CHAPTER 18: ALTERATIONS IN GAS EXCHANGE/RESPIRATOR DISORDER

A nurse is preparing a teaching program for a parenting group about preventing foreign body aspiration. Which of the following would the nurse include? A) Avoid giving popcorn to children younger than the age of 2 years. B) Withhold peanuts from children until they are at least 5 years of age. C) If an object fits through a standard toilet paper roll, the child can aspirate it. D) Keep pennies and dimes out of the child's reach; quarters do not pose a problem.

C

A parent asks the nurse about immunizing her 7-month-old daughter against the flu. Which response by the nurse would be most appropriate? A) "She really doesn't need the vaccine until she reaches 1 year of age." B) "She will probably receive it the next time she is to get her routine shots." C) "Since your daughter is older than 6 months, she should get the vaccine every year." D) "The vaccine has many side effects, so she wouldn't get it until she's ready to go to school."

C

Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? A) Fever B) Oxygen saturation level of 96% C) Tachypnea with retractions D) Pale skin color

C

The nurse hears wheezing when auscultating a 4-year-old. Which of the following conditions would the nurse most likely rule out based on the assessment findings? A) Bronchiolitis B) Asthma C) Influenza D) Cystic fibrosis

C

When performing the physical examination of a child with cystic fibrosis , which of the following would the nurse expect to assess? A) Dullness over the lung fields B) Increased diaphragmatic excursion C) Decreased tactile fremitus D) Hyperresonance over the liver

C

The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which of the following drugs would the nurse identify as an adjunct to a b2-adrenergic agonist for treatment of bronchospasm? A) Ipratropium B) Montelukast C) Cromolyn D) Theophylline

A

The nurse is preparing to provide tracheostomy care to an infant. After gathering the necessary equipment, which of the following would the nurse do next? A) Position the infant supine with a towel roll under the neck B) Cut the new tracheostomy ties to the appropriate length C) Cut the tracheostomy ties from around the tracheostomy tube D) Cleanse around the site of the tracheostomy with the prescribed solution

A

The nurse is examining a 5-year-old boy. Which of the following signs or symptoms is a reliable first indication of respiratory illness in children? A) Slow, irregular breathing B) A bluish tinge to the lips C) Increasing lethargy D) Rapid, shallow breathing

D

The nurse is assessing a 7-year-old boy with pharyngitis. The nurse would least likely expect to assess which of the following? A. Working hard to breathe B. Difficulty swallowing C. Rash on the abdomen D. Sore throat and headache

Ans: A

A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used? A) Simple mask B) Venturi mask C) Nasal cannula D) Oxygen hood

A

The nurse is caring for a 3-year-old girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which of the following? A) Suctioning a tracheostomy tube B) Administering drugs with a nebulizer C) Providing tracheostomy care D) Suctioning with a bulb syringe

A

A nursing instructor is preparing a class on chronic lung disease. Which of the following would the instructor include when describing this disorder? A) It is a result of cystic fibrosis. B) It is seen most commonly in premature infants. C) It typically affects females more often than males. D) It is characterized by bradypnea.

B

The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, which of the following would be least appropriate for the nurse to perform? A) Providing 100% oxygen B) Visualizing the throat C) Having the child sit forward D) Auscultating for lung sounds

B

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which of the following as most helpful in determining the extent of the child's hypoxia? A) Pulmonary function test B) Pulse oximetry C) Peak expiratory flow D) Chest radiograph

B

The nurse is preparing to perform a physical examination of a child with asthma. Which of the following techniques would the nurse be least likely to perform? A) Inspection B) Palpation C) Percussion D) Auscultation

B

A child with a pneumothorax has a chest tube attached to a water seal system. When assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. Which of the following would the nurse do first? A) Notify the physician B) Apply an occlusive dressing C) Clamp the chest tube D) Perform a respiratory assessment

C

A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason? A) Improve gas exchange B) Bypass the obstruction C) Hasten air reabsorption D) Prevent hypoxemia

C

A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. Which of the following would the nurse have most likely assessed? A) High fever B) Dysphagia C) Toxic appearance D) Inspiratory stridor

D

A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which of the following? A) Children's demand for oxygen is lower than that of adults. B) Children develop hypoxemia more rapidly than adults do. C) An increase in oxygen saturation leads to a much larger decrease in pO2. D) Children's bronchi are wider in diameter than those of an adult.

B

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm? A) Salmeterol B) Albuterol C) Ipratropium D) Cromolyn

B

A nurse is preparing a teaching plan for the family of a child with allergic rhinitis. When describing the immune reaction that occurs, the nurse would identify the role of which immunoglobulin? A) IgA B) IgE C) IgG D) IgM

B

A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which of the following would the nurse instruct the parents to administer orally? A) Recombinant human DNase B) Bronchodilators C) Anti-inflammatory agents D) Pancreatic enzymes

D

A rapid strep test has confirmed that a 5-year-old girl has a group A Streptococcus infection. When teaching the parents about measures to implement, which of the following would be the least immediate concern? A) Using a cool mist humidifier B) Encouraging the child to drink liquids C) Discarding the child's toothbrush D) Administering antibiotic therapy

C

The nurse is providing care to several children who have been brought to the clinic by the parents for complaints of cold-like symptoms. The nurse would most likely suspect sinusitis in which child? A) A 2-year-old with thin watery nasal discharge B) A 3-year-old with sneezing and coughing C) A 5-year-old with nasal congestion and sore throat D) A 7-year-old with halitosis and thick, yellow nasal discharge

D