FA Davis Qs CH 12

Which assessment finding would indicate to the nurse that the plan of care for an 8-year-old hospitalized for an acute asthma attack is effective? a. Diminished breath sounds on auscultation b. Decreased tachypnea c. Prolonged expiratory phase of breathing d. Lung sounds have expiratory wheezes

b. Decreased tachypnea

A child with chronic otitis media is having PE tubes placed. Which statement would indicate that the parent understands education about PE tubes? "The tubes have to be surgically removed in 9 months or so." "The tubes were placed to equalize pressure." "The tubes will be visible outside the ear." "The tubes will be placed while the child is awake."

"The tubes were placed to equalize pressure."

A nurse is explaining what a tracheoesophageal (TE) fistula is to a parent. Which statement is correct? a. "It is an abnormal opening between the trachea and the esophagus." b. "The trachea and esophagus do not form in utero." c. "Both the esophagus and trachea end in a pouch." d. "The trachea connects to the stomach and the esophagus to the lungs."

a. "It is an abnormal opening between the trachea and the esophagus."

In educating a mother of a child with laryngomalacia, which statement is correct? a. "Symptoms usually resolve by age 2." b. "Your child will most likely need a tracheostomy." c. "Your child will definitely have feeding problems." d. "Administration of albuterol is most important in this condition."

a. "Symptoms usually resolve by age 2."

In educating a mother of a child with laryngomalacia, which would be a correct statement for the nurse to make? a. "Symptoms usually resolve by age 2." b. "Your child will most likely need a tracheostomy." c. "Your child will definitely have feeding problems." d. "Administration of Albuterol is most important in this condition."

a. "Symptoms usually resolve by age 2."

The nurse understands that, in a child with cystic fibrosis (CF), which vitamin absorption is impaired? Select all that apply. a. A b. B c. C d. D e. E

a. A d. D e. E

Which child does the nurse anticipate to be most at risk for being hospitalized for respiratory syncytial virus (RSV)? a. A 3-month-old who was born at 30 weeks gestation b. A 18-month-old with a tracheostomy c. A 4-year-old with a ventricular septal defect (VSD) d. A 5-year-old who was term but has never received any immunizations

a. A 3-month-old who was born at 30 weeks gestation

Which statement does the nurse understand to be true about clients admitted with pertussis (whooping cough)? a. A paroxysmal cough frequently at night might be present. b. The client should be maintained on contact precautions/isolation. c. Peak occurrence is in the fall and winter. d. It is most often caused by Haemophilus influenzae.

a. A paroxysmal cough frequently at night might be present.

Which abnormal finding indicates to the nurse that a child likely has cystic fibrosis (CF)? a. A positive sweat chloride test b. A positive blood culture c. Excessive mucus production d. Edema and weight gain

a. A positive sweat chloride test

A 3-year-old is noted to speak in a muffled tone and frequently complains of a sore throat. The mother has noted that lately the child is very noisy when he breathes. She states that he seems to "stop breathing." A sleep study was done to confirm obstructive sleep apnea. Which treatments would the nurse expect to occur for this child? Select all that apply. a. Continuous positive airway pressure (CPAP) b. Tonsillectomy c. Administration of Caffeine Citrate d. High caloric diet e. Waking the child at frequent intervals

a. Continuous positive airway pressure (CPAP) b. Tonsillectomy d. High caloric diet

Which techniques would a nurse implement when caring for a child diagnosed with respiratory syncytial virus (RSV)? Select all that apply. a. Corticosteroids b. IV and/or oral fluid therapy c. IV antibiotics for infection d. Cardiorespiratory monitoring e. Immediate intubation to maintain the airway

a. Corticosteroids b. IV and/or oral fluid therapy d. Cardiorespiratory monitoring

A nurse is caring for a neonate with a suspected tracheoesophageal fistula (TEF). What nursing intervention would appropriate for this client? a. Elevate the head for feedings. b. Avoid suctioning the client. c. Elevate the head, but give nothing by mouth. d. Feed the baby glucose water only.

a. Elevate the head for feedings.

Which indicates the earliest sign of hemorrhage in a child who has just had a tonsillectomy? a. Frequent swallowing b. Labored respirations c. Tachypneic stridor d. Dark brown emesis

a. Frequent swallowing

Which statements are true about apnea? Select all that apply. a. It occurs in most infants at less than 34 weeks gestation. b. Apnea is cessation of breathing for longer than 20 seconds. c. It can be a sign of patent ductus arteriosus (PDA). d. It is not affected by maternal drug use. e. It usually resolves by 36 weeks postconceptual age.

a. It occurs in most infants at less than 34 weeks gestation. b. Apnea is cessation of breathing for longer than 20 seconds. c. It can be a sign of patent ductus arteriosus (PDA). e. It usually resolves by 36 weeks postconceptual age.

