Question 1

A 6-month-old presents with rhinorrhea, cough, poor feeding, lethargy, and fever and is diagnosed with bronchiolitis.Which of the following will the nurse most likely observe on the culture report?
A) Parainfluenza virus
B) Haemophilus influenzae type B
C) Respiratory syncytial virus
D) Group A beta-hemolytic streptococcus

Accepted Answer

The most common cause of bronchiolitis is respiratory syncytial virus.Bronchiolitis is not caused by the parainfluenza virus, Haemophilus influenzae type B, or group A beta-hemolytic streptococcus.

Question 2

During a respiratory assessment of an infant diagnosed with respiratory distress syndrome, a depression in the supraclavicular and intercostal areas of the thorax was noted with inspiration.This observation is documented as:
A) grunting.
B) tachypnea.
C) retractions.
D) nasal flaring.

Accepted Answer

The sinking of supraclavicular and intercostal areas is termed retractions.The symptoms do not describe grunting, tachypnea, or nasal flaring.

Question 3

What is the most likely cause of croup?
A) Bacteria
B) Acute hyperventilation
C) Allergy
D) Viral infection

Accepted Answer

The most common cause of croup is viral, not bacterial.Croup is not caused by acute hyperventilation or an allergic response.

Question 4

A 5-year-old presents with high fever, inspiratory stridor, severe respiratory distress, drooling, and dysphagia.Acute epiglottitis is suspected.When assessing the child the nurse would avoid:
A) trying to keep the child calm.
B) examining the throat for redness.
C) auscultating the child's respiratory rate.
D) counting the heart rate apically.

Accepted Answer

Examination of the throat should not be attempted as it may trigger laryngospasm and cause respiratory collapse.It is appropriate to attempt to keep the child calm, listen, and count the child's respiratory and heart rates.

Question 5

A 9-year-old contracted influenza.Which of the following complications is of greatest concern to the nurse?
A) Chronic bronchitis
B) Bronchiolitis obliterans
C) Emphysema
D) Respiratory distress syndrome (RDS)

Accepted Answer

Bronchiolitis obliterans, not just chronic bronchitis, most often occurs as a sequela of a severe viral pulmonary infection (e.g., influenza, adenovirus, pertussis [whooping cough], or measles).Neither emphysema nor RDS is a concern.

Question 6

Which pathology is characteristic of asthma?
A) Increased lung volumes
B) Expiratory wheezing
C) Air trapping
D) Dead space

Accepted Answer

On physical examination, there is expiratory wheezing that is often described as high pitched and musical, and there is prolongation of the expiratory phase of the respiratory cycle.Lung volumes are decreased.Air trapping and dead space occur in emphysema, not asthma.

Question 7

A cardiovascular alteration seen in a newborn diagnosed with respiratory distress syndrome includes:
A) left-to-right shunt.
B) left ventricular dilation.
C) pulmonary hypotension.
D) opening of fetal shunt pathways.

Accepted Answer

Increased pulmonary vascular resistance may even cause a partial return to fetal circulation, with right-to-left shunting of blood through the ductus arteriosus and foramen ovale.A left-to-right shunt does not occur.This situation is not associated with either ventricular dilation or pulmonary hypotension.

Question 8

A 7-month-old presents with cystic fibrosis (CF)accompanied by failure to thrive and frequent, loose, and oily stools.Sweat testing confirms the diagnosis.Which of the following is characteristic of CF?
A) Autoantibodies that target the lungs and pancreas
B) Thick mucous sputum
C) Enzymes that degrade surfactant in the alveoli
D) A toxic amount of electrolytes from secretory glands

Accepted Answer

In CF, thick mucus is present.CF is not characterized by autoantibodies, degraded surfactant, or elevated electrolytes.

Question 9

A newborn experiencing respiratory distress syndrome (RDS)will demonstrate signs:
A) within minutes of birth.
B) 2-3 hours after birth.
C) within the first 12-24 hours after birth.
D) 24-48 hours after exposure to an infectious organism.

