NCLEX-PN THROAT AND RESP PEDIATRIC
The nurse reinforces instructions to the mother of a child with croup about the measures to take if an acute spasmodic episode occurs. Which statement by the mother indicates the need for further teaching?
"I will place a steam vaporizer in my child's bedroom."
The nurse is reinforcing instructions to the mother of an 8-year-old child who had a tonsillectomy. The mother tells the nurse that the child loves tacos and asks when the child can safely eat one. The nurse should make which response to the mother?
"In 3 weeks"
A mother of a child with cystic fibrosis asks the nurse when the postural drainage should be performed. The mother states that the child eats meals at 8:00 am, 12 noon, and at 6:00 pm. What times should the nurse tell the mother to perform postural drainage?
10:00 am, 2:00 pm, and 8:00 pm
The nurse is providing instructions to a child with cystic fibrosis regarding how to perform the "huff" maneuver. The child asks the nurse about the purpose of this type of breathing. Which nursing response is appropriate?
"This type of breathing is used to mobilize secretions so that they can be easily coughed out."
A child is scheduled for a tonsillectomy. Which should present the highest risk of aspiration during surgery?
The presence of loose teeth
After a tonsillectomy, a child is brought to the pediatric unit. The nurse places the child in which appropriate position?
Prone
A hospitalized 2-year-old child with croup is receiving corticosteroid therapy. The mother asks the nurse why the primary health care provider did not prescribe antibiotics. The nurse makes which response to the mother?
"Antibiotics are not indicated unless a bacterial infection is present."
A nursing instructor asks a nursing student about the use of bacillus Calmette-Guerin vaccine (BCG). Which response made by the nursing student is correct?
"BCG is administered to asymptomatic human immunodeficiency virus (HIV)-infected children who are at increased risk for developing TB."
A child is scheduled for a tonsillectomy in the day-stay surgical unit. On the day following surgery, the mother calls the surgical unit and expresses concern because the child has a very bad mouth odor. The nurse should make which response to the mother?
"Bad mouth odor is normal and may be relieved by drinking more liquids."
The nurse is reinforcing home care instructions to the mother of a child diagnosed with pneumonia. Which statement by the mother indicates the need for further teaching?
"I can use a warm mist humidifier to keep the secretions loose."
A child with croup is placed in a cool-mist tent. The mother asks if the child may have her security blanket inside the tent. Which is the most appropriate response by the nurse?
"The child may have the security blanket inside the tent."
The nurse is reinforcing instructions to the mother of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the mother?
"The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
The nursing instructor asks a nursing student about sudden infant death syndrome (SIDS). Which statement by the student indicates further teaching is needed?
"The incidence of SIDS has been found to be higher in breastfed infants and infants that use a pacifier."
A 10-year-old child with asthma is treated for acute exacerbation. Which finding would indicate that the condition is worsening?
Decreased wheezing
A nursing student is preparing a clinical conference, and the topic of the discussion is caring for the child with cystic fibrosis (CF). The student prepares a handout for the group and lists which on the handout? Select all that apply.
It is transmitted as an autosomal recessive trait. It is a disease that causes mucous formation to be abnormally thick. It is a chronic multisystem disorder affecting the exocrine glands.
A child with croup is placed in a cool-mist tent. The mother becomes concerned because the child is frightened, consistently crying, and tries to climb out of the tent. Which is the appropriate nursing action?
Let the mother hold the child and direct a cool mist over the child's face.
A 3-year-old child has returned to his room following a tonsillectomy. Which finding needs immediate notification of the registered nurse?
Nasal flaring and rib retractions
A mother arrives at the emergency department with her child and a diagnosis of epiglottitis is documented. Which of the primary health care provider's prescription should the nurse question?
Obtain a throat culture.
A child with a diagnosis of pertussis (whooping cough) is being admitted to the pediatric unit. As soon as the child arrives in the unit, which action should the nurse do first?
Place the child on a pulse oximeter.
The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by the respiratory syncytial virus (RSV). Which interventions should be included in the plan of care? Select all that apply.
Place the infant in a private room. Place the infant in a room near the nurses' station.
The nurse is reviewing the laboratory results of a child scheduled for tonsillectomy. Which laboratory value would be significant to review?
Platelet count
The nurse is monitoring a child following a tonsillectomy. Which finding would indicate that the child is bleeding?
Restlessness
A nursing student is asked to discuss sudden infant death syndrome (SIDS) at the clinical conference being held at the end of the clinical day. The student plans to include which information in the discussion during the conference?
SIDS usually occurs during sleep and is more common in premature infants.
The nurse is assisting in developing a plan of care for a child who will be returning from the operating room following a tonsillectomy. The nurse plans to place the child in which position on return from the operating room?
Side-lying
The nurse teaches a child with cystic fibrosis how to perform the "huff" maneuver. Which instructions should the nurse tell the child?
Take a deep breath and then exhale rapidly, whispering the word huff.
An 8-year-old boy is being treated with percussion treatments for cystic fibrosis. Which indicates that the treatment is effective?
The child has a productive cough of thick sputum.
