disorders of the respiratory system

Question 1

A nurse is educating a group of students on asthma and associated risk. Propose an accurate statement.

The principal allergens associated with asthma are foods.

Trismus is a common finding for patients presenting with asthma.

Pathologic features of asthma include shedding of airway epithelium and mucus plug formation.

Viral infections contribute to the development of chronic asthma.

Answer 1

Pathologic features of asthma include shedding of airway epithelium and mucus plug formation.

Question 2

A nurse practitioner is evaluating a patient for allergies. Propose a finding that is consistent with a patient presenting with allergic disease.

A 10-year-old with a rash and cervical adenitis

A child presenting with optic disc papilledema and conjunctival inflammation

An 8-year-old with a congested cough, drooling, and dysphagia

Repeated rubbing of nose or allergic salute

Answer 2

Repeated rubbing of nose or allergic salute

Question 3

Determine an accurate statement when evaluating a patient with allergic disease.

Allergen immunotherapy should be considered in patients with mild allergic rhinitis.

Oral decongestants are not usually recommended in children.

For patients with moderate-to-severe persistent allergic rhinitis, antibiotics are recommended.

The most common allergy in the pediatric population is medication.

Answer 3

Oral decongestants are not usually recommended in children.

Question 4

When educating a group of students on respiratory syncytial virus (RSV), establish what the nurse practitioner identifies as accurate.

The most common causes of bacterial pharyngitis include Mycoplasma pneumoniae.

Respiratory syncytial virus is the most common viral cause of acute bronchiolitis.

Group A Strep is the most common cause of RSV in infants.

The usual course of RSV bronchiolitis is conjunctivitis, diarrhea, and cough.

Answer 4

Respiratory syncytial virus is the most common viral cause of acute bronchiolitis.

Question 5

A nurse is educating a parent on acute rhinosinusitis. Conclude an accurate statement when classifying allergic rhinitis.

Patients with persistent allergic rhinitis experience symptoms for less than 4 weeks.

Allergic rhinitis is classified by severity and longevity.

Patients with moderate-to-severe allergic rhinitis experience sleep disturbance and impaired work performance.

Patients with mild allergic rhinitis experience sleep disturbances due to symptoms.

Answer 5

Patients with moderate-to-severe allergic rhinitis experience sleep disturbance and impaired work performance.

Question 6

A mother is concerned regarding her child who presents with upper respiratory symptoms. Establish what suggests a respiratory syncytial virus (RSV) bronchiolitis infection.

Decreased anteroposterior diameter

Wheezing and cough

Left-sided eyelid lag and erythema

Right upper lobe infiltrate

Answer 6

Wheezing and cough

Question 7

A nurse practitioner is educating a group of students on the assessment and treatment of patients presenting with allergic disease. Establish an accurate statement.

Skin testing to identify allergen-specific IgE is the most sensitive.

Allergy skin testing is necessary for initial diagnosis.

Allergic rhinoconjunctivitis is more common in girls during early childhood.

Adolescents are at the highest risk for allergic disease.

Answer 7

Skin testing to identify allergen-specific IgE is the most sensitive.

Question 8

Predict the patient who is at an increased risk of developing bronchiolitis.

A 5-year-old who attends kindergarten

A 6-month-old breast-fed infant

A 3-year-old who was born at 40 weeks gestation

A 10-week-old infant with low birthweight

Answer 8

A 10-week-old infant with low birthweight

Question 9

A nurse practitioner is working to control the asthma symptoms in a 10-year-old male patient. Determine what accurately reflects the specific goals for control.

The patient uses an inhaler 1–2 times per day.

The patient is absent 3–5 days per month from school.

The patient has a diminished forced expiratory volume.

The patient’s forced expiratory volume is greater than 85%.

Answer 9

The patient’s forced expiratory volume is greater than 85%.

Question 10

nurse is educating a group of students on asthma and associated risk. Propose an accurate statement.

Trismus is a common finding for patients presenting with asthma.

Increasing prevalence of asthma is seen in poor children.

Atopic dermatitis is the strongest identifiable predisposing factor for the development of asthma.

Viral infections contribute to the development of chronic asthma.

Answer 10

Increasing prevalence of asthma is seen in poor children.

Question 11

When educating a group of students regarding the use of long-acting beta agonist, recommend what is important to stress.

It should never be taken when using inhaled corticosteroids.

It may be given every 30 minutes up to three times as a rescue medication.

It may be beneficial for exercise-induced asthma.

It is recommended for treatment in moderate persistent asthma.

Answer 11

It is recommended for treatment in moderate persistent asthma.

Question 12

A nurse practitioner student is evaluating a patient for bronchiolitis. Conclude what indicates a need for further education.

A detailed history was obtained from the mother of a 2-year-old.

The patient’s oxygen saturation was measured.

Diagnosis is based on clinical findings.

A chest radiograph was ordered for routine evaluation of a 6-month-old infant.

Answer 12

A chest radiograph was ordered for routine evaluation of a 6-month-old infant.

Question 13

A 4-year-old pediatric patient is being evaluated for asthma. Predict the symptom that is consistent with a diagnosis of asthma.

