Exam 3: Respiratory Dysfunction NCLEX Questions
b
A 3 year old is brought to the ED with coughing and gagging. The parent reports that the child was eating carrots when she began to gag. Which diagnostic evaluation will be used to determine whether the child has aspirated carrots? a. chest x-ray b. bronchoscopy c. arterial blood gas d. sputum culture
b
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? a. After chest physiotherapy (CPT) b. Before chest physiotherapy (CPT) c. After receiving 100% oxygen d. Before receiving 100% oxygen
a b c d
A nurse is discussing risk factors for asthma with a group of newly licensed nurses. Which of the following conditions should the nurse include in the teaching? Select all that apply a. family history of asthma b. family history of allergies c. exposure to smoke d. low birth weight e. being underweight
c
A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition? a. Allergies b. Acute pharyngitis c. Foreign body in the nose d. Acute nasopharyngitis
a
An early indication of hemorrhage in a child who has had a tonsillectomy is a. frequent swallowing b. decreasing blood pressure c. restlessness d. bradycardia
a
An otoscopic examination in a child with otitis media would reveal a. bulging tympanic membrane b. a light reflex c. orange tympanic membrane d. mobile tympanic membrane
a
Clinical manifestations of influenza usually include all of the following except a. nausea and vomiting b. fever and chills c. sore throat and dry mucous membranes d. photophobia and myalgia
c
How will a child with respiratory distress and stridor who is diagnosed with RSV be treated? a. intravenous antibiotics b. intravenous steroids c. nebulized racemic epinephrine d. alternating doses of acetaminophen and ibuprofen
b
Infectious mononucleosis is usually a a. disease complicated by pneumonitis and anemia b. self-limiting disease c. disabling disease d. difficult and prolonged disease
d
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition? a. Otitis media b. Diabetes insipidus (DI) c. Nephrotic syndrome d. Acute rheumatic fever
c
Most children with croup a. require hospitalization b. will need to be intubated c. can be cared for at home d. are over 6 years old
d
Of the following croup syndromes, the one that is potentially life threatening is a. spasmotic croup b. laryngotracheobronchitis c. acute spasmodic laryngitis d. acute epiglottitis
c
Of the following foods, the most appropriate to offer first to an alert child in the postoperative period following a tonsillectomy would be a. ice cream b. red gelatin c. flavored ice pops d. flavored yogurt
c
Pain medication for the child in the postoperative period following a tonsillectomy should be administered a. rectally at regular intervals b. orally only as requested c. orally or intravenously at regular intervals d. rectally or intravenously as needed
d
The age group with the highest asthma mortality risk includes a. infants and toddlers b. preschoolers c. school age d. adolescents
b
The best technique to use to prevent spread of nasopharyngitis is a. antibiotic administration b. to avoid contact with infection persons c. mist vaporization d. to ensure adequate fluid intake
a
The infant is predisposed to developing otitis media because the eustachian tubes a. lie in a relatively horizontal plane b. have a limited amount of lymphoid tissue c. are long and narrow d. are underdeveloped
b
The most common early manifestation of cystic fibrosis is a. meconium aspiration b. meconium ileus c. growth failure d. chronic cough
c
The nurse should suspect epiglottitis if the child has a. cough, sore throat, and agitation b. cough, drooling, and retractions c. drooling, agitation, and absence of cough d. hoarseness, retractions, and absence of cough
a
The parent of a 4 month old with cystic fibrosis asks the nurse what time to begin the child's first chest physiotherapy each day. Which is the nurse's best response? a. "thirty minutes before feeding the child breakfast" b. "after deep-suctioning the child each morning" c. "thirty minutes after feeding the child breakfast" d. "only when the child has congestion or coughing"
d
The parent of a 9 month old calls the ED because his child is choking on a marble. The parent asks how to help his child while awaiting Emergency Medical Services. Which is the nurse's best response? a. "you should administer 5 abdominal thrusts followed by 5 back blows" b. "you should try to retrieve the object by inserting your finger in your child's mouth" c. "you should perform the Heimlich maneuver" d. "you should administer 5 back blows followed by 5 chest thrusts"
b
The parent of a child with frequent ear infections asks the nurse if there is anything that can be done to help avoid future ear infections. Which is the nurse's best response? a. "your child should be put on a daily dose of montelukast (Singulair)" b. "your child should be kept away from tobacco smoke" c. "your child should be kept away from other children with otitis media" d. "your child should always wear a hat when outside in the cold"
a
The parent of a child with influenza asks the nurse when the child is most infectious. Which is the nurse's best response? a. "24 hours before and after the onset of symptoms" b. "24 hours after the onset of symptoms" c. "one week after the onset of symptoms" d. "one week before the onset of symptoms"
c
The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition? a. Has a cough b. Becomes fussy c. Shows signs of an earache d. Has a fever higher than 37.5 C (99 F)
