Question 1

The nurse is assessing a child with acute epiglottitis.Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

Accepted Answer

If a child has acute epiglottitis,examination of the throat may cause complete obstruction and should be performed only when immediate intubation can take place.Stridor is aggravated when a child with epiglottitis is supine.Sore throat and pain on swallowing are early signs of epiglottitis.Epiglottitis is caused by Haemophilus influenzae in the respiratory tract.

Question 2

A child diagnosed with cystic fibrosis is prescribed recombinant human deoxyribonuclease (rhDNase).What information should be included in the medication education provided the child and family?

Accepted Answer

Two of the only adverse effects of rhDNase are voice alterations and laryngitis.rhDNase decreases viscosity of mucus,is given in an aerosolized form,and is safe for children younger than 12 years of age.

Question 3

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

Accepted Answer

The airway in infants and young children is narrower,not wider,and respiratory distress can occur quickly because mucus and edema can cause obstruction to their small airways.Sucking is not necessarily related to problems with the airway.The gag reflex is necessary to prevent aspiration.It does not produce mucus.

Question 4

Which vitamin supplements are necessary for children with cystic fibrosis?

Accepted Answer

Fat-soluble vitamins are poorly absorbed because of deficient pancreatic enzymes in children with cystic fibrosis; therefore,supplements are necessary.Vitamin C and calcium are not fat soluble.Vitamins B₆ and B₁₂ are not fat-soluble vitamins.Magnesium is a mineral,not a vitamin.

Question 5

Abdominal thrusts are recommended for airway obstruction in children older than:

Accepted Answer

Abdominal thrusts are recommended for airway obstruction in children older than 1 year.In children younger than 1 year,back blows and chest thrusts are administered.

Question 6

Which information should the nurse teach families about reducing exposure to pollens and dust? (Select all that apply.)

Accepted Answer

Carpets retain dust.To reduce exposure to dust,carpeting should be replaced with wood,tile,slate,or vinyl.These floors can be cleaned easily.For anyone with pollen allergies,it is best to keep the windows closed and to run the air conditioner.Covering mattresses and pillows with dust-proof covers will reduce exposure to dust.A humidity level above 60% promotes dust mites.It is recommended that household humidity be kept between 40% and 50% to reduce dust mites inside the house.Keeping pets outside will help to decrease exposure to dander,but will not affect exposure to pollen and dust.

Question 7

An 18-month-old child is seen in the clinic is diagnosed with acute otitis media (AOM).Oral amoxicillin is prescribed.Which statement made by the parent indicates a correct understanding of the instructions?

Accepted Answer

Antibiotics should be given for their full course to prevent recurrence of infection with resistant bacteria.Symptoms may subside before the full course is given.Hearing loss is a complication of AOM.Antibiotics should continue to be given.Medication may take 24 to 48 hours to make symptoms subside.It should be continued.

Question 8

A child with cystic fibrosis (CF)receives aerosolized bronchodilator medication.When should this medication be administered?

Accepted Answer

Bronchodilators should be given before CPT to open bronchi and make expectoration easier.Aerosolized bronchodilator medications are not helpful when used after CPT.Oxygen administration is necessary only in acute episodes with caution because of chronic carbon dioxide retention.

Question 9

In providing nourishment for a child with cystic fibrosis (CF),what diet consideration should be stressed to both the child and caregivers?

Accepted Answer

Children with CF require a well-balanced,high-protein,high-calorie diet because of impaired intestinal absorption.Enzyme supplementation helps digest foods; other modifications are not necessary.A well-balanced diet containing fruits and vegetables is important.Fats and proteins are a necessary part of a well-balanced diet.

Question 10

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

Accepted Answer

Hydration is important in children with RSV bronchiolitis to loosen secretions and prevent shock.Clustering of care promotes periods of rest.The use of noninvasive oxygen monitoring is recommended.

Question 11

What nursing intervention should be included in the plan of care for a young child diagnosed with pneumonia?