Infrequent congested cough

Frontal and maxillary tenderness

Cough, fever and abdominal pain

Persistent night-time cough

Answer 13

Persistent night-time cough

Question 14

A nurse is educating a parent on acute rhinosinusitis. Conclude an accurate statement when classifying allergic rhinitis.

Patients with intermittent allergic rhinitis experience symptoms for more than 4 weeks.

Allergic rhinitis is classified by severity and longevity.

Symptoms are present more than 4 days per week in patients with persistent allergic rhinitis.

Patients with persistent allergic rhinitis experience symptoms for less than 4 weeks.

Answer 14

Symptoms are present more than 4 days per week in patients with persistent allergic rhinitis.

Question 15

A nurse practitioner is evaluating a patient for chronic bronchitis. Predict a disorder that is associated with chronic bronchitis.

Cystic fibrosis

Influenza

Adenovirus

Pneumonia

Answer 15

Cystic fibrosis

Question 16

Determine an accurate statement when evaluating a patient with allergic disease.

Oral decongestants are not usually recommended in children.

The most common allergy in the pediatric population is medication.

For patients with moderate-to-severe persistent allergic rhinitis, antibiotics are recommended.

Patients should be referred to an allergist for diagnosis of allergic rhinitis.

Answer 16

Oral decongestants are not usually recommended in children.

Question 17

A nurse practitioner is educating a patient on asthma management. Propose a major contributor to asthma morbidity and mortality.

Overuse of anti-inflammatory medications

Health care disparities

Increased outdoor allergens

Weight loss and poor eating habits

Answer 17

Health care disparities

Question 18

Establish a characteristic of asthma that occurs in the respiratory system.

Pulmonary edema

Inflammation of airways

Bronchiectasis

Irreversible narrowing of airways

Answer 18

Inflammation of airways

Question 19

A nurse practitioner is assessing a pediatric patient for allergic disease. Predict the patient who has an identified risk factor for allergies.

A 15-year-old female who received multiple doses of antibiotics 1 year prior

A 5-year-old who has a family history of atopy

A 13-year-old female who works with animals

A 12-year-old who was born during the winter months

Answer 19

A 5-year-old who has a family history of atopy

Question 20

Establish what clinical presentation least warrants sweat chloride testing.

A newborn who passes his first meconium stool at birth

A 7-year-old with nasal polyps, mildly hyperexpanded lungs, and growth parameters at 25% for age

A 5-year-old with unexplained pancreatitis and growth parameter at 20% for age

A 10-year-old with unexplained bronchiectasis and rectal prolapse

Answer 20

A newborn who passes his first meconium stool at birth

Question 21

A nurse is educating a parent on viral pneumonia. Determine the statement that reflects a need for further education.

Chest radiographs are recommended.

He should be placed in respiratory isolation.

I will be able to manage his fever and difficulty breathing at home.

If he becomes worse, he may need to be hospitalized.

Answer 21

I will be able to manage his fever and difficulty breathing at home.

Question 22

A nurse practitioner is educating a group of students on the assessment and treatment of patients presenting with pneumonia. Determine what is accurate.

An elevated white blood cell count helps to distinguish between viral and bacterial pneumonia.

Bacterial pneumonia usually follows a urinary tract infection.

Treatment of pneumonia is specific to the suspected pathogen.

Wheezing or stridor is usually prominent in bacterial disease.

Answer 22

Treatment of pneumonia is specific to the suspected pathogen.

Question 23

Determine an accurate statement for when evaluating a patient for a croup.

Patients typically present with cervical adenopathy and drooling.

Adolescents are generally affected by croup.

Fever is usually absent in patients presenting with croup.

Many patients present with a high fever and a barking cough.

Answer 23

Fever is usually absent in patients presenting with croup.

Question 24

Predict the patient who is at an increased risk of developing sinusitis.

A 10-year-old with a history of RSV during infancy

A child younger than 2 years of age

A child who sat near a person who smells like smoke

A patient with inflamed sinonasal mucosa

Answer 24

A patient with inflamed sinonasal mucosa

Question 25

A nurse practitioner is completing an examination on a pediatric patient presenting with a cough and inspiratory stridor. Recommend what should be evaluated when obtaining patient history.

Onset of the patients’ symptoms

Patient discomfort with chest palpation

Chest radiograph that is positive for infiltrates

Presence of adventitious breath sounds with auscultation

Answer 25

Onset of the patients’ symptoms

Question 26

A nurse practitioner is educating a family on cystic fibrosis. Predict what accurately reflects the diagnosis and treatment of cystic fibrosis.

Maintains a pediatrician throughout adulthood to provide consistent care

Pancreatic enzyme supplementation instead of a high-calorie, and high-fat diet

Pancreatic enzyme supplementation immediately prior to each meal

Early use of protein rescue medication

Answer 26

Pancreatic enzyme supplementation immediately prior to each meal

Question 27

Establish what is accurate when diagnosing and treating a patient with influenza.

Upper respiratory tract symptoms are most common in children younger than age 5.

Laboratory confirmation is not necessary before initiation of antiviral therapy.

