Deck 23: The Child With Respiratory Dysfunction

Question 1

A child is diagnosed with influenza, probably type A disease. Management includes which of the following?

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

Answer 1

Amantadine hydrochloride to reduce symptoms

Question 2

An infant's parents ask the nurse about preventing OM. Which of the following should be recommended?

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

Answer 2

Avoid tobacco smoke.

Question 3

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

A)When 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 is an appropriate nursing intervention when caring for an infant with an upper respiratory infection and elevated temperature?

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.

Question 5

An appropriate nursing intervention when caring for a child with pneumonia is which of the following?

A)Encourage rest.
B)Avoid lying on affected side.
C)Administer analgesics.
D)Place in Trendelenburg position.

Question 6

An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Instructions to the parent should include which of the following?

A)Administer all of the prescribed medication.
B)Continue medication until all symptoms subside.
C)Immediately stop giving medication if hearing loss develops.
D)Stop giving medication and come to the clinic if fever is still present in 24 hours.

Question 7

The nurse encourages the mother of a toddler with acute LTB to stay at the bedside as much as possible. The nurse's rationale for this action is primarily which of the following?

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 8

Labored breathing is referred to as:

A)Dyspnea.
B)Tachypnea.
C)Hypopnea.
D)Orthopnea.

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 which of the following?

A)Avoid using 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 10

Skin testing for tuberculosis (TB; Mantoux) 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.

Question 11

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

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

Question 12

A school-age child had an upper respiratory 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 which of the following?

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

Question 13

Which of the following statements is characteristic of AOM?

A)The etiology is unknown.
B)Permanent hearing loss often results.
C)It can be treated by IM antibiotics.
D)It is treated with a broad range of antibiotics.

Question 14

Which of the following best describes why children have fewer respiratory 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 15

Which of the following is the most important consideration in managing TB in children?

A)Skin testing
B)Chemotherapy
C)Adequate nutrition
D)Adequate hydration

Question 16

Chronic otitis media with effusion (OME) differentiates from acute otitis media, because it is usually characterized by which of the following?

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 17

Which of the following types of croup is always considered a medical emergency?

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

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

The nurse is assessing a child with croup. Examining the child's throat by using a tongue depressor might precipitate which of the following?

A)Inspiratory stridor
B)Complete obstruction
C)Sore throat
D)Respiratory tract infection

Question 20

An important nursing consideration when caring for a 10-month-old infant with respiratory syncytial virus (RSV)/bronchiolitis would be which of the following?

A)Place in a mist tent.
B)Administer antibiotics.
C)Administer cough syrup.
D)Encourage to drink 8 ounces of formula every 4 hours.

Question 21

$\beta$ -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 22

A child with CF is receiving recombinant human deoxyribonuclease (rhD-Nase). 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 23

The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that life-saving measures are necessary based on which of the following?

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

Question 24

CF is suspected in a toddler. Which of the following tests is essential in establishing this diagnosis?

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

Question 25

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

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

Question 26

Which of the following tests aid in the diagnosis of CF?

A)Sweat chloride test, stool for fat, chest radiograph films
B)Stool for fat, gastric contents for HCl, chest radiograph films
C)Sweat chloride test, bronchoscopy, duodenal fluid analysis
D)Sweat chloride test, stool for trypsin, biopsy of intestinal mucosa

Question 27

Which of the following is an early sign of theophylline toxicity?

A)Nausea
B)Seizures
C)Drowsiness
D)Bradycardia

Question 28

Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which of the following pulses is usually palpated because it is the most central and accessible?

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

Question 29

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 nonwhite population groups.
D)There is a 50% chance that siblings of an affected child also will be affected.

Question 30

The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which of the following 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 in color.

Question 31

Asthma in infants is usually triggered by:

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

Question 32

What is the earliest recognizable clinical manifestation(s) of CF?

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

Question 33

In providing nourishment for a child with CF, which of the following factors 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 34

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

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

Question 35

Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

A)Ephedrine
B)Theophylline
C)Aminophylline
D)Short-acting $\beta$ ₂ agonists

Question 36

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because which of the following may develop?

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

Question 37

The nurse is caring for a child with adult respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following?

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

Question 38

Pancreatic enzymes are administered to the child with CF. Nursing considerations should include which of the following?

A)Do not administer pancreatic enzymes if child is receiving antibiotics.
B)Decrease dose of pancreatic enzymes if 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 39

Which of the following statements is the most descriptive of bronchial asthma?

A)There is heightened airway reactivity.
B)There is decreased resistance in the airway.
C)The single cause of asthma is an allergic hypersensitivity.
D)It is inherited.

Question 40

A child with CF receives aerosolized bronchodilator medication. This medication should be administered:

A)Before chest physiotherapy (CPT).
B)After CPT.
C)Before receiving 100% oxygen.
D)After receiving 100% oxygen.

Question 41

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select 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 42

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 43

Effective CPR on a 5-year-old child should include which of the following?

A)One breath to every five chest compressions
B)Two breaths to every 15 chest compressions
C)Reassessment of child after 50 cycles of compression and ventilation
D)Reassessment of child every 10 minutes CPR continues

Question 44

Which of the following drugs is considered to be the most useful in treating cardiac arrest?

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