Deck 46: Respiratory Dysfunction

Question 1

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

A)Monitor pulse oximetry.
B)Monitor arterial blood gases.
C)Administer oxygen if respiratory distress develops.
D)Administer oxygen if child's lips become bright,cherry red.

Answer 1

Monitor arterial blood gases.

Question 2

Skin testing for tuberculosis (the Mantoux test) is 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.

Answer 2

Periodically for children who reside in high-prevalence regions.

Question 3

When caring for an infant with an upper respiratory tract infection and elevated temperature,an appropriate nursing intervention is to:

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

Answer 3

Give small amounts of favorite fluids frequently to prevent dehydration.

Question 4

A child has a chronic,nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests:

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

Question 5

What 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 6

Asthma in infants is usually triggered by:

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

Question 7

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop:

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

Question 8

Cool-mist vaporizers rather than steam vaporizers are recommended in home treatment of respiratory tract infections because:

A)They are safer.
B)They are less expensive.
C)Respiratory secretions are dried.
D)A more comfortable environment is produced.

Question 9

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include:

A)Avoiding use for more than 3 days.
B)Keeping drops to use again for nasal congestion.
C)Administering drops until nasal congestion subsides.
D)Administering drops after feedings and at bedtime.

Question 10

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:

A)Fever as high as 40° C (104° F).
B)Severe pain in the ear.
C)Nausea and vomiting.
D)A feeling of fullness in the ear.

Question 11

Which type of croup is always considered a medical emergency?

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

Question 12

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 supine position.

Question 13

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that:

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

Question 14

It is generally recommended 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.

Question 15

A child is diagnosed with influenza,probably type A disease. Management includes:

A)Clear liquid diet for hydration.
B)Aspirin to control fever.
C)Amantadine hydrochloride to reduce symptoms.
D)Antibiotics to prevent bacterial infection.

Question 16

The mother of a toddler yells to the nurse,"Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on:

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

Question 17

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:

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

Question 18

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant:

A)Becomes fussy.
B)Has a cough.
C)Has a fever over 99° F.
D)Shows signs of an earache.

Question 19

A school-age child has 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. This is most suggestive of:

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

Question 20

Which statement is characteristic of 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 is treated with a broad range of antibiotics.

Question 21

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug:

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

Question 22

The earliest recognizable clinical manifestation(s) of cystic fibrosis (CF) is:

A)Meconium ileus.
B)History of poor intestinal absorption.
C)Foul-smelling,frothy,greasy stools.
D)Recurrent pneumonia and lung infections.

Question 23

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which actions should the nurse include in the child's postoperative care plan? (Choose all that apply.)

A)Notify the surgeon if the child swallows frequently.
B)Apply a heat collar to the child for pain relief.
C)Place the child on the abdomen until fully awake.
D)Allow the child to have diluted juice after the procedure.
E)Encourage the child to cough frequently.

Question 24

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.

Question 25

An appropriate nursing intervention when caring for a child with pneumonia is to:

A)Encourage rest.
B)Encourage the child to lie on the unaffected side.
C)Administer analgesics.
D)Place the child in the Trendelenburg position.

Question 26

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include:

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.

Question 27

MATCHING
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator,what steps should the nurse take? Place in correct order.
Place heel of one hand on lower half of sternum with other hand on top.

A) Place on a hard surface.
B) Administer 30 chest compressions with two breaths.
C) Feel carotid pulse while maintaining head tilt with the other hand.
D) Use the head tilt-chin lift maneuver and check for breathing.
E) Place heel of one hand on lower half of sternum with other hand on top.
F) Give two rescue breaths.

Question 28

MATCHING
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator,what steps should the nurse take? Place in correct order.
Give two rescue breaths.

A) Place on a hard surface.
B) Administer 30 chest compressions with two breaths.
C) Feel carotid pulse while maintaining head tilt with the other hand.
D) Use the head tilt-chin lift maneuver and check for breathing.
E) Place heel of one hand on lower half of sternum with other hand on top.
F) Give two rescue breaths.

Question 29

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? Choose all that apply.

A)Place in a mist tent.
B)Administer antibiotics.
C)Administer cough syrup.
D)Encourage infant to drink 8 ounces of formula every 4 hours.
E)Cluster care to encourage adequate rest.
F) Place on noninvasive oxygen monitoring.

Question 30

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.

Question 31

MATCHING
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator,what steps should the nurse take? Place in correct order.
Place on a hard surface.

A) Place on a hard surface.
B) Administer 30 chest compressions with two breaths.
C) Feel carotid pulse while maintaining head tilt with the other hand.
D) Use the head tilt-chin lift maneuver and check for breathing.
E) Place heel of one hand on lower half of sternum with other hand on top.
F) Give two rescue breaths.

Question 32

b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action?

A)Liquefy secretions.
B)Dilate the bronchioles.
C)Reduce inflammation of the lungs.
D)Reduce infection.

Question 33

The Heimlich maneuver is recommended for airway obstruction in children older than:

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

Question 34

MATCHING
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator,what steps should the nurse take? Place in correct order.
Feel carotid pulse while maintaining head tilt with the other hand.

A) Place on a hard surface.
B) Administer 30 chest compressions with two breaths.
C) Feel carotid pulse while maintaining head tilt with the other hand.
D) Use the head tilt-chin lift maneuver and check for breathing.
E) Place heel of one hand on lower half of sternum with other hand on top.
F) Give two rescue breaths.

Question 35

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 36

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes (choose all that apply):

A)Cluster care to conserve energy.
B)Round-the-clock administration of antitussive agents.
C)Strict intake and output to avoid congestive heart failure.
D)Administration of antibiotics.

Question 37

MATCHING
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator,what steps should the nurse take? Place in correct order.
Use the head tilt-chin lift maneuver and check for breathing.

A) Place on a hard surface.
B) Administer 30 chest compressions with two breaths.
C) Feel carotid pulse while maintaining head tilt with the other hand.
D) Use the head tilt-chin lift maneuver and check for breathing.
E) Place heel of one hand on lower half of sternum with other hand on top.
F) Give two rescue breaths.

Question 38

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

Question 39

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

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

Question 40

Which drug is considered the most useful in treating cardiac arrest?

A)Bretylium
B)Lidocaine hydrochloride
C)Epinephrine hydrochloride
D)Naloxone (Narcan)

Question 41

MATCHING
The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator,what steps should the nurse take? Place in correct order.
Administer 30 chest compressions with two breaths.

A) Place on a hard surface.
B) Administer 30 chest compressions with two breaths.
C) Feel carotid pulse while maintaining head tilt with the other hand.
D) Use the head tilt-chin lift maneuver and check for breathing.
E) Place heel of one hand on lower half of sternum with other hand on top.
F) Give two rescue breaths.