Accepted Answer

Signs of RDS appear within minutes of birth.Signs of RDS are not associated with an infectious organism.

Question 10

An infant was born 10 weeks premature and requires mechanical ventilation.Two months later the infant presents with hypoxemia and hypercapnia.Which of the following is the most likely diagnosis the nurse will observe documented on the chart?
A) Respiratory distress syndrome of the newborn
B) Bronchopulmonary dysplasia (BPD)
C) Bronchiolitis
D) Pneumonia

Accepted Answer

Mechanical ventilation can result in a proinflammatory state that may contribute to the development of chronic lung disease, such as BPD but not bronchiolitis or pneumonia.Respiratory distress might have led to the intubation, but BPD is the diagnosis.

Question 11

To help confirm a diagnosis of cystic fibrosis in a 1-year-old child which substance will be monitored for in the child's sweat?
A) Potassium
B) Chloride
C) Magnesium
D) Carbonic acid

Accepted Answer

The standard method of diagnosis is the sweat test, which reveals sweat chloride concentration in excess of 60 milliequivalents per liter.None of the other substances is relevant for this diagnosis.

Question 12

A newborn is diagnosed with respiratory distress syndrome.When obtaining the patient's history, which of the following is the most important predisposing factor for this condition?
A) Low birth weight
B) Alcohol consumption by the mother during pregnancy
C) Premature birth
D) Smoking by the mother during pregnancy

Accepted Answer

Newborn respiratory distress occurs almost exclusively in premature infants, not low birth weight.Newborn respiratory distress is not associated with either maternal alcohol use or smoking.

Question 13

After nearly drowning a 2-year-old developed acute respiratory distress syndrome (ARDS).Which of the following should the nurse assess the patient for?
A) Decreased heart rate
B) Increased lung compliance
C) Increased surfactant production
D) Hypoxemia

Accepted Answer

The child diagnosed with ARDS will experience severe hypoxemia, an elevated heart rate, and decreased lung compliance.Surfactant production is not affected in ARDS.

Question 14

Cystic fibrosis (CF)is an _____ disease.
A) autosomal recessive
B) autosomal dominant
C) X-linked recessive
D) X-linked dominant

Accepted Answer

CF is an autosomal recessive disease.CF is not X-linked.

Question 15

A 2-week-old female presents with fever, productive cough, respiratory distress, and empyema.Which of the following is the most likely diagnosis the nurse will observe on the chart?
A) Viral pneumonia
B) Pneumococcal pneumonia
C) Staphylococcal pneumonia
D) Mycoplasma pneumonia

Accepted Answer

Staphylococcal and group A streptococcal pneumonia can be particularly fulminant (sudden, severe)and necrotizing (causing cell death)with a high incidence of accompanying empyema, pneumatocele, and sepsis.Staphylococcal pneumonia is the more likely diagnosis than viral.Staphylococcal pneumonia is more likely to cause empyema than either pneumococcal or Mycoplasma pneumonias.

Question 16

An 11-year-old presents with a low-grade fever and cough and is diagnosed with atypical pneumonia.What type of pneumonia does the nurse suspect the patient is experiencing?
A) Pneumococcal pneumonia
B) Viral pneumonia
C) Mycoplasma pneumonia
D) Streptococcal pneumonia

Accepted Answer

Chlamydophila pneumonia is clinically indistinguishable from and is typically grouped with Mycoplasma as "atypical pneumonia." No other option is considered an atypical pneumonia.

Question 17

A 10-year-old is diagnosed with obstructive sleep apnea.When the parents ask, the nurse shares that the initial treatment will be:
A) tonsillectomy and adenoidectomy (T&A).
B) weight loss.
C) continuous positive airway pressure.
D) drug therapy.

Accepted Answer

Children with sleep apnea are most often referred for T&A.Weight loss, continuous positive airway pressure, and drug therapy are not the treatment of choice.

