Deck 24: Respiratory Alterations

Question 1

Which of the following is the primary function of the respiratory system?

A) facilitate gas exchange
B) get rid of carbon dioxide
C) clean the blood
D) circulate oxygen

Answer 1

facilitate gas exchange

Question 2

Which of the following factors are age-related physical differences in infants that most increase this population's risks for developing a respiratory system dysfunction?

A) small airways and fewer alveoli
B) shape of the chest, smaller ribs
C) abdominal breathing
D) greater weight-to-height ratio

Answer 2

small airways and fewer alveoli

Question 3

During which of the following age periods does a child have the most limited alveolar surface for gas exchange in relation to height and weight?

A) infancy
B) toddler years
C) preschool years
D) school-age years

Answer 3

infancy

Question 4

When an infant is in respiratory distress and having retractions, what causes the retractions?

A) a deficiency of oxygen and a surplus of carbon dioxide in the lungs
B) efforts by the infant to take in more air create a negative-pressure pull
C) soft tissue surrounding the ribs and sternum are drawn inward during inspiration
D) changes in electrolyte status in the lungs

Question 5

Compared to that of an adult, which of the following percentages represents a child's oxygen consumption?

A) 25%
B) 50%
C) 100%
D) 200%

Question 6

When a premature newborn is showing signs of developing respiratory distress syndrome or bronchopulmonary dysplasia, which of the following treatments is most likely given to reduce the chance of the infant having these problems?

A) exogenous surfactant therapy
B) oxygen therapy
C) hyperbaric chamber treatments
D) light therapy

Question 7

Which of the following respiratory alterations is the same as nasopharyngitis?

A) sinusitis
B) bronchitis
C) common cold
D) strep throat

Question 8

What is the major cause of nasopharyngitis?

A) protozoa
B) bacteria
C) bacilli
D) viruses

Question 9

The nurse assessing a child with nasopharyngitis would most likely find the child to have which of the following signs or symptoms?

A) elevated white blood count, elevated temperature, and chronic earache
B) increase in immature white cells, subnormal temperature, and yellow-green discharge
C) a normal white blood cell count (WBC), stuffy nose, nasal discharge, cough, sore throat, and malaise
D) a normal CBC, headache, pain around the sinuses, and lethargy

Question 10

When the nurse is teaching the parents how to relieve nasal congestion in their infant, the nurse will recommend which of the following?

A) saline nasal drops instilled every 3 to 4 hours
B) over-the-counter cold remedies for children
C) humidifier with concurrent use of a camphor product
D) applying a camphor product in and around the nostrils

Question 11

The pediatric nurse is assessing a child with nasopharyngitis. The parents ask about the possibility of the child getting an antibiotic. Which of the following is the nurse's best answer?

A) "We need to be careful about starting antibiotics in children because we are creating more antibiotic-resistant organisms."
B) "There is no need to buy expensive antibiotics because we have other treatments that are less expensive."
C) "Antibiotics are not effective in the treatment of nasopharyngitis."
D) "There is a risk of your child being allergic to the antibiotic."

Question 12

The nurse will teach parents of a young infant who has nasopharyngitis to modify the feedings. Which modification would be most important and helpful?

A) Make a steam tent, and feed the baby while in warm, moist air.
B) Administer nasal drops containing a mild antihistamine prior to each feeding.
C) With a calm and patient approach, feed the infant with frequent rest periods during each feeding.
D) Thicken the formula with some infant rice cereal, and feed less at each regularly scheduled feeding.

Question 13

Which of the following makes children prone to tonsillitis and pharyngitis?

A) not brushing their teeth and flossing after meals and at bedtime
B) frequent upper respiratory tract infections and being around other children who may be infected
C) eating large amounts of sugar and drinking high-sugar content drinks that encourage growth of pathogens
D) not bathing properly or frequently

Question 14

The school nurse encourages the parents of a student who has a severe sore throat to take the child to the pediatrician. The nurse is especially concerned about the possibility of streptococcal tonsillitis mainly because of which of the following?

A) If streptococcal tonsillitis is not treated adequately it may lead to scarlet fever, otitis media, or more serious complications.
B) The student may miss a lot of school, risking falling behind in schoolwork and homework assignments, which would negatively impact self-esteem.
C) Other children may also get sore throats if this student is not aggressively treated.
D) If untreated, streptococcal tonsillitis may cause anemia, weight loss, and lethargy.