a
The primary therapeutic regimen for croup usually includes a. vigilant assessment, cool mist, nebulized epinephrine, and corticosteroids b. vigilant assessment, cool mist, racemic epinephrine, and antibiotics c. intubation, cool mist, racemic epinephrine, and corticosteroids d. intubation, nebulized epinephrine, and antibiotics
b
The standard effective treatment for GABHS is a. intravenous antibiotic administration b. oral or IM antibiotic administration c. nebulized racemic epinephrine d. warm saline gargles
a c d e
What does the therapeutic management of cystic fibrosis patients include? a. providing a high protein, high calorie diet b. providing a high fat, high carbohydrate diet c. encouraging exercise d. minimizing pulmonary complications e. encouraging medication compliance
c
What information should the nurse provide the parent of a child diagnosed with nasopharyngitis? a. complete the entire prescription of antibiotics b. avoid sending the child to daycare c. use comfort measures for the child d. restrict the child to clear liquids for 24 hours
d
What is a primary intervention when an infant chokes on a piece of food? a. Administer mouth-to-mouth resuscitation. b. Open the infant's mouth and perform a blind finger sweep. c. Have the infant lie quietly while a call is placed for emergency help. d. Position the infant in a head-down, prone position and administer five quick blows between the shoulder blades.
d
What should be the nurse's first action with a child who has a high fever, dysphagia, drooling, tachycardia, and tachypnea? a. immediate IV placement b. immediate respiratory treatment c. thorough physical assessment d. lateral neck radiographs
b
What statement is the most descriptive of asthma? a. It is inherited. b. There is heightened airway reactivity. c. There is decreased resistance in the airway. d. The single cause of asthma is an allergic hypersensitivity.
a
What would the nurse advise the parent of a child with a barky cough that gets worse at night? a. take the child outside into the more humid air for 15 minutes b. take the child to the ED immediately c. give the child an OTC cough suppressant d. give the child warm liquids to soothe the throat
b c
Which child would benefit most from having ear tubes placed? Select all that apply a. a 9 month old who has had one ear infection b. a 13 month old with recurrent ear infections c. a 2 year old who has had five previous ear infections d. a 3 year old whose sibling has had 4 ear infections e. a 7 year old who has had 2 ear infections this year
d
Which clinical findings would be of most concern in an infant with respiratory distress? a. tachypnea b. mild retractions c. wheezing d. grunting
c
Which information will be most helpful in teaching parents about the primary prevention of foreign body aspiration? a. signs and symptoms of foreign body aspiration b. therapeutic management of foreign body aspiration c. most common objects that toddlers aspirate d. risks associated with foreign body aspiration
d
Which intervention is most appropriate to teach the mother of a child diagnosed with a URI and a dry, hacking cough that prevents him from sleeping? a. give cough suppressants at night b. give an expectorant every 4 hours c. give cold and flu medication every 8 hours d. give 1/2 teaspoon of honey 4-5 times per day
a
Which is the nurse's best response to the parent of a child diagnosed with epiglottitis who asks what the treatment will be? a. complete a course of IV antibiotics b. surgery to remove the tonsils c. 10 days of aerosolized ribavirin d. no intervention
c
Which is the nurse's best response to the parent of an infant diagnosed with the first otitis media who wonders about long-term effects? a. "the child could suffer hearing loss" b. "the child could suffer some speech delays" c. "the child could suffer recurrent ear infections' d. "the child could require ear tubes"
c
Which of the following diagnostic adjuncts is often used to diagnose acute epiglottitis? a. a 2 view chest radiograph b. throat inspection with tongue blade c. a lateral neck soft tissue radiograph d. laryngoscopy with mild sedation
c
Which of the following techniques would be contraindicated for the nurse to recommend to parents to prevent recurrent otitis media? a. place a combination of vinegar and alcohol in each ear after swimming b. allow the child to swim every day for 2-4 hours c. dry the ear canal after swimming with a cotton swab d. use a hair dryer on low heat at 1-2 feet for 30 seconds several times a day
c
Which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching? a. "if I quit smoking, my child may have a decreased chance of getting an ear infection" b. "as my child gets older, he should have fewer ear infections, because his immune system will be more developed" c. "my child will have fewer ear infections if he has his tonsils removed" d. "my child may need a speech evaluation"
a
Which would be appropriate nursing care management of a child with the diagnosis of mononucleosis? a. only family visitors b. bedrest c. clear liquids d. limited daily fluid intake
d
A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action? a. Throat culture b. Nasal pharynx washing c. Administration of corticosteroids d. Emergency intubation
b
A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action? a. Notify the health care provider. b. Continue to assess for bleeding. c. Give the child a red flavored ice pop. d. Position the child in a Trendelenburg position.
