Respiratory Dysfunction (PH)

Question 1

Which statement 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. Repeated exposure to organisms causes increased immunity.

Question 2

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal
drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition?

a. Allergic rhinitis
b. Bronchitis
c. Asthma
d. Sinusitis

Answer 2

d. Sinusitis

Question 3

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract
infection. Instructions for nose drops should include:

a. Avoiding use for more than 3 days.
b. Keeping drops to use again for nasal congestion.
c. Administering drops until nasal congestion subsides.
d. Administering drops after feedings and at bedtime.

Answer 3

a. Avoiding use for more than 3 days.

Question 4

When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to:

a. Give tepid water baths to reduce fever.
b. Encourage food intake to maintain caloric needs.
c. Have child wear heavy clothing to prevent chilling.
d. Give small amounts of favorite fluids frequently to prevent dehydration.

Answer 4

d. Give small amounts of favorite fluids frequently to prevent dehydration.

Question 5

The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the infant:

a. Becomes fussy.
b. Has a cough.
c. Has a fever over 99 F.
d. Shows signs of an earache.

Answer 5

d. Shows signs of an earache.

Question 6

It is generally recommended 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. After taking antibiotics for 24 hours.

Question 7

A child is diagnosed with influenza, probably type A disease. Management includes:

a. Clear liquid diet for hydration.
b. Aspirin to control fever.
c. Amantadine hydrochloride to reduce symptoms.
d. Antibiotics to prevent bacterial infection.

Answer 7

c. Amantadine hydrochloride to reduce symptoms.

Question 8

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:

a. Fever as high as 40 C (104 F).
b. Severe pain in the ear.
c. Nausea and vomiting.
d. A feeling of fullness in the ear.

Answer 8

d. A feeling of fullness in the ear.

Question 9

Which statement is characteristic of 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 is treated with a broad range of antibiotics.

Answer 9

d. It is treated with a broad range of antibiotics.

Question 10

An infants 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 supine position.

Answer 10

a. Avoid tobacco smoke.

Question 11

Which type of croup is always considered a medical emergency?

a. Laryngitis
b. Epiglottitis
c. Spasmodic croup
d. Laryngotracheobronchitis (LTB

Answer 11

b. Epiglottitis

Question 12

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurses rationale for this action is primarily that:

a. Mothers of hospitalized toddlers often experience guilt.
b. The mothers presence will reduce anxiety and ease the childs respiratory efforts.
c. Separation from the mother is a major developmental threat at this age.
d. The mother can provide constant observations of the childs respiratory efforts.

Answer 12

b. The mothers presence will reduce anxiety and ease the childs respiratory efforts.

Question 13

A school-age child has 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. This is most suggestive of:

a. Bronchitis.
b. Bronchiolitis.
c. Viral-induced asthma.
d. Acute spasmodic laryngitis.

Answer 13

a. Bronchitis.

Question 14

Skin testing for tuberculosis (the Mantoux test) is 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 14

d. Periodically for children who reside in high-prevalence regions.

Question 15

The mother of a toddler yells to the nurse, Help! He is choking to death on his food. The nurse determines
that lifesaving measures are necessary based on:

a. Gagging.
b. Coughing.
c. Pulse over 100 beats/min.
d. Inability to speak.

Answer 15

d. Inability to speak.

Question 16

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:

a. Force fluids.
b. Monitor pulse oximetry.
c. Institute seizure precautions.
d. Encourage a high-protein diet.

Answer 16

b. Monitor pulse oximetry.

Question 17

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this childs care?

a. Monitor pulse oximetry.
b. Monitor arterial blood gases.
c. Administer oxygen if respiratory distress develops.
d. Administer oxygen if childs lips become bright, cherry red.

Answer 17

b. Monitor arterial blood gases.

Question 18

Asthma in infants is usually triggered by:

a. Medications.
b. A viral infection.
c. Exposure to cold air.
d. Allergy to dust or dust mites.

Answer 18

b. A viral infection.

Question 19

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests:

a. Asthma.
b. Pneumonia.
c. Bronchiolitis.
d. Foreign body in the trachea.

Answer 19

a. Asthma

Question 20

It is now recommended that children with asthma who are taking long-term inhaled steroids should be
assessed frequently because they may develop:

a. Cough.
b. Osteoporosis.
c. Slowed growth.
d. Cushings syndrome

Answer 20

c. Slowed growth.

Question 21

b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is
their action?

a. Liquefy secretions
b. Dilate the bronchioles
c. Reduce inflammation of the lungs
d. Reduce infection

Answer 21

b. Dilate the bronchioles

Question 22

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can
participate. The nurse should recommend:

a. Soccer.
b. Running.
c. Swimming.
d. Basketball.

Answer 22

c. Swimming.

Question 23

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. It is a genetic defect found primarily in non-Caucasian population groups.
d. There is a 50% chance that siblings of an affected child also will be affected.

Answer 23

a. If it is present in a child, both parents are carriers of this defective gene.

Question 24

The earliest recognizable clinical manifestation of cystic fibrosis (CF) is:

a. Meconium ileus.
b. History of poor intestinal absorption.
c. Foul-smelling, frothy, greasy stools.
d. Recurrent pneumonia and lung infections.

Answer 24

a. Meconium ileus.

Question 25

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

a. Bronchoscopy
b. Serum calcium
c. Urine creatinine
d. Sweat chloride test

Answer 25

d. Sweat chloride test

Question 26

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug:

a. May cause mucus to thicken.
b. May cause voice alterations.
c. Is given subcutaneously.
d. Is not indicated for children younger than 12 years.