Question 15

The mother of a 2-1/2-year old child who has had tonsillitis asks about the possibility of a tonsillectomy for the child. The nurse informs the mother that tonsillectomies are usually performed when the child is over 3 years old. The mother wants to know why children younger than 3 have to wait for a tonsillectomy. Which of the following is the nurse's best answer?

A) "Surgery is too difficult on a younger child, because their mouths are so small, making it difficult to get to the tonsils."
B) "It is too scary for younger children, and they don't understand what is happening."
C) "Younger children are more prone to excessive blood loss and the tonsils growing back."
D) "Separation from the parents or caregivers is much more difficult in the child under 3."

Question 16

The nurse explains to parents why an adenoidectomy is sometimes indicated with the tonsillectomy. Which of the following is the nurse's best explanation?

A) "An adenoidectomy is justified when a child's enlarged adenoids block the flow of air through the nasal passages."
B) "Some surgeons prefer to take out the adenoids at the same time as the tonsillectomy because it saves the child from a second surgery."
C) "Without the tonsils to screen out foreign proteins, the adenoids are more easily infected."
D) "It is hard to take out the tonsils without removing the adenoids, because they often are adhered to each other."

Question 17

Which of the following positions does the nurse use for the child who has just returned to the room from a tonsillectomy?

A) elevated head and legs
B) on the abdomen or side
C) on the back and flat
D) on the back or sitting up

Question 18

A child who is in the first postoperative day after a tonsillectomy starts to cough and wants to blow his nose. Which of the following actions by the nurse would be best?

A) Offer the child some tissue, and give instructions on its disposal.
B) Remind the child not to cough or blow his nose.
C) Tell him he can cough but not to blow his nose.
D) Inform the child that he can blow his nose but not cough.

Question 19

The nurse is assigned to care for a child who had a tonsillectomy yesterday. The child complains of a sore throat and wants something cool. Which of the following cool drinks or foods would be acceptable to offer the child?

A) chilled tomato juice
B) cold cola
C) lime sherbet
D) cherry-flavored gelatin

Question 20

Which of the following signs or symptoms is the earliest manifestation of bleeding in a child who has had a tonsillectomy?

A) frequent swallowing
B) spitting up blood
C) coffee-ground emesis
D) complaint of thirst

Question 21

Which of the following outcomes is the most important for a child who has had a tonsillectomy?

A) absence of pain
B) bonding with the nursing staff
C) drinking sufficient water
D) no postoperative bleeding

Question 22

Which of the following instructions is the most important discharge teaching for the caregivers of a child who is postoperative from a tonsillectomy?

A) The pain medication must be given in amounts sufficient to permit the child to swallow and take nourishment without any difficulty.
B) Between 4 and 10 days postoperatively, a membrane that formed over the surgical site may hemorrhage and require immediate medical attention.
C) Limit the child's activity, and include several rest periods during the day.
D) The child must be encouraged to drink at least 8 glasses of fluid a day and eat sufficient calories to maintain or gain weight.

Question 23

Otitis media can occur with or without an effusion. Which of the following best describes an effusion?

A) accumulation of fluid such as in the middle ear or pleural cavity
B) movement of fluid back and forth between the outer ear and inner ear
C) a blocked eustachian tube causes pressure in the middle ear
D) escape of fluid from the middle ear into surrounding tissues

Question 24

Which of the following characterizes the course of acute otitis media?

A) lengthy duration after slow onset
B) insidious onset and varied duration
C) exacerbations and remissions
D) sudden onset and short duration

Question 25

Chronic otitis media is an inflammation of the middle ear that persists beyond which of the following time periods?

A) 1 week
B) 6 weeks
C) 2 months
D) 3 months

Question 26

The nurse is talking with parents about the prevention of otitis media. Which of the following would the nurse identify as preventive measures?

A) immunizations and breastfeeding
B) daily vitamin and mineral supplement
C) providing the child with adequate calories and a balanced diet
D) side-lying position for sleep

Question 27

The nurse who is teaching parents about reducing risk factors for otitis media in children would mention which of the following as putting children most at risk for otitis media?

A) household plants
B) secondhand smoke
C) overtiring the child
D) exposure to a cool climate

Question 28

A parent asks the nurse to explain why children under the age of 3 are more vulnerable to otitis media. The nurse explains that this is mainly due to which of the following?

A) They are exposed to many more small children who are prone to otitis media.
B) The outer ear is more conducive to receiving and hosting microorganisms.
C) Young children have wider, shorter, and straighter eustachian tubes than older children and adults.
D) Parents tend not to clean the ears of small children properly or sufficiently.

