with the parents. The parents tell the nurse that the child is a big eater, and they want to know what foods to give the child for the next 24 hours. What is the nurse's best response?

"The child's diet should be restricted to soft foods."

A 2-year-old is diagnosed with asthma. The parents are big sports fans and want their child to play sports. The parents ask the nurse what impact asthma will have on the child's future in sports. Which is the nurse's best response?

"The earlier a child is diagnosed with asthma, the more significant the symptoms."

A 6-week-old male is admitted to the hospital with influenza. The child is crying, and the father tells the nurse that his son is hungry. The nurse explains that the baby is taking nothing by mouth. The parent does not understand why the child cannot eat. Which is the nurse's best response to the parent?

"The shorter and narrower airway of infants increases their chances of aspiration."

A 3-year-old female is admitted to the ER with drooling, difficulty swallowing, sore throat, and a fever of 39°C (102.2° F). The physician suspects epiglottitis. The parents ask the nurse how the physician will know for sure if their daughter has epiglottitis. Which is the nurse's best response?

"We will do a lateral neck x-ray of the soft tissue."

A 2-year-old is admitted to the hospital in respiratory distress. The physician tells the parents that the child probably has RSV. The parents ask the nurse how they will determine if their child has RSV. Which is the nurse's best response?

"We will swab your child's nose and send those secretions for testing."

A pediatric client is diagnosed with epiglottitis. The parents ask the nurse what treatment their child will receive. Which is the nurse's best response?

"Your child will need to complete a course of intravenous antibiotics."

Which of the following patients is at highest risk for requiring hospitalization as a result of RSV?

A 2-month-old who is a former 32-week preemie.

A sweat chloride test is used to diagnose CF. A chloride level greater than _____________________ is a positive diagnostic indicator of CF.

60 mEq/L

Which of the following children diagnosed with pneumonia would benefit most from hospitalization?

A 15-year-old who has been vomiting for 3 days and has a fever of 38.5°C (101.3°F).

There are several children in the ER waiting area who all have asthma. The nurse has only one room left in the ER. Based on the following information, which child should be seen first?

A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%.

Which of the following children would benefit most from having ear tubes placed?

A 2-year-old who has had five previous ear infections.

A school-age child has been diagnosed with strep throat. The parent asks the nurse when the child can return to school. Which is the nurse's best response?

"24 hours after the first dose of antibiotics."

The parent of a pediatric client with influenza is concerned about when the child will be able to return to school. The parent asks the nurse when the child is most infectious. Which is the nurse's best response?

"24 hours before and after the onset of symptoms."

A physician prescribes 10 days of amoxicillin to treat a 6-year-old male with an ear infection. The nurse is reviewing discharge instructions with the parent. Which information should be included in the discharge instructions?

"Administer the amoxicillin until all the medication is gone."

The parents of a 6-year-old who has a new diagnosis of asthma asks the nurse what to do to make their home a more allergy-free environment for the child. Which is the nurse's best response?

"Avoid purchasing upholstered furniture."

A pediatric client is admitted to the ER with an acute asthma exacerbation. The nurse tells the parents that blood will have to be drawn for some diagnostic laboratory studies. Which laboratory result will provide the health-care team with the most important information regarding the child's respiratory status?

An ABG.

A 6-month-old is diagnosed with an ear infection. The parents report that the child is not sleeping well and is crying frequently. The child also has a moderate amount of yellow drainage coming from the infected ear. This is the parents' first baby. Which of the following nursing objectives is the priority for this family at this time?

Providing pain relief for the child.

The school nurse is planning to educate kindergarten children on how to stop the spread of influenza in the classroom. Which of the following should the nurse instruct the children?

Wash their hands after sneezing.

A 5-year-old is brought to the ER with a temperature of 99.5° F (37.5°C), a barky cough, stridor, and hoarseness. Which of the following nursing interventions should the nurse prepare for?

Respiratory treatment of racemic epinephrine.

A school-age child is admitted to the hospital for a tonsillectomy. The nurse caring for this patient is assessing the child 8 hours after surgery. During the nurse's assessment, the child's parent tells the nurse that the child is in pain. Which of the following observations should be of most concern to the nurse?

The child is swallowing excessively.

Which of the following statements about the inheritance of CF is most accurate?

The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.

A 2-year-old child is brought to the ER with a high fever, dysphagia, drooling, rapid pulse, and tachypnea. What should the nurse's first action be?

