Deck 25: Alterations in Respiratory Function

Question 1

A two-year-old male child arrived in the emergency department with complaints of sore throat, difficulty swallowing, and suspected diagnosis of acute epiglottitis. Which of the following interventions should not be included in the child's immediate care and assessment?

A)Throat culture
B)Medical history
C)Vital signs
D)Assessment of breath sounds

Answer 1

Throat culture

Question 2

A two-month-old infant is a direct admission to the pediatric unit with a diagnosis of ALTE (apparent life-threatening event). The physician is to see the infant to write medical orders. The nurse completes the nursing history and performs an assessment and finds no abnormal findings. While waiting on the physician, which activity can the nurse perform independently?

A)Place the child on an apnea monitor.
B)Place the child on nasal cannula oxygen.
C)Draw blood for arterial blood gases.
D)Place the child on contact isolation.

Answer 2

Place the child on an apnea monitor.

Question 3

A child is being discharged from the hospital following treatment of asthma. Discharge medications include cromolyn sodium (a mast cell stabilizer). Nursing instructions to the parents about this medication would include explaining: Standard Text: Select all that apply.

A)The medication works to prevent exacerbations.
B)The medication should be administered at the first symptom of an asthmatic attack.
C)The medication should be taken on a daily basis.
D)Avoid taking the medication if the child has symptoms of a cold.
E)The medication desensitizes the child against specific allergens.

Answer 3

The medication works to prevent exacerbations.
The medication should be taken on a daily basis.

Question 4

A child is admitted to the hospital with pneumonia. The child's oximetry reading is 88% upon admission to the pediatric floor. The priority nursing activity for this child would be to:

A)Begin administration of intravenous fluids.
B)Obtain a blood sample to send to the lab for electrolyte analysis.
C)Begin oxygen per nasal cannula at 1 liter.
D)Medicate for pain.

Question 5

Two hours after admission for asthma exacerbation, the 10-year-old boy is lethargic with mottled skin color. He has increased the use of accessory muscles and demonstrates nasal flaring. He is unable to speak and his respiratory rate has increased. The nurse would suspect:

A)Improvement in his condition is imminent.
B)Respiratory failure is imminent.
C)The medical diagnosis is incorrect and the child should be diagnosed with pneumonia.
D)The child may be receiving too much oxygen, which is a respiratory depressant.

Question 6

The nurse is teaching a group of mothers of infants about the benefits of immunization. The nurse will explain that the life-threatening disease epiglottitis can be prevented by immunization against:

A)Hepatitis B.
B)Polio.
C)Measles, mumps, and rubella (MMR).
D)Haemophilus influenzae type B (HIB).

Question 7

A premature infant develops acute respiratory distress syndrome (ARDS). How will the nurse position the baby? Standard Text: Select all that apply.

A)Upright
B)Semi-Fowler's position
C)Prone position
D)With his head hyperextended
E)With his head in a sniffing position

Question 8

The family rushes a four-month-old infant to the hospital after finding the infant not breathing. The child is diagnosed as a victim of sudden infant death syndrome. Supportive care for this family would include:

A)Sheltering parents from the grief by not giving them any personal items of the infant, such as footprints.
B)Allowing parents to hold, touch, and rock the dead infant.
C)Advising parents that an autopsy is not necessary.
D)Interviewing parents to determine the cause of the SIDS incident.

Question 9

A mother of a three-year-old tells the nurse that her child often puts small toys in his mouth and she is concerned about choking. She asks the nurse what she should do if the child chokes. In addition to recommending the mother take a CPR course, the best response by the nurse would be to:

A)Show the mother how to do cardiac compressions and rescue breathing.
B)Recommend the mother perform back blows and chest thrusts.
C)Teach the mother how to perform abdominal thrusts.
D)Tell the mother to do nothing until the child loses consciousness.

Question 10

After a routine vaginal delivery, the infant transitions with the mother in the recovery room without difficulty. Prior to being discharged from the recovery room, it is noted that the infant's respiratory rate is 102 and the lungs are clear to auscultation. Based on these findings, an appropriate transfer for this infant would be to:

A)The newborn nursery for the first bath.
B)The NICU and placed under an over-bed warmer for observation.
C)To the mother's room to promote bonding with the parents.
D)The newborn nursery for its first feeding.

Question 11

An infant was born at 34 weeks' gestation and is being treated in the NICU for apnea of prematurity. The infant is in an isolette with an apnea monitor and intravenous fluids. The apnea monitor sounds, and the nurse checks the infant to find the infant is not breathing. The initial intervention by the nurse would be to:

A)Administer oxygen.
B)Perform back blows and chest thrusts.
C)Call a code.
D)Stroke the infant's back.

Question 12

A child is on rifampin (Rimactane) for treatment of tuberculosis. The parents call the clinic and report that the child's urine is orange. The nurse should advise the parents to:

A)Encourage the child to drink cranberry juice.
B)Expect orange-colored urine while the child is on rifampin.
C)Bring the child to the clinic for a urinalysis.
D)Bring the child to the clinic for a radiograph of the kidneys.

Question 13

A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). The nurse should be prepared to perform which intervention?

A)Administer antibiotics and assist with possible intubation.
B)Obtain a sputum specimen.
C)Swab the throat for a throat culture.
D)Administer nebulized epinephrine and oral or IM dexamethasone.

Question 14

The nurse is evaluating the parent's understanding of teaching related to environmental control for their child's asthma management. Which statement by the parents indicates that they understand the teaching?

A)"We're glad the dog can continue to sleep in our child's room."
B)"We'll keep the plants in our child's room dusted."
C)"We'll be sure to use the fireplace often to keep the house warm in the winter."
D)"We will replace the carpet in our child's bedroom with tile."

Question 15

A newborn who is 24 hours old is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse what symptoms made the physician suspect cystic fibrosis. The nurse would reply that the clinical manifestation of cystic fibrosis that is seen first is:

A)Rectal prolapse.
B)Constipation.
C)Steatorrheic stools.
D)Meconium ileus.

Question 16

The nurse is teaching the parents of a patient who is newly diagnosed with cystic fibrosis how to administer the pancreatic enzymes. The nurse will advise the parents to administer the enzymes:

A)qid (four times daily).
B)bid (twice daily).
C)With meals and snacks.
D)Every six hours around the clock.

Question 17

The nurse stops at the scene of an accident and finds a child conscious but with a sucking wound of the chest. The immediate action by the nurse would be to:

A)Place the child in trendelenburg.
B)Begin rescue breathing.
C)Begin cardiac resuscitation.
D)Cover the wound with an air occlusive dressing.

Question 18

Which nursing diagnosis would be most appropriate for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV)?

A)Activity intolerance
B)Tissue perfusion, ineffective (peripheral)
C)Pain, acute
D)Decreased cardiac output

Question 19

A toddler has had recurrent respiratory infections. The mother of the child expresses concern that her infant seems to be at increased risk for complications from respiratory infections in comparison with her older children. The best response from the nurse would be:

A)"You are incorrect in your assessment."
B)"The younger child's airways are smaller and more easily occluded."
C)"Air passages are more likely to become blocked with mucus because younger children make more mucus than older children."
D)"Toddlers do not breathe as deeply as do older children."