Question 1

Following parental teaching, the nurse is evaluating the parents' understanding of environmental control for their child's asthma management. Which statement by the parents indicates appropriate understanding of the teaching?

Accepted Answer

Replacing the carpet with tile will decrease the amount of dust and allergens in the child's bedroom, which can trigger asthma symptoms.

Answer: D
 Keeping plants in the child's room can increase the amount of dust and allergens present. Dusting the plants will decrease the amount of dust and allergens that can be inhaled.

Therefore, the correct answer is A and D.

Question 2

Parents of a child admitted with respiratory distress are concerned because the child won't lie down and wants to sit in a chair leaning forward. Which response by the nurse is the most appropriate?

Accepted Answer

Sitting upright and leaning forward can help open the airway and facilitate breathing in a child with respiratory distress. It is important to reassure parents that this position is appropriate and can help the child feel more comfortable. It does not confirm the child has asthma, and forcing the child to lie down can potentially compromise their breathing.

Question 3

The toddler is admitted to the hospital during an acute asthma attack. The physician orders: methylprednisolone 80 mg infused IV push every 3 hours.
Medication on hand: methylprednisolone 125 mg/2 mL
Calculate how many ml of methylprednisolone the patient will receive.

Accepted Answer

1.28 mL

Question 4

The nurse is providing care to an infant in the emergency department. Upon assessment, the infant is noted to have to be experiencing tachypnea, wheezing, retractions, and nasal flaring. The infant is irritability and the parents state the infant has had poor fluid intake for two days. Pulse ox reading is currently at 85 percent on room air. The infant's blood gas is pending. Which diagnosis does the nurse anticipate for this infant?

Accepted Answer

The infant is presenting with classic signs and symptoms of bronchiolitis, including tachypnea, wheezing, retractions, nasal flaring, and irritability. The low pulse ox reading and poor fluid intake also support this diagnosis. Bronchitis may present with similar symptoms, but typically affects older children and adults. Pneumonia may also present similarly, but typically presents with a fever and productive cough. Active pulmonary tuberculosis is unlikely in an infant and typically presents with other symptoms such as night sweats, weight loss, and hemoptysis.

Question 5

A nurse delegates the task of neonatal vital-sign assessment to a nurse technician. Which instruction will the nurse give to the technician prior to assign care?

Accepted Answer

A breathing pause that lasts for 20 seconds or longer is considered apnea in newborns and requires immediate intervention. This is the most critical vital sign to report to the nurse. Using the abdominal muscles to breathe is a normal finding in newborns and does not require immediate intervention. Counting respirations for 15 seconds and multiplying by 4 is a standard method for determining respiratory rate in adults, but in neonates, it's important to count the full minute due to the variability in their breathing patterns. Reporting apnea for 10 seconds may not be considered significant enough to warrant immediate intervention.

Question 6

A child is showing signs of acute respiratory distress. Which position will the nurse place this child?

Accepted Answer

Placing the child in an upright or semi-Fowler’s position can help alleviate the symptoms of acute respiratory distress by improving airflow and reducing pressure on the lungs. This allows the child to breathe more easily and can prevent their condition from worsening. Side-lying or flat positions may further compromise breathing and should be avoided in this situation.

Question 7

The nurse educator is teaching a group of nursing students how to perform a respiratory assessment for a newborn in the newborn intensive care unit (NICU) diagnosed with respiratory distress syndrome (RDS). Which normal characteristics of the newborn's respiratory system increase the risk for obstruction? Select all that apply.

Accepted Answer

The shorter and narrower airway, higher trachea, and bronchial branching at different angles increase the risk of obstruction in newborns.

Question 8

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

Accepted Answer

Activity Intolerance is most appropriate because infants with acute bronchiolitis often experience difficulty in maintaining normal activity levels due to increased work of breathing and oxygen demand.

Question 9

A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse which symptoms made the practitioner suspect cystic fibrosis. Which response by the nurse is the most appropriate?

Accepted Answer

Meconium ileus, meaning intestinal obstruction in a newborn due to thick mucus in the intestines, is a common presentation of cystic fibrosis. Other symptoms may include failure to thrive, chronic cough, and recurrent respiratory infections. Steatorrheic stools, constipation, and rectal prolapse may be seen in cystic fibrosis but are not as commonly associated with the disease as meconium ileus.