Allow the child to sit in the parent's lap while awaiting an x-ray.

A 15-month-old is brought to the ER. The parents tell the nurse that the child has not been eating well and has had an increased respiratory rate. Which of the following assessments is of greatest concern?

The patient is in the tripod position and has diminished breath sounds and a muffled cough.

A pediatric client with severe cerebral palsy is admitted to the hospital with aspiration pneumonia. What is the most beneficial educational information that the nurse can provide to the parents?

The prevention of aspiration pneumonia.

The parent of an 18-year-old with CF is excited about the possibility of the child receiving a double lung transplant. What should the parent understand?

The transplant will not cure the child of CF but will allow the child to have a longer life.

A 2-year-old is admitted to the hospital with croup. The parent tells the nurse that her 7-year-old just had croup and it cleared up in a couple of days without intervention. She asks the nurse why her 2-year-old is exhibiting worse symptoms and needs to be hospitalized. Which is the nurse's best response?

"Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed."

A 3-year-old is brought to the ER with coughing and gagging. The parent reports that the child was eating carrots when she began to gag. What diagnostic evaluation will be used to determine if the child has aspirated the carrot?

A bronchoscopy will be performed.

A 5-year-old female is diagnosed with pharyngitis. The child is complaining of throat pain. Which of the following statements by the mother indicates that she needs more education regarding the care and treatment of her daughter's throat pain?

"I will give my daughter her amoxicillin until all doses of the antibiotic are gone."

A 2-year-old has just been diagnosed with CF. The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best response?

"You can expect your child to develop wheezing respirations."

A pediatric client was seen at the pediatrician's office and was diagnosed with viral tonsillitis. The parent asks how to care for the child at home. Which is the nurse's best response?

"You can give your child Tylenol every 4 to 6 hours as needed for pain."

The parent of a 10-month-old with CF asks the nurse how to meet the child's increased nutritional needs. Which is the nurse's best suggestion?

"You may need to change your child to a higher-calorie formula."

The parent of a 9-month-old calls the ER because his child is choking on a marble. The parent tells the nurse that he knows cardiopulmonary resuscitation. The parent asks how to help his child while waiting for Emergency Medical Services. Which is the nurse's best response?

"You should administer five back blows followed by five chest thrusts."

The parent of a pediatric client who has had frequent ear infections asks the nurse if there is anything that can be done to help the child avoid future ear infections. Which is the nurse's best response?

"Your child should be kept away from tobacco smoke."

A female child with CF is hospitalized with constipation. The parent asks the nurse what will need to be done to relieve the child's constipation. Which is the nurse's best response?

"Your child will likely be given GoLYTELY to relieve her constipation."

A physician diagnoses a school-age child with strep throat and pharyngitis. The child's parent asks the nurse what treatment the child will need. Which is the nurse's best response?

"Your child will need oral penicillin for 10 days and should feel better in a few days."

A pediatric client is seen in the ER with a nonproductive cough, clear nasal drainage, and congestion. The child is diagnosed with nasopharyngitis. What information should the nurse include in the discharge instructions?

Educate the parents on comfort measures for the child.

A 7-month-old is taken to the pediatrician's office with a low-grade fever, nasal congestion, and a mild cough. Which should the nursing care management of this child include?

Instilling saline nose drops and bulb suctioning.

The community health nurse is teaching a child-safety class to parents of toddlers. Which information will be most helpful in teaching the parents about the primary prevention of foreign body aspiration?

Knowledge of the most common objects that toddlers aspirate.

Nursing care management of the pediatric client with a diagnosis of mononucleosis should include which of the following?

Limit the child's visitors to family only.

A pediatric client is admitted to the hospital with left-sided pneumonia. The client is complaining of pain and wants to be repositioned in the bed. The nurse knows the patient may be most comfortable in which position?

Lying on the left side.

What does the therapeutic management of CF patients include? Select all that apply.

Providing a high-protein, high-calorie diet. Encouraging exercise. Minimizing pulmonary complication. Encouraging medication compliance.

The parents of a 5-week-old have just been told that their child has CF. The mother had a sister who died of CF when she was 19 years of age. The parents are sad and ask the nurse several questions about CF and the current projected life expectancy. What is the nurse's best initial intervention?

The nurse should listen to the parents and be available to them anytime during the day to answer their questions.