Deck 45: Respiratory Dysfunction

Question 1

The nurse is caring for a child with acute respiratory distress syndrome (ARDS)associated with sepsis.Which nursing action should be included in the child's care?

A) Force fluids.
B) Monitor pulse oximetry.
C) Institute seizure precautions.
D) Encourage a high-protein diet.

Answer 1

Monitor pulse oximetry.

Question 2

Why are cool-mist vaporizers rather than steam vaporizers recommended in home treatment of respiratory tract infections?

A) They are safer.
B) They are less expensive.
C) Steam dries out respiratory secretions.
D) A more comfortable environment is produced.

Answer 2

They are safer.

Question 3

When do physicians generally recommend that a child with acute streptococcal pharyngitis can return to school?

A) When the sore throat is better
B) If no complications develop
C) After taking antibiotics for 24 hours
D) After taking antibiotics for 3 days

Answer 3

After taking antibiotics for 24 hours

Question 4

What sentence below best describes why children have fewer respiratory tract infections as they grow older?

A) The amount of lymphoid tissue decreases.
B) Repeated exposure to organisms causes increased immunity.
C) Viral organisms are less prevalent in the population.
D) Secondary infections rarely occur after viral illnesses.

Question 5

An infant's parents ask the nurse about preventing otitis media (OM).What should the nurse recommend?

A) Avoid tobacco smoke.
B) Use nasal decongestant.
C) Avoid children with OM.
D) Bottle-feed or breastfeed in the supine position.

Question 6

What is the appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?

A) Give tepid water baths to reduce fever.
B) Encourage food intake to maintain caloric needs.
C) Have the child wear heavy clothing to prevent chilling.
D) Give small amounts of favourite fluids frequently to prevent dehydration.

Question 7

A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry,hacking cough that was worse at night.The cough has become productive in the past 24 hours.What is this description most suggestive of?

A) Bronchitis
B) Bronchiolitis
C) Viral-induced asthma
D) Acute spasmodic laryngitis

Question 8

The nurse is caring for a child with carbon monoxide (CO)poisoning associated with smoke inhalation.What is the most essential part of this child's care?

A) Monitoring pulse oximetry
B) Monitoring arterial blood gases
C) Administering oxygen if respiratory distress develops
D) Administering oxygen if the child's lips become bright cherry red

Question 9

Which type of croup is always considered a medical emergency?

A) Laryngitis
B) Epiglottitis
C) Spasmodic croup
D) Laryngotracheobronchitis (LTB)

Question 10

When teaching a parent group about respiratory complications,which symptom should be reported to the health care provider?

A) Becomes fussy
B) Has a cough
C) Has a fever for more than 3 days
D) Shows signs of an earache

Question 11

Which should be frequently assessed in children with asthma who are taking long-term inhaled steroids?

A) Cough
B) Osteoporosis
C) Slowed growth
D) Cushing's syndrome

Question 12

Which is a common trigger for the development of asthma in infants?

A) Medications
B) A viral infection
C) Exposure to cold air
D) Allergy to dust or dust mites

Question 13

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection.Which instruction for nose drops should be included when teaching the parent?

A) Avoid using drops for more than 3 days.
B) Keep drops to use again for nasal congestion.
C) Administer drops until nasal congestion subsides.
D) Administer drops after feedings and at bedtime.

Question 14

A child has a chronic,nonproductive cough and diffuse wheezing during the expiratory phase of respiration.What do these symptoms suggest?

A) Asthma
B) Pneumonia
C) Bronchiolitis
D) A foreign body in the trachea

Question 15

Which best describes acute otitis media (AOM)?

A) The etiology is unknown.
B) Permanent hearing loss often results.
C) It can be treated by intramuscular antibiotics.
D) It can be treated with antibiotics.

Question 16

When is skin testing (the Mantoux test)for tuberculosis (TB)recommended?

A) Every year for all children older than 2 years
B) Every year for all children older than 10 years
C) Every 2 years for all children starting at age 1 year
D) Periodically for children who reside in high-prevalence regions

Question 17

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the child's bedside as much as possible.What is the nurse's primary reason for this suggestion?

A) Mothers of hospitalized toddlers often experience guilt.
B) The mother's presence will reduce the child's anxiety and ease respiratory efforts.
C) Separation from the mother is a major developmental threat at this age.
D) The mother can provide constant observations of the child's respiratory efforts.

