Ricci 40

Question 1

1. 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 1

ANS: D

Question 2

2. For which problem should the child with chronic otitis media with effusion be evaluated?

A. Brain abscess
B. Meningitis
C. Hearing loss
D. Perforation of the tympanic membrane

Answer 2

ANS: C

Question 3

3. The nurse expects the initial plan of care for a 9-month old child with an acute otitis media infection to include…?

A. Symptomatic treatment and observation for 48 to 72 hours after diagnosis
B. An oral antibiotic, such as amoxicillin, five times a day for 7 days
C. Pneumococcal conjugate vaccine
D. Myringotomy with tympanoplasty tubes

Answer 3

ANS: A

Question 4

4. Which statement by a parent indicates an understanding about treatment of streptococcal pharyngitis?
   A. I guess my child will need to have his tonsils removed.
   B. A couple of days of rest and some ibuprofen will take care of this.
   C. I should give the penicillin three times a day for 10 days.
   D. I am giving my child prednisone to decrease the swelling of the tonsils.

Answer 4

C. I should give the penicillin three times a day for 10 days.

Question 5

5. The father of an infant calls the nurse to his sons room because he is making a strange noise. A diagnosis of laryngomalacia is made. What does the nurse expect to find on assessment?
   A. Stridor
   B. High-pitched cry
   C. Nasal congestion
   D. Spasmodic cough

Answer 5

A. Stridor

Question 6

6. The nurse should assess a child who has had a tonsillectomy for
   A. Frequent swallowing
   B. Inspiratory stridor
   C. Rhonchi
   D. Elevated white blood cell count

Answer 6

A. Frequent swallowing

Question 7

7. 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 7

B. It has a harsh, barky cough.

Question 8

8. 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 8

C. Take the child outside.

Question 9

9. A 5-year-old child is brought to the emergency department with copious drooling and a croaking sound on inspiration. Her mother states that the child is very agitated and only wants to sit upright. What should be the nurses first action in this situation?
   A. Prepare intubation equipment and call the physician.
   B. Examine the childs oropharynx and call the physician.
   C. Obtain a throat culture for respiratory syncytial virus (RSV).
   D. Obtain vital signs and listen to breath sounds.

Answer 9

A. Prepare intubation equipment and call the physician.

Question 10

10. What intervention can be taught to the parents of a 3-year-old child with pneumonia who is not hospitalized?
    A. Offer the child only cool liquids
    B. Offer the child her favorite warm liquid drinks.
    C. Use a warm mist humidifier.
    D. Call the physician for a respiratory rate less than 28 breaths/min.

Answer 10

B. Offer the child her favorite warm liquid drinks.

Question 11

11. What sign is indicative of respiratory distress in infants?
    A. Nasal flaring
    B. Respiratory rate of 55 breaths/min
    C. Irregular respiratory pattern
    D. Abdominal breathing

Answer 11

A. Nasal flaring

Question 12

12. Once an allergen is identified in a child with allergic rhinitis, the treatment of choice about which to educate the parents is
    A. Using appropriate medications
    B. Beginning desensitization injections
    C. Eliminating the allergen
    D. Removing the adenoids

Answer 12

C. Eliminating the allergen

Question 13

13. Which assessment finding after tonsillectomy should be reported to the physician?
    A. Vomiting bright red blood
    B. Pain at surgical site
    C. Pain on swallowing
    D. The ability to only take small sips of liquids

Answer 13

A. Vomiting bright red blood

Question 14

14. Teaching safety precautions with the administration of antihistamines is important because of what common side effect?
    A. Dry mouth
    B. Excitability
    C. Drowsiness
    D. Dry mucous membranes

Answer 14

C. Drowsiness

Question 15

15. What is an appropriate beverage for the nurse to give to a child who had a tonsillectomy earlier in the day?
    A. Chocolate ice cream
    B. Orange juice
    C. Fruit punch
    D. Apple juice

Answer 15

D. Apple juice

Question 16

16. Which type of croup is always considered a medical emergency?
    A. Laryngitis
    B. Epiglottitis
    C. Spasmodic croup
    D. Laryngotracheobronchitis (LTB)

Answer 16

B. Epiglottitis

Question 17

17. What information should the nurse teach workers at a daycare center about 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 handwashing can decrease the spread of the virus.