c
A child has a streptococcal throat infection and is being treated with antibiotics. What should the nurse teach the parents to prevent infection of others? a. The child can return to school immediately. b. The organism cannot be transmitted through contact. c. The child can return to school after taking antibiotics for 24 hours. d. The organism can only be transmitted if someone uses a personal item of the sick child.
c
A term infant is delivered, and before delivery, the medical team was notified that a congenital diaphragmatic hernia (CDH) was diagnosed on ultrasonography. What should be done immediately at birth if respiratory distress is noted? a. Give oxygen. b. Suction the infant. c. Intubate the infant. d. Ventilate the infant with a bag and mask.
c
Children who are taking long-term inhaled steroids should be assessed frequently for what potential complication? a. Cough b. Osteoporosis c. Slowed growth d. Cushing syndrome
a
Children with nasopharyngitis may be treated with a. decongestants b. antihistamines c. expectorants d. cough suppressants
b
Children with tympanostomy tubes should a. swim only in fresh water lakes without earplugs b. keep bath water out of the ear c. notify the physician immediately if a grommet appears d. never allow any water to enter their ears
c
Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms? a. Severe pain in the ear b. Anorexia and vomiting c. A feeling of fullness in the ear d. Fever as high as 40 C (104 F)
a
Retraction is defined as a. the sinking in of soft tissues during the respiratory cycle b. proliferation of the tissue near the terminal phalanges c. an increase in the end-expiratory pressure d. contraction of the sternocleidomastoid muscles
b
Stridor, a high-pitched, noisy respiration, is usually an indication of a. lower airway obstruction b. narrowing of the upper airway c. a deficiency of pulmonary surfactant d. imminent respiratory arrest
b
The ER 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? a. the child exhibits nasal flaring and bradycardia b. the child is leaning forward, with the chin thrust out c. the child has a low grade fever and complains of sore throat d. the child is leaning backward, supporting himself with hands and arms
c
The best method to stimulate deep breathing in a child is to a. encourage the child to cover the mouth and suppress his cough b. encourage the child to cough repeatedly c. use games that extend the expiratory time and pressure d. leave some balloons at the bedside for the child to blow up
d
The most severe complication that can occur during the intubation procedure is a. infection b. sore throat c. hoarseness d. hypoxia
b
The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed RSV. On the basis of this finding, which is the most appropriate nursing action? a. initiate strict enteric precautions b. move the infant to a room with another child with RSV c. leave the infant in the present room because RSV is not contagious d. inform the staff that they must wear a mask, gloves, and a gown when caring for the child
a
The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? a. I can use an ice collar on my child for pain control along with analgesics. b. My child should clear the throat frequently to clear the secretions. c. I should allow my child to be as active as tolerated. d. My child should gargle and brush teeth at least three times per day.