You are teaching a family with a child who has cystic fibrosis (CF) about bronchial hygiene. Which of the following teaching points are correct to include? Select all that apply. a. It should be performed three to four times a day. b. It may cause bronchospasm. c. It is all right to percuss over the spine or internal organs. d. When manually percussing, you should use a cupped hand. Perform on bare skin for better results.

a. It should be performed three to four times a day. b. It may cause bronchospasm. d. When manually percussing, you should use a cupped hand.

A 2-week-old who was born at 35 weeks is in respiratory distress. The parents state that the infant has always been a "noisy breather that sounds like a crow." Upon initial assessment, severe suprasternal retractions and stridor are present that worsen when the infant is lying down. What illness might the nurse expect the child to have? a. Laryngomalacia b. Apnea of prematurity c. Bronchiolitis d. Severe gastroesophageal (GE) reflux

a. Laryngomalacia

Which are signs and symptoms of respiratory distress syndrome in a 2-month-old? Select all that apply. a. Nasal flaring b. Intercostal retractions c. Coughing d. Bronchovesicular lung sounds e. Grunting

a. Nasal flaring b. Intercostal retractions e. Grunting

An infant is diagnosed with central apnea. What symptoms might the nurse expect to see for this infant? Select all that apply. a. Observed periods of cessation of breathing for 20 seconds or more b. Enlarged tonsils c. Seizure activity d. Desaturations on the pulse oximeter e. Primarily nasal breathing and nasal flaring

a. Observed periods of cessation of breathing for 20 seconds or more c. Seizure activity d. Desaturations on the pulse oximeter

A 15-month-old is admitted to the pediatric unit with a history of a recent upper respiratory infection. Which symptom is consistent with the diagnosis of laryngo-tracheobronchitis (croup)? Select all that apply. a. Reported inspiratory stridor that is worse at night. b. Suprasternal retractions are present upon examination. c. The toddler has a barking, seal-like, harsh cough. d. Lung sounds have inspiratory wheezing. e. Lung sounds with crackles in the bases bilaterally.

a. Reported inspiratory stridor that is worse at night. b. Suprasternal retractions are present upon examination. c. The toddler has a barking, seal-like, harsh cough.

Nursing education provided to caregivers of a child diagnosed with bronchopulmonary dysplasia (BPD) should include which interventions? Select all that apply. a. Safe oxygen administration b. Signs and symptoms of respiratory distress c. Strict hand washing d. Ventilator management e. Low-calorie feedings

a. Safe oxygen administration b. Signs and symptoms of respiratory distress c. Strict hand washing d. Ventilator management

The nurse understands appropriate drug therapy for infants with bronchopulmonary dysplasia (BPD) includes which therapy? a. Surfactant b. Vitamin D c. Methylphenidate (Ritalin) d. Sodium Chloride (NaCl)

a. Surfactant

The nurse should instruct the parent whose child is diagnosed with respiratory syncytial virus (RSV) to notify the health-care provider for which issue? Select all that apply. a. The child is not eating. b. There is a decrease in wet diapers. c. There is increased work of breathing. d. The child develops yellow drainage from the nose. e. Only when the child wheezes.

a. The child is not eating. b. There is a decrease in wet diapers. c. There is increased work of breathing.

The nurse is educating parents of a toddler about ways to avoid foreign body aspiration. Which statement made by the parents indicates their understanding of this concept? a. "I will use back blows and abdominal thrusts for my toddler if he begins to choke." b. "I will cut table foods into small pieces before feeding my child." c. "I will allow my 2-year-old to play with his older brother's Legos." d. "I will make sure he chews his food properly."

b. "I will cut table foods into small pieces before feeding my child."

A 2-year-old was found playing with coins in his mother's purse. He has no significant past medical history. Later that day, the mother noticed he was blue and having difficulty breathing. She called 911 and the child was brought to the emergency department. What does the nurse determine as the most likely cause of his symptoms? a. Acute asthma attack b. Foreign body aspiration c. Reactive airway disease d. Acute bronchiolitis

b. Foreign body aspiration

Which are risk factors for the development of sudden infant death syndrome (SIDS)? Select all that apply. a. Mothers over 40 b. Low birth weight neonates c. A multiple pregnancy like triplets d. Maternal smoking e. Mothers who breastfeed

b. Low birth weight neonates c. A multiple pregnancy like triplets d. Maternal smoking

The nurse is caring for an infant who has bronchopulmonary dysplasia (BPD). What issues would the nurse associate with this diagnosis? Select all that apply a. Term infants can develop BPD. b. Mild forms of BPD can heal as the lungs grow and remodel. c. Children with BPD often are poor feeders. d. All clients with BPD will develop heart failure. e. Pulmonary hypertension frequently occurs with BPD.

b. Mild forms of BPD can heal as the lungs grow and remodel. c. Children with BPD often are poor feeders. e. Pulmonary hypertension frequently occurs with BPD.