Accepted Answer

The pain of pneumonia may be referred to the abdomen in young children.Lying on the affected side may promote comfort by splinting the chest and reducing pleural rubbing.Analgesics are not indicated.Children should be placed in a semierect position or position of comfort.

Question 12

Pancreatic enzymes are administered to the child with cystic fibrosis.What information should be included in patient education concerning the administration of these enzymes?

Accepted Answer

Enzymes may be administered in a small amount of cereal or fruit or swallowed whole at the beginning of a meal,not between meals.Pancreatic enzymes are not contraindicated with antibiotics.The dose of enzymes should be increased if the child is having frequent,bulky stools.

Question 13

Parents have understood teaching about prevention of childhood otitis media if they make which statement?

Accepted Answer

Parents have understood the teaching about preventing childhood otitis media if they respond they will keep childhood immunizations up to date.The child should be maintained upright during feedings and after.Otitis media can be prevented by exclusively breastfeeding until at least 6 months of age.Propping bottles is discouraged to avoid pooling of milk while the child is in the supine position.

Question 14

Which information should the nurse stress to workers at a day care center about respiratory syncytial virus (RSV)?

Accepted Answer

Meticulous hand washing can decrease the spread of organisms.RSV infection is not airborne.It is acquired mainly through contact with contaminated surfaces.RSV can live on skin or paper for up to 1 hour and on cribs and other nonporous surfaces for up to 6 hours.

Question 15

A nurse is charting that a hospitalized child has labored breathing.Which medical term describes labored breathing?

Accepted Answer

Dyspnea is labored breathing.Tachypnea is rapid breathing.Hypopnea is breathing that is too shallow.Orthopnea is difficulty breathing except in upright position.

Question 16

A nurse is conducting an in-service on asthma.Which statement is the most descriptive of bronchial asthma?

Accepted Answer

In bronchial asthma,spasm of the smooth muscle of the bronchi and bronchioles causes constriction,producing impaired respiratory function.In bronchial asthma,there is increased resistance in the airway.There are multiple causes of asthma,including allergens,irritants,exercise,cold air,infections,medications,medical conditions,and endocrine factors.Atopy or development of an immunoglobulin E (IgE)-mediated response is inherited but is not the only cause of asthma.

Question 17

What distinguishing manifestation of spasmodic croup should parents be taught to identify?

Accepted Answer

Spasmodic croup is viral in origin,is usually preceded by several days of symptoms of upper respiratory tract infection,and often begins at night.It is marked by a harsh,metallic,barky cough; sore throat; inspiratory stridor; and hoarseness.Wheezing is not a distinguishing manifestation of croup.It can accompany conditions such as asthma or bronchiolitis.A high fever is not usually present.

Question 18

Which intervention for treating croup at home should be taught to parents?

Accepted Answer

Taking the child into the cool,humid,night air may relieve mucosal swelling and improve symptoms.Decongestants are inappropriate for croup,which affects the middle airway level.A dry environment may contribute to symptoms.Croup is caused by a virus.Antibiotic treatment is not indicated.

Quiz 40: The Child With Respiratory Dysfunction

The nurse is assessing a child with acute epiglottitis.Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

A child diagnosed with cystic fibrosis is prescribed recombinant human deoxyribonuclease (rhDNase) .What information should be included in the medication education provided the child and family?

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

Which vitamin supplements are necessary for children with cystic fibrosis?

Abdominal thrusts are recommended for airway obstruction in children older than:

Which information should the nurse teach families about reducing exposure to pollens and dust? (Select all that apply.)

An 18-month-old child is seen in the clinic is diagnosed with acute otitis media (AOM) .Oral amoxicillin is prescribed.Which statement made by the parent indicates a correct understanding of the instructions?

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication.When should this medication be administered?

In providing nourishment for a child with cystic fibrosis (CF) ,what diet consideration should be stressed to both the child and caregivers?

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