Ch. 40 The child with respiratory dysfunction
A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests which respiratory condition? a. Asthma b. Pneumonia c. Bronchiolitis d. Foreign body in the trachea
a. Asthma
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? a. Before chest physiotherapy (CPT) b. After CPT c. Before receiving 100% oxygen d. After receiving 100% oxygen
a. Before chest physiotherapy (CPT)
In providing nourishment for a child with cystic fibrosis (CF), what diet consideration should be stressed to both the child and caregivers? a. Diet should be high in carbohydrates and protein. b. Diet should be high in easily digested carbohydrates and fats. c. Most fruits and vegetables are not well tolerated. d. Fats and proteins must be greatly curtailed.
a. Diet should be high in carbohydrates and protein.
Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? a. If it is present in a child, both parents are carriers of this defective gene. b. It is inherited as an autosomal dominant trait. c. It is a genetic defect found primarily in non-Caucasian population groups. d. There is a 50% chance that siblings of an affected child also will be affected.
a. If it is present in a child, both parents are carriers of this defective gene.
What are the earliest recognizable clinical manifestations of cystic fibrosis (CF)? a. Meconium ileus b. History of poor intestinal absorption c. Foul-smelling, frothy, greasy stools d. Recurrent pneumonia and lung infections
a. Meconium ileus
Which information should the nurse teach families about reducing exposure to pollens and dust? (Select all that apply.) a. Replace wall-to-wall carpeting with wood and tile floors b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses. d. Keep humidity in the house above 60%. e. Keep pets outside.
a. Replace wall-to-wall carpeting with wood and tile floors b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses.
A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma? a. There is heightened airway reactivity. b. There is decreased resistance in the airway. c. The single cause of asthma is an allergic hypersensitivity. d. It is inherited.
a. There is heightened airway reactivity.
The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratory tract infection
b. Complete obstruction
Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottis c. Spasmodic croup d. Laryngotracheobronchitis (LTB)
b. Epiglottis
What distinguishing manifestation of spasmodic croup should parents be taught to identify? a. Wheezing is heard audibly. b. It has a harsh, barky cough. c. It is bacterial in nature. d. The child has a high fever.
b. It has a harsh, barky cough.
A child diagnosed with cystic fibrosis is prescribed recombinant human deoxyribonuclease (rhDNase). What information should be included in the medication education provided the child and family? a. May cause mucus to thicken. b. May cause minor voice alterations. c. Is given subcutaneously. d. Is not indicated for children younger than 12 years.
b. May cause minor voice alterations.
The nurse is caring for a 10-month-old infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? (Select all that apply.) a. Administer antibiotics. b. Administer cough syrup. c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.
c. Encourage infant to drink 8 ounces of formula every 4 hours. d. Institute cluster care to encourage adequate rest. e. Place on noninvasive oxygen monitoring.
b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack for what resulting action? a. Liquefaction of secretions b. Dilation of the bronchioles c. Reduction of inflammation of the lungs d. Reduction of existing infection
c. Reduction of inflammation of the lungs
It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently to monitor for what increased risk? a. Cough b. Osteoporosis c. Slowed growth d. Cushing's syndrome
c. Slowed growth
A parent whose two school-age children diagnosed with exercise-induced bronchospasm (EIB) asks the nurse in what sports, if any, they can participate. The nurse should recommend which sport? a. Soccer b. Running c. Swimming d. Basketball
c. Swimming
Which intervention for treating croup at home should be taught to parents? a. Have a decongestant available to give the child when an attack occurs. b. Have the child sleep in a dry room. c. Take the child outside if air is cool and moist. d. Give the child an antibiotic at bedtime.
c. Take the child outside if air is cool and moist.
Which information should the nurse stress to workers at a day care center about respiratory syncytial virus (RSV)? a. RSV is transmitted through particles in the air. b. RSV can live on skin or paper for up to a few seconds after contact. c. RSV can survive on nonporous surfaces for about 60 minutes. d. Frequent hand washing can decrease the spread of the virus.
d. Frequent hand washing can decrease the spread of the virus.
Pancreatic enzymes are administered to the child with cystic fibrosis. What information should be included in patient education concerning the administration of these enzymes? a. Do not administer pancreatic enzymes if the child is receiving antibiotics. b. Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools. c. Administer pancreatic enzymes between meals if at all possible. d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? a. Bronchoscopy b. Serum calcium c. Urine creatinine d. Sweat chloride test
d. Sweat chloride test
Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C and calcium b. Vitamins B6 and B12 c. Magnesium d. Vitamins A, D, E, and K
d. Vitamins A, D, E, and K