The nurse is teaching the parents of a child using inhaled aerosolized steroids to use a spacer device with the child's metered dose inhaler (MDI). The parents want to know the purpose of the spacer. What is the appropriate nursing response? a. To minimize the risk of oral candidiasis b. To ensure proper dosing c. To minimize the adverse effects of the drug d. To cleanse the oral cavity

b. To ensure proper dosing

The nurse is taking care of a 12-year-old client with cystic fibrosis (CF). The breakfast tray has arrived. The client is ordered pancreatic enzymes. When should the nurse administer this medication for maximal effect? a. One hour before breakfast b. With breakfast c. Two hours after breakfast d. With antibiotics

b. With breakfast

The nursing student asks the nurse about genetic implications related to cystic fibrosis (CF). How should the nurse respond? a. "It is inherited as an autosomal dominant trait." b. "It is a genetic defect found primarily in non-Caucasian people." c. "If it is present in a child, both parents are carriers of the defective gene." d. "There is a 50% chance the siblings of an affected child will also be affected."

c. "If it is present in a child, both parents are carriers of the defective gene."

The nurse is speaking with a parent of a premature infant with apnea of prematurity. Which statement made by the parent indicates to the nurse that they understand the diagnosis? a. "It can be cured if my baby takes a lot of caffeine." b. "It is caused by my baby being tired." c. "It is a pause in breathing for 20 seconds or more." d. "It is caused by infants sensing carbon dioxide in their brain to breathe."

c. "It is a pause in breathing for 20 seconds or more."

A 9-month-old is admitted with influenza. Which statement made by the nurse would be the best response when caring for this infant? a. "This infection could have been prevented if the parents washed their hands at home." b. "Antibiotics should be given as soon as a diagnosis is made to prevent further infection." c. "Supportive care such as encouraging fluids to liquefy secretions will help prevent dehydration." d. "Antiviral medications such as Oseltamivir (Tamiflu) can be given at any time during the illness.

c. "Supportive care such as encouraging fluids to liquefy secretions will help prevent dehydration."

A mother is breastfeeding her infant and looks down to notice her baby's lips are blue and the baby isn't breathing. She takes the baby off the breast and rubs the baby's sternum. The baby then coughs and starts to breathe. The mother calls 911 and the child is admitted for an acute life-threatening event (ALTE). The mother is crying and wants to know what happened. She is afraid to breastfeed the baby again. What would be the correct statement to tell the mother? a. "Don't worry; the baby won't die if you breastfeed again." b. "Does your baby have reflux? This could explain it." c. "We need to be sure the baby's nose is not obstructed." d. "When your baby naps, be extra vigilant because he might have sudden infant death syndrome (SIDS)."

c. "We need to be sure the baby's nose is not obstructed."

The nurse is educating the parents of a child with asthma about environmental control. The nurse knows teaching has been understood if the parent states: a. "We will allow the cat to sleep in her room just on the floor." b. "We will be sure to keep the house cool throughout the year." c. "We will be sure to use an exterminator to decrease the likelihood of cockroaches or other bugs in the house." d. "We will use the wood fireplace often in the winter to keep our house warm."

c. "We will be sure to use an exterminator to decrease the likelihood of cockroaches or other bugs in the house."

The nurse instructs the parent of a 5 -year-old with asthma to use the AeroChamber because it: a. Can help identify asthma triggers b. Monitors daily changes in airway reactivity c. Delivers more medication d. Indicates whether allergen exposure has occurred

c. Delivers more medication

A nurse is assessing a preterm infant. Which assessment items might indicate that the infant's respiratory status is worsening? a. Arterial CO2 of 43 b. Acrocyanosis c. Grunting and nasal flaring d. Respiratory rate of 50

c. Grunting and nasal flaring

A 12-year-old is brought into the emergency department in severe respiratory distress. His respiratory rate is 45 breaths per minute. Oxygen saturations are 84% on room air. His mouth is open and he is gasping for air. Which oxygen delivery device would me most effective in delivering the highest oxygen concentration quickly? a. Nasal cannula b. Simple mask c. Nonrebreather mask d. An oxygen tent

c. Nonrebreather mask

A child is admitted to the hospital with pneumonia. The child's pulse oximetry reading is 85% on room air. What would the priority nursing activity for this child be? a. Obtain an arterial blood gas (ABG). b. Start an intravenous (IV) line and begin fluids. c. Place the child on oxygen at 1 liter via nasal cannula. d. Obtain a respiratory viral panel to determine the cause of illness.

c. Place the child on oxygen at 1 liter via nasal cannula.