a f
The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by RSV. Which intervention should the nurse include in the plan of care? a. place the infant in a private room b. ensure that the infant's head is in a flexed position c. wear a mask at all times when in contact with the infant d. place the infant in a tent that delivers warm humidified air e. position the infant on the side, with the head lower than the chest f. ensure that nurses caring for the infant do not care for other high risk children
b c e
The nurse is preparing to admit a 7-year-old child with acute laryngotracheobronchitis (LTB). What clinical manifestations should the nurse expect to observe? Select all that apply a. Dysphagia b. Brassy cough c. Low-grade fever d. Toxic appearance e. Slowly progressive
a
The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these signs and symptoms are suggestive of what condition? a. Pneumothorax b. Bronchodilation c. Carbon dioxide retention d. Increased viscosity of sputum
d
The pediatric nurse knows that the early subtle indication of hypoxia in an older child is a. peripheral cyanosis b. central cyanosis c. hypotension d. mood changes and restlessness
a
What do the initial signs of respiratory syncytial virus (RSV) infection in an infant include? a. Rhinorrhea, wheezing, and fever b. Tachypnea, cyanosis, and apnea c. Retractions, fever, and listlessness d. Poor breath sounds and air hunger
a b c e
What interventions can the nurse teach parents to do to ease respiratory efforts for a child with a mild respiratory tract infection? Select all that apply a. Cool mist b. Warm mist c. Steam vaporizer d. Keep child in a flat, quiet position e. Run a shower of hot water to produce steam
a
A 3 month old infant is seen in the clinic with the following symptoms: irritability, crying, refusal to nurse for more than 2-3 minutes, rhinitis, and a rectal temperature of 101.8. The labor, delivery, and postpartum history for this term is unremarkable. The nurse anticipates a diagnosis of a. acute otitis media b. otitis media with effusion c. otitis externa d. respiratory syncitial virus (RSV)
d
A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner? a. Make her lie down and rest quietly. b. Examine her oral pharynx and report to the physician. c. Auscultate her lungs and prepare for placement in a mist tent. d. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.
b
A 5 year old is brought to the ED with a temperature of 99.5, a barky cough, stridor, and hoarseness. Which nursing intervention should the nurse prepare for? a. immediate IV placement b. respiratory treatment of racemic epinephrine c. a tracheostomy set at the bedside d. informing the child's parents about a tonsillectomy
a b d f
A 5 year old is recovering from a tonsillectomy and adenoidectomy and is being discharged home with his mother. Home care instructions should include which of the following? a. observe the child for continuous swallowing b. encourage the child to take sips of cool, clear liquds c. administer codeine elixir as necessary for throat pain d. observe the child for restlessness or difficulty breathing e. encourage the child to cough every 4-5 hours to prevent pneumonia f. administer an analgesic such as acetaminophen for pain
c
A 5 year old is seen in the urgent care clinic with the following history and symptoms: sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temperature of 102.2, clear breath sounds, and absence of cough. The child appears anxious and is flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of a. group A beta hemolytic streptococcus (GABHS) pharyngitis b. acute tracheitis c. acute epiglottitis d. acute laryngotracheobronchitis
b
A 6 week old is admitted to the hospital with influenza. The child is crying, and the father tells the nurse he is hungry. The nurse explains that they baby is not to have anything by mouth. The parent does not understand why the child cannot eat. Which is the nurse's best response to the parent? a. "we are giving your child IV fluids, so there is no need for anything by mouth" b. "the shorter and narrower airway of 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 the child's energy" d. "your child has too much nasal congestion; if we feed the child by mouth, the distress will likely increase"
c
A 7 month old child has been diagnosed with nasopharyngitis. The parent is concerned because the child has had little or no appetite for the last 24 hours. Which is the nurse's best response? a. "do not be concerned; it is common for children to have a decreased appetite during a respiratory illness" b. "be sure your child is taking an adequate amount of fluids. The appetite should return soon" c. "try offering the child some favorite foods. Maybe that will improve the appetite" d. "you need to force your child to eat whenever you can; adequate nutrition is essential"
d
A child is complaining of throat pain. Which statement by the mother indicates that she needs more education regarding the care and treatment of her child's pharyngitis? a. "I will have my child gargle with salt water 3 times a day" b. "I will offer my child ice chips several times a day" c. "I will give my child Tylenol every 4-6 hour as needed" d. "I will ask the nurse practitioner for some amoxicillin"
c
A child is developing respiratory failure. What are the assessment findings to indicate the signs of hypoxia are becoming severe? a. Tachypnea b. Tachycardia c. Somnolence d. Restlessness
