Respiratory

The nurse caring for a hospitalized 8-year-old child being treated for right lower lobe pneumonia is providing teaching for the parents regarding the best positioning for improved lung aeration. The best recommendation by the nurse is: A. "Place child in Trendelenberg position." B. "Place the child in prone position." C. "Encourage your child to lie on the right side with elevated head of the bed." D. "Encourage your child to lie on their left side with elevated head of the bed."

D

The parent of a 9-month-old calls the ER because his child is choking on a marble. The parent asks how to help his child while awaiting Emergency Medical Services (EMS). Which is the nurse's best response? A. "You should administer five abdominal thrusts followed by five back blows." B. "You should try to retrieve the object by inserting your finger in your child's mouth." C. "You should provide the Heimlich maneuver." D. "You should administer five back blows followed by five chest thrusts."

D

The parent of a 9-month-old child with croup tells the nurse that her older child just had croup and it cleared up in a couple of days without intervention. She asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. The nurse's best response is... A. "Some children just react differently to viruses. It is best to treat each child as an individual." B. Younger children have wider airways that make it easier for bacteria to enter and colonize." C. "Younger children have short, wide eustachian tubes, making them more susceptible to respiratory infections." D. "Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed."

D

Which child with asthma should the nurse see first? A. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 90% on room air. B. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezing bilaterally, and has an oxygen saturation of 95% on room air. C. A 9-year-old who is quiet, is pale in color, is wheezing bilaterally with an oxygen saturation of 94% on room air. D. A 16-year-old who is speaking in short sentences, is wheezing, is sitting in a tripod position, and has an oxygen saturation of 93% on room air.

A

Who is at the highest priority to receive the inactivated flu vaccine? A. A healthy 8-month-old who attends day care. B. An 8-year-old who previously had Guillain Barre Syndrome (GBS). C. A 7-year-old who attends public school. D. An 17-year-old who is living in a college dormitory.

A

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply. A. Place the infant in a private room or in a room with another child with RSV. B. Ensure the infant's head is in a flexed position at all times. C. Place the infant in a tent that delivers warm humidified air. D. Position the child on the side, with the head lower than the chest. E. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

A,E

The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement by the nurse to the parent is most appropriate? "Your child will... A. "need to have their immunization schedule altered." B. "should not receive any hepatitis vaccines." C. "receive all the immunizations except for the polio series." D. "receive the recommended basic series of immunizations along with the yearly influenza vaccination."

D

Which breathing exercises should the nurse have an asthmatic 3-year-old do to increase her expiratory phase? A. Use an incentive spirometer. B. Breathe into a paper bag. C. Blow a pinwheel. D. Take several deep breaths.

C

Which child is at highest risk for requiring hospitalization to treat respiratory syncytial virus (RSV)? A. A 2-month-old who was born at 36 weeks. B. A 16-month-old with a tracheostomy. C. An 18 month-old with a congenital heart defect. D. A 4-year-old who was born at 30 weeks.

C

Which child with pneumonia would benefit most from hospitalization? A. 13-year-old who is coughing, has coarse breath sounds, and is not sleeping well. B. 14-year-old with a fever of 38.6°C (101.5°F), rapid breathing and a decreased appetite. C. 15-year-old who has been vomiting for 3 days and has a fever of 38.5°C (101.3°F). D. 16-year-old who has a cough, chills, fever of 38.5°C (101.3°F), and wheezing.

C

A six-week-old is admitted to the pediatric floor with influenza. The child is crying and the father tells the nurse his son is hungry. The nurse explains that the child is not to have anything by mouth. The parent does not understand why the child cannot eat. What is the best response by the nurse? A. "We are giving your child intravenous fluids, so there is no need for anything by mouth." B. "The shorter and narrower airway of the infants increases their chances of aspiration, so your child should not have anything to eat now." C. "When your child eats, he burns too many calories. We want to conserve your child's energy." D. "Your child has too much nasal congestion. If we feed the child by mouth, the distress will likely increase."

B

An emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? The child is... A. exhibiting nasal flaring and tachycardia. B. leaning forward with the chin thrust out and drooling. C. has a low grade fever and complains of a sore throat. D. is leaning backward, supporting themselves with the hands and arms.

B

Which assessment is of greatest concern in a 15-month-old child? The child... A. is lying down, has moderate retractions, low-grade fever, and nasal congestion. B. has diminished breath sounds, no cough, and has a protruding tongue with drooling. C. is sitting up and has coarse breath sounds, coughing, and fussiness. D. is restless and crying, has bilateral wheezing, and is feeding poorly.

B

Which would be an early sign of distress in a 2-month-old child? A. Shallow respirations B. Tachypnea C. Tachycardia D. Bradycardia

B

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the health care provider did not prescribe antibiotics. Which response should the nurse provide? A. "Your child may be allergic to antibiotics." B. "Your child is too young to receive antibiotics." C. "Antibiotics are not indicated unless there is a bacterial infection." D. "Your child still has maternal antibodies from birth and does not does not need antibiotics."

C