Question 29

A child with acute otitis media is put on antibiotics. The caregivers ask when the child will be better. The nurse will explain that, then treated with antibiotics, an acute otitis media will begin to resolve in how many days?

A) 2 to 3
B) 4 to 5
C) 7
D) 14

Question 30

The treatment of chronic fluid collections in the middle ear that take more than 3 or 4 months to resolve are treated with antibiotics or which of the following procedures?

A) adenoidectomy
B) tonsillectomy
C) placement of tubes
D) packing the ears

Question 31

The nurse inspecting the tympanic membrane of a child with acute otitis media will find a tympanic membrane that is best described as:

A) thin and translucent with a pearl-like color
B) obscured by wax or purulent material
C) yellow in color and no longer opaque in character
D) red and bulging with full or absent light reflex

Question 32

The nurse is assessing a preverbal child who keeps pulling on his ear. The nurse knows that this behavior is one way that children express:

A) frustration
B) irritability
C) hunger
D) pain

Question 33

Which of the following is the primary complication of otitis media?

A) conductive hearing loss
B) abscess in adjacent tissues
C) septicemia
D) meningitis

Question 34

The nurse assessing a child with a respiratory problem finds stridor, which is best described by which of the following?

A) excursion of the chest wall beyond that normally seen in the healthy child
B) substernal retractions and nasal flaring
C) a high-pitched sound produced by an obstruction of the trachea or larynx
D) a triad of respiratory symptoms

Question 35

Which of the following body structures is infected then a child has croup?

A) epiglottis
B) lungs
C) alveoli, bronchioles, and pleura
D) larynx, trachea, and large bronchi

Question 36

Examination of the throat of a child with acute epiglottis by depressing the tongue is:

A) a good idea because there is a characteristic patchy redness that aids in diagnosis
B) contraindicated due to the possibility of causing complete airway obstruction
C) impossible because the tongue is too swollen and tender to allow it
D) to be done carefully because of the possibility of causing additional pain

Question 37

The nurse is assessing a child with croup. Which of the following signs or symptoms would the nurse associate with croup and most expect to find?

A) bark-like cough, hoarseness, inspiratory stridor
B) expiratory stridor, irregular breathing, and weak cough
C) Cheyne-Stokes respirations and substernal retraction
D) almost continual cough and complete laryngitis

Question 38

Which of the following statements best describes croup?

A) a common viral syndrome
B) an autoimmune-initiated infection
C) a life-threatening bacterial infection
D) a respiratory condition similar to a cold

Question 39

The nurse is assessing the skin moisture of a child with laryngotracheobronchitis. Which of the following explains why the nurse assessed the skin moisture in this case?

A) to get some measure of how dehydrated the child might become
B) increased skin moisture will signal danger of ketoacidosis
C) skin moisture is a relatively good measure of the degree of infection
D) diaphoresis is associated with increased respiratory effort

Question 40

The nurse working with a child with laryngotracheobronchitis is offering the child tiny medicine cups of fluid and giving stickers and prizes for meeting goals related to intake of fluid. All this effort on the part of the nurse to get the child to drink more fluid is because the fluid is needed to:

A) prevent diarrhea
B) loosen secretions
C) maintain electrolyte balance
D) keep kidneys functioning

Question 41

Which of the following pathogens causes bronchiolitis?

A) viruses
B) bacteria
C) spirochete
D) protozoa

Question 42

The nurse assessing a child with acute epiglottitis looks up the disorder as a review and is most likely to find which of the following classic symptoms associated with this disorder?

A) clubbing of the fingers, poor circulation of extremities, and bluish color
B) bark\-like cough and thick yellow nasal discharge
C) patchy rash on the body, rapid respirations, and exhaustion
D) respiratory distress, drooling, fever, agitation, and lethargy

Question 43

Which of the following therapies is the only specific therapy for respiratory syncytial virus (RSV) bronchiolitis?

A) ribavirin (Virazole)
B) chest percussion
C) an oxygen tent
D) antibiotics

Question 44

The nurse is caring for a child who is on ribavirin. Which of the following people most need to be discouraged from visiting?

A) children
B) pregnant health care workers
C) the very elderly population
D) anyone who is under stress

Question 45

The nurse is caring for a child with a diagnosis of bronchiolitis who is being managed at home. Which of the following strategies to foster adequate ventilation would be best for the nurse to suggest to the family?

A) installing an attic fan
B) having the child take a walk twice a day
C) administering oxygen therapy
D) raising the head of the child's bed

Question 46

Which of the following outcomes is the primary criterion for evaluating the resolution of ineffective airway clearance?