Question 18

The mother of a toddler yells to the nurse,"Help! He is choking to death on his food." What finding causes the nurse to determine that life-saving measures are necessary?

A) Gagging
B) Coughing
C) Pulse over 100 beats/min
D) Inability to speak

Question 19

â-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack.How do these medications act on asthma?

A) They liquefy secretions.
B) They dilate the bronchioles.
C) They reduce inflammation in the lungs.
D) They reduce infection.

Question 20

Which characteristic regarding chronic otitis media with effusion (OME)differentiates if from acute otitis media (AOM)?

A) Fever as high as 40°C
B) Severe pain in the ear
C) Nausea and vomiting
D) A feeling of fullness in the ear

Question 21

What should a nurse know when administering pancreatic enzymes to a child with cystic fibrosis?

A) Do not administer pancreatic enzymes if the child is receiving antibiotics.
B) Decrease the 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.

Question 22

What is the priority nursing intervention when caring for a child with pneumonia?

A) Encourage rest.
B) Encourage the child to lie on the affected side.
C) Administer an opioid.
D) Place the child in the Trendelenburg position.

Question 23

Cardiopulmonary resuscitation is begun on a toddler.Which pulse is usually palpated because it is the most central and accessible?

A) Radial
B) Carotid
C) Femoral
D) Brachial

Question 24

What is the earliest recognizable clinical manifestation(s)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

Question 25

Subdiaphragmatic abdominal thrusts are recommended for airway obstruction in children older than which age?

A) 1 year
B) 4 years
C) 8 years
D) 12 years

Question 26

A parent whose two school-age children have asthma asks the nurse what sports,if any,they can participate in.What sport should the nurse recommend?

A) Soccer
B) Running
C) Swimming
D) Basketball

Question 27

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours.What action should the nurse include in the child's postoperative care plan?

A) Notify the surgeon if the child swallows frequently.
B) Apply a heat collar to the child for pain relief.
C) Place the child in prone supine position until fully awake.
D) Encourage the child to cough frequently.

Question 28

Cystic fibrosis (CF)is suspected in a toddler.Which test is essential to confirm this diagnosis?

A) Bronchoscopy
B) Serum calcium
C) Urine creatinine
D) Sweat chloride test

Question 29

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase).Which is true about this drug?

A) It may cause mucus to thicken.
B) It may cause voice alterations.
C) It is given subcutaneously.
D) It is not indicated for children younger than 12 years.

Question 30

Which are true in relation to the influenza vaccination? Select all that apply.Express answer in small numbers followed by a comma and a space-e.g. ,a,b,c

A) Annual vaccination is recommended for all children age 6 months or older.
B) Vaccination is not recommended for immunocompromised children.
C) Trivalent vaccines are preferred over quadrivalent vaccines.
D) Children with neurological disorders are high risk and should have an annual vaccination.
E) Children aged 6 months to 8 years receive their initial vaccine in two doses,4 weeks apart.
F) Indigenous peoples are identified as high risk and should receive annual vaccinations.

Question 31

What should be included in nursing care for a child with staphylococcal pneumonia?

A) Nursing care should be supportive and directed at relieving symptoms.
B) Nursing care should include round-the-clock administration of antitussive agents.
C) Nursing care should include strict intake and output to avoid heart failure.
D) Nursing care should include administration of opioids.

Question 32

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) Seventy percent of individuals with CF in Canada are children.
D) There is a 50% chance that siblings of an affected child will also be affected.

Question 33

The nurse is caring for a 10-month-old infant with mild acute respiratory distress syndrome (ARDS).Which initial intervention should be included in the child's care?

A) Place in a mist tent.
B) Administer antibiotics.
C) Administer cough syrup.
D) Place on noninvasive oxygen monitoring.

Question 34

When doing discharge teaching with parents of a 9-year-old child who had a tonsillectomy 10 hours ago,which will the nurse include? Select all that apply.Express answer in small numbers followed by a comma and a space-e.g. ,a,b,c

A) Gargle with warm water TID
B) Avoid vigorous brushing of the teeth
C) Use straws when providing clear fluid drinks
D) Use an ice collar for pain
E) Drink at least 1 L of fluid per day
F) Offer chewing gum
G) Provide orange juice at least once per day

Question 35

In providing nourishment for a child with cystic fibrosis (CF),which factor should the nurse keep in mind?

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.