The best protection against the flu is prophylactic antibiotics.

Hospitalization rates are highest in children older than 2 years old.

Answer 27

Laboratory confirmation is not necessary before initiation of antiviral therapy.

Question 28

Conclude what statement is accurate when evaluating and treating a patient with sinusitis.

First-line antibiotic therapy should be amoxicillin or amoxicillin-clavulanate.

Streptococcus pneumoniaeis the most common cause of acute sinusitis.

Sinusitis is usually precipitated by an acute viral respiratory tract infection.

Antibiotics are not needed in patients with sinusitis.

Answer 28

First-line antibiotic therapy should be amoxicillin or amoxicillin-clavulanate.

Question 29

A 6-month-old infant is brought to the clinic for a 1-week history of nasal congestion and occasional cough. Determine what is accurate when assessing and treating this patient.

Antihistamines, decongestants, and cough suppressants are recommended.

Cough suppressants are recommended for comfort.

The patient should be treated with amoxicillin for 10 days.

Patients with viral infections should receive supportive care.

Answer 29

Patients with viral infections should receive supportive care.

Question 30

A nurse practitioner student is completing a respiratory examination on a 10-year-old male who presented to the clinic for a congested cough. Determine what is accurate when completing an assessment on this patient.

The chest should be inspected for vibration.

The chest wall can be palpated for evaluation of symmetry.

Auscultation is needed to determine the tracheal position.

The chest wall can be palpated to assess for wheezing.

Answer 30

The chest wall can be palpated for evaluation of symmetry.

Question 31

Ben, a 10-year-old, is being evaluated for influenza. Determine what is a routine part of his clinic management.

Antiviral drugs started within 72 hours of the onset of symptoms

Chest physiotherapy

Antibiotic therapy for 10 days

Treatment with antiviral medications for 5 days

Answer 31

Treatment with antiviral medications for 5 days

Question 32

Predict what is consistent with patients presenting with bacterial pneumonia.

Interstitial infiltrate

Peribronchial infiltrates

Parainfluenza virus

Cough

Answer 32

Cough

Question 33

A nurse practitioner is evaluating a patient for sinusitis. Determine what is consistent with a patient presenting with sinusitis.

An 8-year-old with high fever and respiratory distress

A 12-year-old with sudden onset of nasal discharge and facial pain

A 15-year-old with cough and decreased breath sounds

A 1-year-old with clear nasal discharge for 1 week

Answer 33

A 12-year-old with sudden onset of nasal discharge and facial pain

Question 34

Predict which of the following is consistent with a patient presenting with cystic fibrosis.

Increased exercise tolerance and weight gain

Persistent currant jelly-like stools

Severe dehydration and hypochloremic alkalosis

Telescoping of the bowel

Answer 34

Severe dehydration and hypochloremic alkalosis

Question 35

A nurse is educating a parent on viral pneumonia. Determine the statement that reflects a need for further education.

Most children with viral pneumonia recover uneventfully.

Chest radiographs are recommended.

At least I will not have to worry about a bacterial pneumonia now.

If he becomes worse, he may need to be hospitalized.

Answer 35

At least I will not have to worry about a bacterial pneumonia now.

Question 36

A nurse practitioner is educating a group of students on pediatric patient assessment. When assessing the upper respiratory tract, predict what indicates a need for further education.

Patient lung assessment

Assessment of the larynx

Assessment of the nasal cavity

Assessment of the pharynx

Answer 36

Patient lung assessment

Question 37

Establish what is accurate when diagnosing and treating a patient with influenza.

Diagnosis is confirmed by analyzing nasopharyngeal secretions for rapid detection testing.

The best protection against the flu is prophylactic antibiotics.

Upper respiratory tract symptoms are most common in children younger than age 5.

Secondary infections are uncommon in the pediatric population.

Answer 37

Diagnosis is confirmed by analyzing nasopharyngeal secretions for rapid detection testing.

Question 38

Treatment of viral croup is based on the symptoms. Conclude what statement indicates a need for further education.

Mild croup requires supportive therapy with oral hydration and minimal handling.

Mild croup requires ongoing nebulizer treatments and hospitalization.

The Westley croup score is used to measure the severity of symptoms.

Pharmacologic therapy is directed toward decreasing airway edema.

Answer 38

Mild croup requires ongoing nebulizer treatments and hospitalization.

Question 39

A nurse practitioner is evaluating a patient for sinusitis. Determine what is consistent with a patient presenting with sinusitis.

A 15-year-old with cough and decreased breath sounds

An 8-year-old with high fever and respiratory distress

A 10-year-old with nasal discharge and maxillary dental pain

A 1-year-old with clear nasal discharge for 1 week

Answer 39

A 10-year-old with nasal discharge and maxillary dental pain

Question 40

A nurse practitioner is completing an examination on a pediatric patient presenting with a cough and inspiratory stridor. Recommend what should be evaluated when obtaining patient history.

Examination of the chest that begins with inspection

Patient discomfort with chest palpation

Chest radiograph that is positive for infiltrates

Any factor that makes the symptoms better

Answer 40

Any factor that makes the symptoms better