d
A child with cerebral palsy is admitted to the hospital with aspiration pneumonia. What is the most beneficial education information that the nurse can provide to the parents? a. the signs and symptoms of aspiration pneumonia b. the treatment plan for aspiration pneumonia c. the risks associated with recurrent aspiration pneumonia d. the prevention of aspiration pneumonia
c
A child's parent asks the nurse what treatment the child will need for the diagnosis of strep throat. Which is the nurse's best response? a. "your child will be sent home on bedrest and should recover in a few days without any intervention" b. "your child will need to have the tonsils removed to prevent future strep infections" c. "your child will need oral penicillin for 10 days and should feel better in a few days" d. "your child will need to be admitted to the hospital for 5 days of intravenous antibiotics"
c
A nurse in the emergency department is assessing a newly-admitted infant. Which of the following findings is an early indication of hypoxemia? a. nonproductive cough b. hypoventilation c. tachypnea d. nasal stuffiness
b c e
A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? Select all that apply a. oxygen saturation 95% b. wheezing c. retraction of sternal muscles d. warm extremities e. nasal flaring
a b d f
A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? Select all that apply a. hoarseness and difficulty breathing b. difficulty swallowing c. low-grade fever d. drooling e. dry, barking cough f. stridor
b
A nurse is caring for a child in the postoperative period following a tonsillectomy. Which of the following actions should the nurse take? a. encourage the child to blow her nose gently b. administer analgesics on a schedule c. offer orange juice d. position the child supine
c d
A nurse is caring for a child who has bronchiolitis. Which of the following actions should the nurse take? Select all that apply a. administer oral prednisone b. initiate chest-percussion and postural drainage c. administer humidified oxygen d. suction the nasopharynx as needed e. administer oral penicillin
c
A nurse is caring for a child who is in the postoperative period following a tonsillectomy. Which of the following is a clinical finding of postoperative bleeding? a. Hbg 11.6 and Hct 37% b. inflamed and reddened throat c. frequent swallowing and clearing of throat d. blood-tinged mucus
c
A nurse is caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is reading 89%. Which of the following actions should the nurse take first? a. increase the oxygen flow rate b. encourage the child to take deep breaths c. ensure proper placement of the sensor probe d. place the child in the Fowler's position
a b c
A nurse is performing an admission assessment for a child who has cystic fibrosis. Which of the following findings should the nurse expect? Select all that apply a. wheezing b. clubbing of fingers and toes c. barrel-shaped chest d. thin, watery mucus e. rapid growth spurts
b c d
A nurse is planning care for a child who has asthma. Which of the following interventions should the nurse include in the plan of care? Select all that apply a. perform chest percussion b. place the child in an upright position c. monitor oxygen saturation d. administer bronchodilators e. administer dornase alfa daily
b
A nurse is providing discharge teaching for a child who has cystic fibrosis. Which of the following instructions should the nurse include? a. provide a low-calorie, low-protein diet b. administer pancreatic enzymes with meals and snacks c. implement a fluid restriction during times of infection d. restrict physical activity
a
A nurse is reviewing the diagnostic findings for a preschool age child who is suspected of having cystic fibrosis. Which of the following findings should the nurse identify as an indication of cystic fibrosis? a. sweat chloride content 85 mEq/L b. increased blood levels of fat-soluble vitamins c. 72 hr stool analysis sampling indicating hard, packed stools d. chest x-ray negative for atelectasis
d
A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise? a. fluticasone/salmeterol b. montelukast c. prednisone d. albuterol
c
A parent asks how to care for a child at home who has the diagnosis of viral tonsillitis. Which is the nurse's best response? a. "you will need to give your child a prescribed antibiotic for 10 days" b. "you will need to schedule a follow up examination in 2 weeks" c. "you can give your child acetaminophen every 4-6 hours as needed for pain" d. "you can place warm towels around your child's neck for comfort"
c
A parent asks the nurse how it will be determined whether their child has respiratory syncytial virus (RSV). Which is the nurse's best response? a. "we will do a simple blood test to determine whether your child has RSV" b. "there is no specific test for RSV. The diagnosis is made based on the child's symptoms" c. "we will swab your child's nose and send that specimen for testing" d. "we will have to send a viral culture to an outside lab for testing"
a
An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent? a. Administer all of the prescribed medication. b. Continue medication until all symptoms subside. c. Immediately stop giving medication if hearing loss develops. d. Stop giving medication and come to the clinic if fever is still present in 24 hours.