A) regular respirations
B) ability to cough effectively
C) clear airway sounds
D) resolved coughing

Question 47

Pneumonia in children appears:

A) in a more primitive form, which is easier to cure than that found in adults
B) as a secondary disease
C) as a tertiary disease
D) as a primary disease or a complication of another disease

Question 48

What is meant by the ventilation/perfusion ratio?

A) the strength with which a person can blow a stream of air
B) a comparison of oxygen in the body with that in the heart
C) the comparison of alveolar ventilation to capillary perfusion
D) how quickly the oxygen taken in circulates once through the body

Question 49

The treatment of pneumonia most depends on:

A) the presence or absence of fever
B) the etiologic agent
C) what the insurance companies will pay for
D) what drugs the child received in the past

Question 50

Which of the following types of pneumonia would be treated with antibiotics?

A) viral
B) adenoviral
C) bacterial
D) aspiration

Question 51

The nurse is assessing a child with a diagnosis of pneumonia. The child is taking shallow respirations. Which of the following is the most likely explanation?

A) an attempt to minimize pain
B) a deficiency of carbon dioxide
C) exhaustion and lack of energy
D) strained chest muscles

Question 52

The nurse is making home visits to a child who is being treated for a diagnosis of pneumonia. The nurse notices that the family has a large amount of garlic on hand. Which of the following most likely explains why the garlic is present?

A) for cooking to enhance flavor and entice the child to eat
B) to be eaten raw to treat the cough and to serve as an antibiotic
C) as a deterrent to evil spirits and possibly even vampires
D) to be served as a weak garlic tea to reduce fever

Question 53

Which of the following is an herbal substance that is mixed with water and taken orally to soothe and relax the airway and relieve cough?

A) licorice
B) lavender
C) mullein
D) rosemary

Question 54

Which of the following is the nurse's best course of action when he or she finds out that a family is using herbal remedies?

A) Ignore the use of herbs because there is little time to research them.
B) Question the caregiver about the herb(s) because some herbs are not safe or have adverse interactions with prescribed medications.
C) Encourage the family to use alternative medications and treatments to supplement traditional medicine.
D) Advise the family to cut the adult dose of herbal remedies down by three-fourths or one-half, depending on the age and weight of the child.

Question 55

In assessing a client with allergic rhinitis and in teaching the caregivers, the nurse will keep in mind that perennial allergic rhinitis is most often related to sensitivity to which of the following allergens?

A) food substances such as nuts, shellfish, and hot peppers
B) outdoor allergens such as tree, grass, and weed pollen
C) animals such as cats, dog, birds, lizards, and monkeys
D) indoor allergens such as dust mites and mold

Question 56

The nurse who is teaching the caregivers of children who are going to be skin tested for allergies will teach them to avoid giving the child which of the following medications for several days to weeks before the test?

A) Tylenol and like products
B) antihistamines
C) antacid medications
D) vitamin supplements

Question 57

The nurse who is teaching a caregiver about avoiding triggers of asthma for a child. The nurse will evaluate the caregiver as having understood the instruction when the caregiver comes back in 2 weeks and gives which of the following reports?

A) "We have several new house plants that are producing carbon dioxide."
B) "We only allow the cat to be in the family room, which is carpeted."
C) "I launder the bed linens and clothing in water that is at least 54.4 degrees C (130 degrees F)."
D) "We have turned off the air conditioner and opened the windows."

Question 58

Which of the following conditions is the leading cause of pediatric chronic illness?

A) asthma
B) diabetes
C) heart disease
D) tuberculosis

Question 59

Which of the following statements best defines cystic fibrosis?

A) an acquired lung condition that occurs at birth due to oxygen deficiency
B) a congenital anomaly occurring during fetal development as a result of dietary deficiencies of the mother
C) an autosomal recessive disorder that mainly affects the exocrine glands and does multiple system damage
D) a respiratory condition affecting people of Mediterranean descent, involving mainly exchange at a microscopic level in the lungs

Question 60

Which of the following represents the life-expectancy of a child with cystic fibrosis?

A) 7 years
B) 12 years
C) 21 years
D) 30 years +

Question 61

A nurse working in the health clinic is performing the initial history for an adopted Chinese child who has recently immigrated to the United States. The nurse anticipates exploring which of the following priority questions with the child's parents? Select all that apply.

A) "Tell me about the child's immunization history."
B) "Has the child been exposed to any known communicable illnesses?"
C) "Has the child's health care experience been positive in the past?"
D) "Tell me about genetic illnesses in your family."