chapter 45-respiratory conditions

Question 1

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.

Answer 1

B

Question 2

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.

Answer 2

A

Question 3

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Which instruction 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.

Answer 3

A

Question 4

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.

Answer 4

D

Question 5

When teaching a parent group about respiratory complications, which symptom should be reported to the health care provider?
a. Becomes fussy
b. Has a cough
c. Has a fever for more than 3 days
d. Shows signs of an earache

Answer 5

D

Question 6

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

Answer 6

C

Question 7

Which characteristic regarding chronic otitis media with effusion (OME) differentiates if from acute otitis media (AOM)?
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

Answer 7

D

Question 8

Which 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.

Answer 8

D

Question 9

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 9

A

Question 10

Which type of croup is always considered a medical emergency?
a. Laryngitis
b. Epiglottitis
c. Spasmodic croup
d. Laryngotracheobronchitis (LTB)

Answer 10

B

Question 11

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.

Answer 11

B

Question 12

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 12

A

Question 13

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

Answer 13

D

Question 14

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 life-saving measures are necessary?
a. Gagging
b. Coughing
c. Pulse over 100 beats/min
d. Inability to speak

Answer 14

D

Question 15

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Which nursing action 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.

Answer 15

B

Question 16

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

Answer 16

B

Question 17

Which is a common trigger for the development of asthma in infants?
a. Medications
b. A viral infection
c. Exposure to cold air
d. Allergy to dust or dust mites

Answer 17

B

Question 18

A child has a chronic, nonproductive 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

Answer 18

A

Question 19

Which should be frequently assessed in children with asthma who are taking long-term inhaled steroids?
a. Cough
b. Osteoporosis
c. Slowed growth
d. Cushing’s syndrome

Answer 19

C

Question 20

â-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.

Answer 20

B

Question 21

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

Answer 21

C

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. Seventy percent of individuals with CF in Canada are children.
d. There is a 50% chance that siblings of an affected child will also be affected.

Answer 22

A

Question 23

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

Answer 23

A

Question 24

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

Answer 24

D

Question 25

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). Which 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.

Answer 25

B

Question 26

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.

Answer 26

D

Question 27

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.

Answer 27

A

Question 28

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

Answer 28

B

Question 29

Subdiaphragmatic abdominal thrusts are recommended for airway obstruction in children older than which age?
a. 1 year
b. 4 years
c. 8 years
d. 12 years

Answer 29

A

Question 30

What is the priority nursing intervention when caring for a child with pneumonia?
a. Encourage rest.
b. Encourage the child to lie on the affected side.
c. Administer an opioid.
d. Place the child in the Trendelenburg position.

Answer 30

B

Question 31

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 heart failure.
d. Nursing care should include administration of opioids.

Answer 31

A

Question 32

The nurse is caring for a 10-month-old infant with mild acute respiratory distress syndrome (ARDS). Which initial 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 noninvasive oxygen monitoring.

Answer 32

D

Question 33

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 postoperative 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.

Answer 33

A