c
An infant is not sleeping well, is crying frequently, has yellow drainage from the ear, and is diagnosed with an ear infection. Which nursing objective is the priority for the family? a. educating the parents about signs and symptoms of an ear infection b. providing emotional support for the parents c. providing pain relief for the child d. promoting the flow of drainage from the ear
c
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation? a. Reverse isolation b. Airborne isolation c. Contact Precautions d. Standard Precautions
d
Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? a. Hyperactivity of sweat glands b. Hypoactivity of autonomic nervous system c. Atrophic changes in mucosal wall of intestines d. Mechanical obstruction caused by increased viscosity of mucous gland secretions
e
Identify which of the following therapies is not usually included in the care of the child or adolescent with cystic fibrosis a. insulin administration b. administration of pancreatic enzymes c. airway clearance therapy d. administration of fat-soluble vitamins e. administration of water-soluble vitamins
c
In about half of all cases of infectious mononucleosis, there will be a. skin rash b. otitis media c. splenomegaly d. failure to thrive
d
In addition to acute pain, the clinical manifestations of otitis media include a. purulent discharge in the external auditory canal b. clear discharge in the external auditory canal c. enlarged axillary lymph nodes d. enlarged cervical lymph nodes
c
In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind? a. Fats and proteins must be greatly curtailed. b. Most fruits and vegetables are not well tolerated. c. Diet should be high in calories, proteins, and unrestricted fats. d. Diet should be low fat but high in calories and proteins.
a
In the child who is suspected of having epiglottitis, the nurse should a. have the intubation equipment available b. prepare to immunize the child for H. influenzae c. obtain a throat culture d. do all of the above
d
In the postoperative period following a tonsillectomy, the child should be a. placed in Trendelenburg position b. encouraged to cough and deep breathe c. suctioned vigorously to clear the airway d. observed for subtle signs of hemorrhage
b
Of the following medications, the one that would most likely be prescribed for uncomplicated otitis media would be a. tetracycline b. amoxicillin c. gentamicin d. methicillin
d
Offensive mouth odor, persistent dry cough, and a voice with a muffled nasal quality are commonly the result of a. pneumonia b. otitis externa c. tonsillitis d. otitis media
a
Postural drainage is best when performed a. before meals but after other respiratory therapy b. after meals but before other respiratory therapy c. before meals and before other respiratory therapy d. after meals and after other respiratory therapy
d
Recurrent otitis media with effusion after a total of 4-6 months of bilateral effusion with bilateral hearing deficit would most likely be managed therapeutically by a. tonsillectomy b. steroids c. polyvalent pneumoccal polysaccharide vaccine d. tympanoplasty tubes
c
The most likely reason that the respiratory tract infection rate increases drastically in the age range from 3-6 months is that the a. infant's exposure to pathogens is greatly increased during this time b. viral agents that are mild in older children are severe in infants c. maternal antibodies have disappeared, and the infant's own antibody production is immature d. diameter of the airways is smaller in the infant than in the older child
b
The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37 C (98.6 F). The nurse suspects mild croup and should recommend which intervention? a. Admit to the hospital and observe for impending epiglottitis. b. Provide fluids that the child likes and use comfort measures. c. Control fever with acetaminophen and call if cough gets worse tonight. d. Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement.
d
The nurse is teaching a mother how to perform chest physiotherapy and postural drainage on her 3-year-old child, who has cystic fibrosis. What would the nurse include in the instructions for performing percussion? a. Strike the chest wall with a flat-hand position. b. Percuss before and after positioning for postural drainage. c. Percuss over the entire trunk anteriorly and posteriorly. d. Cover the skin with a shirt or gown before percussing.
