Deck 46: Respiratory Dysfunction

Question 1

A school-age child 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.What is this description most suggestive of?

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

Answer 1

Bronchitis

Question 2

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

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

Answer 2

Slowed growth

Question 3

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 the supine position.

Answer 3

Avoid tobacco smoke.

Question 4

Asthma in infants is usually triggered by which of the following?

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

Question 5

Which statement best describes 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 can be treated with antibiotics.

Question 6

Which type of croup is always considered a medical emergency?

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

Question 7

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant exhibits which one of the following symptoms?

A) Becomes fussy
B) Has a cough
C) Has a fever for more than 10 days
D) Shows signs of an earache

Question 8

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

A) They are safer.
B) They are less expensive.
C) Steam dries out respiratory secretions.
D) A more comfortable environment is produced.

Question 9

When is skin testing for tuberculosis (the Mantoux test)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 10

When do physicians generally recommend 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 11

The nurse is caring for a child with acute respiratory distress syndrome (ARDS)associated with sepsis.Which of the following nursing actions should be included in the child's care?

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

Question 12

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the child's bedside as much as possible.What is the nurse's primary reason for this suggestion?

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

Question 13

Chronic otitis media with effusion (OME)is different from acute otitis media (AOM)because OME is usually characterized by which one of the following?

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

Question 14

Which intervention should be used when providing care to a child diagnosed with Avian influenza?

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

Question 15

The mother of a toddler yells to the nurse,"Help! He is choking to death on his food." What finding causes the nurse to determine that lifesaving measures are necessary?

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

Question 16

A child has a chronic,non-productive cough and diffuse wheezing during the expiratory phase of respiration.What do these symptoms suggest?

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

Question 17

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

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

Question 18

What is the appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?

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

Question 19

What sentence below 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 20

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection.Which one of the following instructions for nose drops should be included when teaching the parent?

A) Avoid using drops 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 21

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 22

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

Question 23

The Heimlich manoeuvre is recommended for airway obstruction in children older than which age?

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

Question 24

Which drug is considered to be the most useful for treating cardiac arrest?

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

Question 25

What should be included in nursing care for a child with staphylococcal pneumonia?

A) Nursing care should be supportive and directed at relieving symptoms.
B) Nursing care should include round-the-clock administration of antitussive agents.
C) Nursing care should include strict intake and output to avoid congestive heart failure.
D) Nursing care should include administration of narcotics.

Question 26

What is the most appropriate nursing intervention when caring for a child with pneumonia?

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 27

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase).Which of the following statements is true about this drug?

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

Question 28

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours.What action should the nurse include in the child's post-operative care plan?

A) Notify the surgeon if the child swallows frequently.
B) Apply a heat collar to the child for pain relief.
C) Place the child in prone supine position until fully awake.
D) Encourage the child to cough frequently.

Question 29

b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack.How do these medications act on asthma?

A) They liquefy secretions.
B) They dilate the bronchioles.
C) They reduce inflammation in the lungs.
D) They reduce infection.

Question 30

Cystic fibrosis (CF)is suspected in a toddler.Which test is essential to confirm this diagnosis?

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

Question 31

What should a nurse know when administering pancreatic enzymes to a child with cystic fibrosis?

A) Do not administer pancreatic enzymes if the child is receiving antibiotics.
B) Decrease the 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 32

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

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

Question 33

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

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

Question 34

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

A) Place in a mist tent.
B) Administer antibiotics.
C) Administer cough syrup.
D) Place on non-invasive oxygen monitoring.

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