Answer 26

b. May cause voice alterations.

Question 27

Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should
include:

a. Do not administer pancreatic enzymes if the child is receiving antibiotics.
b. Decrease 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 27

d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the
beginning of a meal.

Question 28

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 28

a. Diet should be high in carbohydrates and protein.

Question 29

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 29

b. Carotid

Question 30

Abdominal thrusts (the Heimlich maneuver) are recommended for airway obstruction in children older
than:

a. 1 year.
b. 4 years.
c. 8 years.
d. 12 years.

Answer 30

a. 1 year.

Question 31

An appropriate nursing intervention when caring for a child with pneumonia is to:

a. Encourage rest.
b. Encourage the child to lie on the unaffected side.
c. Administer analgesics.
d. Place the child in the Trendelenburg position.

Answer 31

a. Encourage rest.

Question 32

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of
spasmodic croup?

a. Wheezing is heard audibly.
b. It has a harsh, barky cough.
c. It is bacterial in nature.
d. The child has a high fever.

Answer 32

b. It has a harsh, barky cough.

Question 33

Which intervention for treating croup at home should be taught to parents?

a. Have a decongestant available to give the child when an attack occurs.
b. Have the child sleep in a dry room.
c. Take the child outside.
d. Give the child an antibiotic at bedtime.

Answer 33

c. Take the child outside.

Question 34

Which information should the nurse teach workers at a day care center about respiratory syncytial virus
(RSV)?

a. RSV is transmitted through particles in the air.
b. RSV can live on skin or paper for up to a few seconds after contact.
c. RSV can survive on nonporous surfaces for about 60 minutes.
d. Frequent hand washing can decrease the spread of the virus.

Answer 34

d. Frequent hand washing can decrease the spread of the virus.

Question 35

Which vitamin supplements are necessary for children with cystic fibrosis?

a. Vitamin C and calcium
b. Vitamins B6 and B12
c. Magnesium
d. Vitamins A, D, E, and K

Answer 35

d. Vitamins A, D, E, and K

Question 36

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system?

a. They have a widened, shorter airway.
b. There is a defect in their sucking ability.
c. The gag reflex increases mucus production.
d. Mucus and edema obstruct small airways.

Answer 36

d. Mucus and edema obstruct small airways.

Question 37

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?

a. Dyspnea
b. Tachypnea
c. Hypopnea
d. Orthopnea

Answer 37

a. Dyspnea

Question 38

Parents have understood teaching about prevention of childhood otitis media if they make which
statement?

a. We will only prop the bottle during the daytime feedings.
b. Breastfeeding will be discontinued after 4 months of age.
c. We will place the child flat right after feedings.
d. We will be sure to keep immunizations up to date.

Answer 38

d. We will be sure to keep immunizations up to date.

Question 39

An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is
prescribed. Which statement made by the parent indicates a correct understanding of the instructions?

a. I should administer all the prescribed medication.
b. I should continue medication until the symptoms subside.
c. I will immediately stop giving medication if I notice a change in hearing.
d. I will stop giving medication if fever is still present in 24 hours.

Answer 39

a. I should administer all the prescribed medication.

Question 40

The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue
depressor might precipitate which symptom or condition?

a. Inspiratory stridor
b. Complete obstruction
c. Sore throat
d. Respiratory tract infection

Answer 40

b. Complete obstruction

Question 41

Which consideration is the most important in managing tuberculosis (TB) in children?

a. Skin testing annually
b. Pharmacotherapy
c. Adequate nutrition
d. Adequate hydration

Answer 41

b. Pharmacotherapy

Question 42

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial
asthma?

a. There is heightened airway reactivity.
b. There is decreased resistance in the airway.
c. The single cause of asthma is an allergic hypersensitivity.
d. It is inherited.

Answer 42

a. There is heightened airway reactivity.

Question 43

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this
medication be administered?

a. Before chest physiotherapy (CPT)
b. After CPT
c. Before receiving 100% oxygen
d. After receiving 100% oxygen

Answer 43

a. Before chest physiotherapy (CPT)

Question 44

A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is human
immunodeficiency virus (HIV) positive. Which induration size indicates a positive result for this child 48 to 72
hours after the test?

a. 5 mm
b. 10 mm
c. 15 mm
d. 20 mm

Answer 44

a. 5 mm

Question 45

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes
which of the following? (Select all that apply).

a. Cluster care to conserve energy
b. Round-the-clock administration of antitussive agents
c. Strict intake and output to avoid congestive heart failure
d. Administration of antibiotics
e. Placement in a mist tent

Answer 45

a. Cluster care to conserve energy

d. Administration of antibiotics

Question 46

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which
interventions should be included in the childs care (Select all that apply)?

a. Administer antibiotics.
b. Administer cough syrup.
c. Encourage infant to drink 8 ounces of formula every 4 hours.
d. Institute cluster care to encourage adequate rest.
e. Place on noninvasive oxygen monitoring.

Answer 46

c. Encourage infant to drink 8 ounces of formula every 4 hours.
d. Institute cluster care to encourage adequate rest.
e. Place on noninvasive oxygen monitoring.

Question 47

Which information should the nurse teach families about reducing exposure to pollens and dust(Select all
that apply)?

a. Replace wall-to-wall carpeting with wood and tile floors.
b. Use an air conditioner.
c. Put dust-proof covers on pillows and mattresses.
d. Keep humidity in the house above 60%.
e. Keep pets outside.

Answer 47

a. Replace wall-to-wall carpeting with wood and tile floors.
b. Use an air conditioner.
c. Put dust-proof covers on pillows and mattresses.