b
The parent of a child with cystic fibrosis is excited about the possibility of the child receiving a double lung transplant. What should the parent understand? a. the transplant will cure the child of CF and allow the child to lead a long and healthy life b. the transplant will not cure the child of CF but will allow the child to have a longer life c. the transplant will help to reverse the multisystem damage that has been caused by CF d. the transplant will be the child's only chance at surviving long enough to graduate from college
c
The parent of an infant with cystic fibrosis asks the nurse how to meet the child's increased nutritional needs. Which is the nurse's best suggestion? a. "you may need to increase the number of fresh fruits and vegetables you give your infant" b. "you may need to advance your infant's diet to whole cow's milk because it is higher in fat than formula" c. "you may need to change your infant to a higher-calorie formula" d. "you may need to increase your infant's carbohydrate intake"
a
When caring for a child after a tonsillectomy, what intervention should the nurse do? a. Watch for continuous swallowing. b. Encourage gargling to reduce discomfort. c. Apply warm compresses to the throat. d. Position the child on the back for sleeping.
b
Which assessment is of greater concern in a 15 month old? a. the child is lying down and has moderate retractions, low-grade fever, and nasal congestion b. the child is in the tripod position and has diminished breath sounds and a muffled cough c. the child is sitting up and has course breath sounds, coughing, and fussiness d. the child is restless and crying, has bilateral wheezes, and is feeding poorly
c
Which breathing exercise should the nurse have an asthmatic 3 year old child 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
a
Which is the nurse's best response to a parent who asks what can be done at home to help an infant with upper respiratory infection symptoms and a fever get better? a. "give your child small amounts of fluid every hour to prevent dehydration" b. "give your child Robitussin at night to reduce his cough and help him sleep" c. "give your child a baby aspirin every 4-6 hours to help reduce the fever" d. "give your child an OTC cold medicine at night"
b c
Which should the nurse instruct children to do to stop the spread of influenza in the classroom? Select all that apply a. stay home if they have a runny nose and cough b. wash their hands after using the restroom c. wash their hands after sneezing d. have a flu shot annually e. drink lots of water during the day
d
Which would the nurse explain to parents about the inheritance of cystic fibrosis? a. CF is an autosomal-dominant trait passed on from the child's mother b. CF is an autosomal-dominent trait passed on from the child's father c. the child of parents who are both carriers of the gene for CF has a 50% chance of acquiring CF d. 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
Who is at the highest priority to receive the flu vaccine? a. a healthy 8 month old who attends day care b. a 3 year old who is undergoing chemotherapy c. a healthy 7 year old who attends public school d. an 18 year old who is living in a college dormitory
d
A 2 year old has just been diagnosed with cystic fibrosis. The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best resposne? a. "you can expect your child to develop a barrel-shaped chest" b. "you can expect your child to develop a chronic productive cough" c. "you can expect your child to develop bronchiectasis" d. "you can expect your child to develop wheezing respirations"
c
A 12 year old child is in the urgent care clinic with a complaint of fever, headache, and sore throat. A diagnosis of group A beta hemolytic streptococcus (GABHS) pharyngitis is established with a rapid strep test, and oral penicillin is prescribed. The nurse knows which of the following statements about GABHS is correct? a. children with a GABHS infection are less likely to contract the illness again after the antibiotic regimen is completed b. a follow up throat culture is recommended following the completion of antibiotic therapy c. children with a GABHS infection are at increased risk for the development of rheumatic fever and glomerulonephritis d. children with GABHS infection are at increased risk for the dvelopment of rheumatoid arthritis in adulthood
b
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action? a. Mothers of hospitalized toddlers often experience guilt. b. The mothers presence will reduce anxiety and ease the childs respiratory efforts. c. Separation from the mother is a major developmental threat at this age. d. The mother can provide constant observations of the childs respiratory efforts.
b
The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this childs care? a. Monitor pulse oximetry. b. Monitor arterial blood gases. c. Administer oxygen if respiratory distress develops. d. Administer oxygen if childs lips become bright, cherry-red in color.
d
The nurse is reviewing discharge instructions with the parents of a child who had a tonsillectomy a few hours ago. 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? a. "the child's diet should not be restricted at all" b. "the child's diet should be restricted to clear liquids" c. "the child's diet should be restricted to ice cream and cold liquids" c. "the child's diet should be restricted to soft foods"
