Pulmonary Flashcards
1
Q
An infant involved in a near-drowning incident yesterday is in respiratory distress. There are bilateral infiltrates on the chest radiograph and the child's PaO2/FiO2 ratio is 180. These findings suggest A. viral pneumonia B. bilateral pulmonary hypoplasia C. acute lung injury D. acute respiratory distress syndrome
A
D. acute respiratory distress syndrome
2
Q
In a child with acute respiratory distress syndrome (ARDS), which of the following management strategies will fail to improve ventilation?
A. Prevent alveolar collapse
B. Permit hypercapnia
C. Maximize tidal volume
D. Normalize functional residual capacity
A
C. Maximize tidal volume
3
Q
While talking to the nurse, an adolescent admitted for pelvic fractures suddenly becomes tachypneic, tachycardic, and hypoxic. These findings suggest A. pulmonary embolism B. pleural effusion C. tension pneumothorax D. fat embolism syndrome
A
A. pulmonary embolism
4
Q
A child with Duchenne muscular dystrophy is in respiratory failure. Which of the following drugs must be avoided during rapid sequemce induction intubation? A. Midazolam B. Succinylcholine C. Rocuronium D. Ketamine
A
B. Succinylcholine
5
Q
Which of the following clinical findings is the best inficator of acute respiratory failure in a 1-year-old child with bronchiolitis? A. Hypothermia B. Copious secretions C. Hypotension D. Persistent lethargy
A
D. Persistent lethargy
6
Q
After receiving a dose of amoxicillin, a child develops tachypneic, stridor, and hives. The priority medication is A. methylprednisolone B. epinepherine C. diphenhydramine D. albuterol
A
B. epinepherine
7
Q
A 16-year-old child is admitted after huffing a volatile hydrocarbon. Initial assessment reveals tachypnea, dyspnea, cyanosis, bilaterally diminished lung sounds, and frothy secretions. The nurse anticipates the priority intervention for this patient is A. intravenous furosemide injection B. endotracheal intubation C. bronchodilator nebulization D. steroid administration
A
B. endotracheal intubation
8
Q
A 12-year-old child has been receiving noninvasive positive pressure ventilation following a submersion injury. There are moderate crackles in all lung fields and mental status is waning. An arterial blood gas sample shows the following values: pH 7.30; PaCO2 65 mmHg; PaO2 55 mmHg; HCO3 26 mEq/L. The definitive intervention for this child is A. albuterol administration B. intravenous sodium bicarbonate C. bag-mask ventilation D. endotracheal intubation
A
D. endotracheal intubation
9
Q
A 4-week-old infant is admitted following an apparent life-threatening event. The child exhibits intermittent episodes of a gasping cough associated with cyanosis and apnea. These findings suggest A. pertussis B. bronchiolitis C. pneumonia D. croup
A
A. pertussis
10
Q
Cervical soft tissues radiographs are obtained in a child experiencing respiratory distress. The patient's subglottic lumen is narrowed and resembles a church steeple. This finding is associated with A. peritonsillar abscess B. acute epiglottitis C. laryngotracheal bronchitis D. bacterial tracheitis
A
C. laryngotracheal bronchitis
11
Q
A child with pneumonia admitted for tachypnea, cough, and fever is on an oxygen reservoir mask at 12L/min. Arterial blood gas results are pH 7.28, PaCO2 66 mmHg; Pa)2 85 mmHg; HCO3 24 mEq/L. This child is in A. uncompensated respiratory acidosis B. compensated respiratory acidosis C. uncompensated metabolic alkalosis D. compensated metabolic alkalosis
A
A. uncompensated respiratory acidosis
12
Q
A child with cerebral palsy and chronic lung disease was admitted for bronchitis. The child is on BiPAP mask ventilation. The arterial blood gas results are: pH 7.36; PaCO2 65 mmHG; PaO2 85 mmHg; HCO3 28 mEq/L. This child is in A. compensated metabolic alkalosis B. uncompensated metabolic alkalosis C. compensated respiratory acidosis D. uncompensated respiratory acidosis
A
C. compensated respiratory acidosis
13
Q
A 5 month-old infant with a history of preterm birth is admitted for fever, cough, and tachypnea associated with intercostal and substernal muscle retractions. Which organism is most likely responsible for this child's condition? A. Adenovirus B. Respiratory syncytial virus C. Bacterial pneumonia D. Viral parainfluenze
A
B. Respiratory syncytial virus
14
Q
A child involved in a high speed motor vehicle collision is intubated at the scene. Upon PICU arrival the nurse identifies diffuse subcutaneous emphysema. Which of the following is the most likely etiology? A. Tracheobronchial injury B. Hollow viscus perforation C. Vomiting with aspiration D. Tension pneumothorax
A
A. Tracheobronchial injury
15
Q
A 3-year-old child with a 1-month history of cough and wheezing is now admitted for fever and increased work of breathing. Initial assessment reveals unilateral wheezes on the right. What is the likely cause of these symptoms? A. Bacterial pneumonia B. Pulmonary hypoplasia C. Status asthmaticus D. Foreign body aspiration
A
D. Foreign body aspiration