A child with a tracheal obstruction is brought to the emergency department by emergency medical services. The child aspirated a grape, and the foreign body was removed by direct laryngoscopy. Following the procedure, which information does the nurse plan to give to the parents of the child?
The child will need to be hospitalized for observation.
The nurse is caring for a 2-year-old child diagnosed with croup. The nurse collects data on the child, knowing that which are characteristics of this illness? Select all that apply.
The cough is harsh and metallic. Inspiratory stridor may be present. Symptoms usually worsen at night and are better during the day. It is usually preceded by several days of upper respiratory infection symptoms.
The nurse reinforces instructions to the mother of a child who has been hospitalized with croup. Which statement made by the mother would indicate the need for further teaching?
The nurse reinforces instructions to the mother of a child who has been hospitalized with croup. Which statement made by the mother would indicate the need for further teaching?
The nurse is working in the emergency department and is caring for a child who has been diagnosed with epiglottitis. Which is an indication that the child may be experiencing airway obstruction?
Tripod positioning and dyspnea
After a tonsillectomy, the child begins to vomit bright red blood. Which is the initial nursing action?
Turn the child to the side.
A nurse discussing options with a mother of a child with cystic fibrosis (CF) asks if she understands the education. Which statement by the mother indicates a need for further teaching?
"I can give my child whatever foods he likes to eat, since he gets enzymes anyway."
The nurse has provided instructions to the mother of an infant with viral pneumonia. Which statement by the mother would indicate the need for further teaching?
"I understand I will need to have my baby on antibiotics for this pneumonia."
The nurse is preparing for the administration of ribavirin to a child with respiratory syncytial virus. Which supplies will the nurse obtain for the administration of this medication?
A pair of goggles
Following a tonsillectomy, which of the primary health care provider's prescriptions should the nurse question?
Allow ice cream when awake.
The nurse employed in an emergency department is instructed to monitor a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. The nurse interprets this observation as indicating which finding?
An airway obstruction
A mother arrives at the clinic with her child. The mother tells the nurse that the child has had a fever and a cough for the past 2 days, and this morning the child began to wheeze. Viral pneumonia is diagnosed. Which component of the treatment plan should the nurse anticipate?
Supportive treatment
The nurse caring for an infant with bronchiolitis is monitoring for signs of dehydration. The nurse monitors which method as reliable for determining fluid loss?
Body weight
The emergency department nurse is gathering initial data on a child suspected of epiglottitis. Which is the nurse's highest priority?
Check for a patent airway.
The nurse is instructing the mother of a child with cystic fibrosis (CF) about the appropriate dietary measures. Which meal best illustrates the most appropriate diet for a client with cystic fibrosis (CF)?
Chicken tenders and a baked potato with butter
A mother of a child with cystic fibrosis asks the clinic nurse about the disease. How should the nurse respond to the mother about the disease?
Cystic fibrosis is a chronic multisystem disorder affecting the exocrine glands.
The nurse checks the vital signs of an infant with a respiratory infection and notes that the respiratory rate is 50 breaths per minute. Which action is appropriate?
Document the findings.
A mother of a child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child has discomfort on the right side and that the acetaminophen is not very effective. Which is the best suggestion by the nurse?
Encourage the child to lie on the right side.
The nurse is developing goals for a school-age child with a knowledge deficit related to the use of inhalers and peak flow meters. The nurse identifies which goal as appropriate for this child?
Expresses feelings of mastery and competence with breathing devices
A child has epistaxis. The nurse understands that which treatment is appropriate for epistaxis?
Have the child sit up and lean forward.
The nurse is planning education for the parent whose child has recently been prescribed cromolyn sodium as a part of the treatment plan for asthma. Which information should the nurse reinforce in the teaching? Select all that apply.
This medication is inhaled using a Spinhaler. This medication is not to be used as a rescue inhaler. This medication should be inhaled slowly to ensure the medication reaches the lower airways.
The nurse is observing a nursing student preparing to suction a pediatric client through a tracheostomy. The nurse intervenes if the student verbalizes which intention?
To apply continuous suction when inserting the catheter
The nurse is caring for a hospitalized infant with a diagnosis of bronchiolitis. The nurse places the infant in which position?
With the head and chest at a 30-degree angle, with the neck slightly extended
The nurse is caring for a child who returned from tonsillectomy surgery 30 minutes ago and enters the room for routine monitoring to see the child repeatedly and rapidly swallowing. Using the SBAR (Situation, Background, Assessment, Recommendation) technique, which statements and/or questions should the nurse include in the conversation with the primary health care provider? Select all that apply.
"Could you please come assess the child as soon as possible?" "I am concerned that the child is bleeding from the surgical sites." "Two minutes ago, I entered the child's room for routine monitoring and observed that she was swallowing repeatedly and rapidly." "Hello, this is Maria on the third floor. I am the nurse caring for Ella Smith, the 6-year-old child in room 342 who returned 30 minutes ago from a tonsillectomy."
A child with croup is being discharged from the hospital. The nurse reinforces home care instructions to the mother and advises the mother to bring the child to the emergency department if the child develops which symptom?
Stridor