Question 18

A 2-year-old presents with fever and cough and is diagnosed with pneumonia.While planning treatment for this patient, the nurse recognizes that which of the following is the most likely cause?
A) Bacteria
B) Viruses
C) Mycoplasma species
D) Toxic inhalations

Accepted Answer

Viral pneumonia is more common than bacterial pneumonia, and children are 2-3 times more likely than adults to acquire these viruses.Neither Mycoplasma species nor toxic inhalations are commonly associated with childhood pneumonia.

Question 19

A newborn diagnosed with respiratory distress syndrome is monitored for atelectasis because of:
A) a lack of surfactant.
B) pulmonary edema.
C) airway obstruction.
D) pulmonary fibrosis.

Accepted Answer

Atelectasis in newborn respiratory distress is due to lack of surfactant, not pulmonary edema.Atelectasis in newborn respiratory distress is not due to either an airway obstruction or pulmonary fibrosis.

Question 20

A 13-year-old female is diagnosed with asthma.Which of the following should the nurse teach the patient to recognize as a part of an asthmatic attack?
A) Headache
B) Chest pain
C) Wheezing
D) Low heart rate

Accepted Answer

Wheezing but not chest pain occurs in asthma due to narrowing of airways.Headache is not a part of an asthma attack.The heart rate will be increased, not decreased.

Quiz 28: Alterations of Pulmonary Function in Children

A 6-month-old presents with rhinorrhea, cough, poor feeding, lethargy, and fever and is diagnosed with bronchiolitis.Which of the following will the nurse most likely observe on the culture report?

During a respiratory assessment of an infant diagnosed with respiratory distress syndrome, a depression in the supraclavicular and intercostal areas of the thorax was noted with inspiration.This observation is documented as:

What is the most likely cause of croup?

A 5-year-old presents with high fever, inspiratory stridor, severe respiratory distress, drooling, and dysphagia.Acute epiglottitis is suspected.When assessing the child the nurse would avoid:

A 9-year-old contracted influenza.Which of the following complications is of greatest concern to the nurse?

Which pathology is characteristic of asthma?

A cardiovascular alteration seen in a newborn diagnosed with respiratory distress syndrome includes:

A 7-month-old presents with cystic fibrosis (CF) accompanied by failure to thrive and frequent, loose, and oily stools.Sweat testing confirms the diagnosis.Which of the following is characteristic of CF?

A newborn experiencing respiratory distress syndrome (RDS) will demonstrate signs:

An infant was born 10 weeks premature and requires mechanical ventilation.Two months later the infant presents with hypoxemia and hypercapnia.Which of the following is the most likely diagnosis the nurse will observe documented on the chart?

To help confirm a diagnosis of cystic fibrosis in a 1-year-old child which substance will be monitored for in the child's sweat?

A newborn is diagnosed with respiratory distress syndrome.When obtaining the patient's history, which of the following is the most important predisposing factor for this condition?

After nearly drowning a 2-year-old developed acute respiratory distress syndrome (ARDS) .Which of the following should the nurse assess the patient for?

Cystic fibrosis (CF) is an _____ disease.

A 2-week-old female presents with fever, productive cough, respiratory distress, and empyema.Which of the following is the most likely diagnosis the nurse will observe on the chart?

An 11-year-old presents with a low-grade fever and cough and is diagnosed with atypical pneumonia.What type of pneumonia does the nurse suspect the patient is experiencing?

A 10-year-old is diagnosed with obstructive sleep apnea.When the parents ask, the nurse shares that the initial treatment will be:

A 2-year-old presents with fever and cough and is diagnosed with pneumonia.While planning treatment for this patient, the nurse recognizes that which of the following is the most likely cause?

A newborn diagnosed with respiratory distress syndrome is monitored for atelectasis because of:

A 13-year-old female is diagnosed with asthma.Which of the following should the nurse teach the patient to recognize as a part of an asthmatic attack?