Question 10

A child with asthma will be receiving an oral dose of prednisone. The order reads prednisone 2 mg/kg per day. The child weighs 50 lbs. The child will receive ________ milligrams daily. (Round the answer.)
Round the answer to the nearest whole number.

Accepted Answer

The answer of A child with asthma will be receiving...

Question 11

The practitioner changes the medications for the child with asthma to salmeterol (Serevent). The mother asks the nurse what this drug will do. The nurse explains that salmeterol (Serevent) is used to treat asthma because the drug produces which characteristic?

Accepted Answer

Salmeterol (Serevent) is a long-acting beta-agonist which dilates the bronchioles and improves breathing in patients with asthma by relaxing the smooth muscles of the airways.

Question 12

A child is admitted to the hospital with pneumonia. The child's oximetry reading is 88 percent upon admission to the pediatric floor. Which is the priority nursing intervention for this child?

Accepted Answer

The priority nursing intervention for a child with a low oximetry reading due to pneumonia is to begin oxygen therapy immediately to increase oxygen saturation and prevent further respiratory distress. Obtaining a blood sample, medicating for pain, and administering IV fluids may also be important, but they are not the priority in this situation.

Question 13

A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). Which nursing intervention is the priority for this child?

Accepted Answer

Laryngotracheobronchitis (LTB) is a viral infection that causes inflammation of the upper airway, resulting in difficulty breathing. Administering nebulized epinephrine and oral or IM dexamethasone is the priority intervention as it helps to reduce the inflammation and swelling in the airway, making it easier for the child to breathe. Antibiotics are not effective for viral infections like LTB, and intubation is only necessary in severe cases where the child is unable to breathe adequately. Throat culture and sputum specimens may be obtained as needed, but they are not the priority intervention in this case.

Question 14

A school nurse is planning care for a school-age child recently diagnosed with asthma. Which items will the school nurse include in the plan of care at the school? Select all that apply.

Accepted Answer

The answer of A school nurse is planning care for...

Question 15

The nurse is assessing a school-age client who experienced blunt force trauma to the chest when an airbag deployed following a motor vehicle crash. Which areas of assessment are essential for this client? Select all that apply.

Accepted Answer

The answer of The nurse is assessing a school-age client...

Question 16

The nurse is teaching a group of mothers of infants about the benefits of immunization. Which immunization will the nurse teach to the mothers that can assist in preventing the life-threatening disease epiglottitis?

Accepted Answer

Haemophilus influenzae type B (HIB) vaccine is recommended for infants and young children to protect against epiglottitis, a life-threatening infection of the epiglottis. The vaccine is effective in preventing HIB infection and its complications, including meningitis and pneumonia.

Question 17

The nurse is providing care to an infant who is diagnosed with bronchiolitis. Which breath sounds indicate the infant is experiencing respiratory distress? Select all that apply.

Accepted Answer

The answer of The nurse is providing care to an...

Question 18

A nurse is assessing a neonate. Which assessment finding indicates that the neonate's respiratory status is worsening?

Accepted Answer

Grunting respirations with nasal flaring are signs of respiratory distress and indicate the neonate's respiratory status is worsening. Acrocyanosis, arterial CO₂ of 40, and periorbital edema are not specifically indicative of respiratory distress.

Question 19

A child is prescribed rifampicin for treatment of tuberculosis. For which length of time will the nurse tell the parents that this child must remain on the medication?

Accepted Answer

Rifampicin is a first-line medication for the treatment of tuberculosis, and the standard treatment regimen for uncomplicated tuberculosis includes a 6-month course of treatment with this medication. Therefore, the nurse will instruct the parents that their child should remain on rifampicin for 6 months.

Question 20

The nurse is teaching the parents of a newly diagnosed cystic fibrosis patient how to administer the pancreatic enzymes. How often will the nurse teach the parents to administer the enzymes?

Accepted Answer

Pancreatic enzymes should be administered with meals and snacks to aid in digestion and absorption of nutrients.

Quiz 20: Alterations in Respiratory Function