A 6-week-old is admitted for respiratory syncytial virus (RSV). The infant has expiratory wheezes, increased work of breathing, and substernal and subcostal retractions. Oxygen saturations is 87% on room air. An intravenous line (IV) is placed, and the infant is placed on 2 liters via nasal cannula. Nursing care for this infant should include: a. Administering Acyclovir intravenously b. Giving morphine as needed for pain c. Providing nebulized hypertonic saline d. Giving Palivizumab (Synagis) prior to discharge

c. Providing nebulized hypertonic saline

Which statement does the nurse understand to be true about giving palivizumab, the immunization for respiratory syncytial virus (RSV), to an infant? a. Preterm infants are not able to receive the vaccine. b. It is 100% effective in preventing RSV. c. The immunization must be given monthly during RSV season. d. Palivizumab is one of several prevention vaccines for RSV.

c. The immunization must be given monthly during RSV season.

The nurse is caring for a child who swallowed a quarter. A bronchoscopy with retrieval is planned for later that day. Which assessment finding would be most concerning? a. The child develops a fever of 101°F (38.3°C). b. Intermittent audible stridor is noted. c. The respiratory rate is 45 with the increased work of breathing. d. Oxygen saturations drop to 96% on room air.

c. The respiratory rate is 45 with the increased work of breathing.

The parent of a 7-year-old girl who has just received her second influenza vaccine asks when she will be protected from the flu. What answer should the nurse give? a. Immediately after vaccination b. 5 days c. Two weeks d. 1 month

c. Two weeks

The nurse is providing discharge teaching to the mother of a 4-year-old who had a tonsillectomy. Which statement made by the mother indicates she has a good understanding of what to feed her child when they arrive home? a. "I will give her whatever she wants so she eats something." b. "She likes to eat pretzels and tortilla chips for a snack. I will give that to her if she asks." c. "I will give her cool apple juice and orange juice to drink to help her throat." d. "I will give her Italian ice and yogurt initially when she gets hungry."

d. "I will give her Italian ice and yogurt initially when she gets hungry."

A 4-year-old is presented to the urgent care center with a history of a sudden onset of a severe sore throat. He began drooling and has difficulty swallowing. The temperature is 102.2°F (39.0°C). Lung sounds are clear and there is no cough. The child is very anxious and flushed, and is leaning forward in a tripod position. Based on these symptoms, the nurse anticipates a diagnosis of: a. Acute asthma attack b. Laryngotracheomalacia c. Acute laryngotracheobronchitis (Croup) d. Epiglottitis

d. Epiglottitis Sudden onset of high fever, sore throat with the 4 Ds (drooling, dysphagia, dysphonia, distressed air movement/stridor), and the tripod position are classic signs of acute epiglottitis

The nurse is caring for a child who has cystic fibrosis (CF). Which type of diet does the nurse anticipate will be ordered for this child? a. High fat, high salt b. High carbohydrate, high calorie c. High sodium, high fat d. High calorie, high protein

d. High calorie, high protein

At what age should annual influenza vaccines first be given to children? a. Newborn b. Two weeks c. Three months d. Six months

d. Six months

The nurse is assigned to take care of a five-month-old with Respiratory Syncytial Virus (RSV). The baby presents with a temperature of 102.2°F (39°C) rectally, HR 165, RR, 72, and O2 saturation of 96% on room air. The best initial intervention for the nurse to do would be to: a. Make sure the baby eats to maintain hydration. b. Place an intravenous catheter (IV) promptly and hang IV antibiotics ASAP. c. Put the infant on 4 liters of oxygen via nasal cannula. d. Suction the nares bilaterally frequently.

d. Suction the nares bilaterally frequently.

A 6-year-old is admitted to the emergency department after being a restrained front seat passenger in a motor vehicle crash. The airbags deployed. Vital signs on admission are T-98F, HR 110, RR 56, BP 108/96. The child is having great difficulty breathing. The trachea is deviated to the left. There are no lung sounds on the right side. What problem might you suspect the child has? a. Cardiac contusion b. Fractured ribs c. Pneumonia d. Tension pneumothorax

d. Tension pneumothorax