Answer 17

D. Frequent handwashing can decrease the spread of the virus.

Question 18

18. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
    A. Position on the side with neck slightly flexed.
    B. Administer antibiotics as ordered.
    C. Restrict oral and parenteral fluids if tachypneic.
    D. Give cool, humidified oxygen.

Answer 18

D. Give cool, humidified oxygen.

Question 19

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 trachea

Answer 19

A. Asthma

Question 20

20. The nurse encourages the mother of a toddler with acute LTB 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 childs respiratory efforts.
    C. Separation from mother is a major developmental threat at this age.
    D. The mother can provide constant observations of the childs respiratory efforts.

Answer 20

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

Question 21

21. Which statement indicates that a parent of a toddler needs more education about preventing foreign body aspiration?
    A. I keep objects with small parts out of reach.
    B. My toddler loves to play with balloons.
    C. I wont permit my child to have peanuts.
    D. I never leave coins where my child could get to them.

Answer 21

B. My toddler loves to play with balloons.

Question 22

22. What is a common trigger for asthma attacks in children?
    A. Febrile episodes
    B. Dehydration
    C. Exercise
    D. Seizures

Answer 22

C. Exercise

Question 23

23. Which child requires a Mantoux test?
    A. The child who has episodes of nighttime wheezing and coughing
    B. The child who has a history of allergic rhinitis
    C. The child whose baby-sitter has received a tuberculosis diagnosis
    D. The premature infant who is being treated for apnea of infancy

Answer 23

C. The child whose baby-sitter has received a tuberculosis diagnosis

Question 24

24. What explanation should the nurse give to the parent of a child with asthma about using a peak flow meter?
    A. It is used to monitor the childs breathing capacity.
    B. It measures the childs lung volume.
    C. It will help the medication reach the childs airways.
    D. It measures the amount of air the child breathes in.

Answer 24

A. It is used to monitor the childs breathing capacity.

Question 25

25. What is the best nursing response to the parent of a child with asthma who asks if his child can still participate in sports?
    A. Children with asthma are usually restricted from physical activities.
    B. Children can usually play any type of sport if their asthma is well controlled.
    C. Avoid swimming because breathing underwater is dangerous for people with asthma.
    D. Even with good asthma control, I would advise limiting the child to one athletic activity per school year.

Answer 25

B. Children can usually play any type of sport if their asthma is well controlled.

Question 26

26. 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. This is most suggestive of
    A. Bronchitis
    B. Bronchiolitis
    C. Viral-induced asthma
    D. Acute spasmodic laryngitis

Answer 26

A. Bronchitis

Question 27

27. Which classification of drugs is used to relieve an acute asthma episode?
    A. Short-acting beta2-adrenergic agonist
    B. Inhaled corticosteroids
    C. Leukotriene blockers
    D. Long-acting bronchodilators

Answer 27

A. Short-acting beta2-adrenergic agonist

Question 28

28. The nurse getting an end-of-shift report on a child with status asthmaticus should question which intervention?
    A. Administer oxygen by nasal cannula to keep oxygen saturation at 100%.
    B. Assess intravenous (IV) maintenance fluids and site every hour.
    C. Notify physician for signs of increasing respiratory distress.
    D. Organize care to allow for uninterrupted rest periods.

Answer 28

A. Administer oxygen by nasal cannula to keep oxygen saturation at 100%.

Question 29

29. What is the earliest recognizable clinical manifestation(s) of CF?
    A. Meconium ileus
    B. History of poor intestinal absorption
    C. Foul-smelling, frothy, greasy stools
    D. Recurrent pneumonia and lung infections

Answer 29

A. Meconium ileus

Question 30

30. What should the nurse teach a child about using an albuterol metered-dose inhaler for exercise-induced asthma?
    A. Take two puffs every 6 hours around the clock.
    B. Use the inhaler only when the child is short of breath.
    C. Use the inhaler 30 minutes before exercise.
    D. Take one to two puffs every morning upon awakening.

Answer 30

C. Use the inhaler 30 minutes before exercise.

Question 31

31. The infant with bronchopulmonary dysplasia (BPD) who has RSV bronchiolitis is a candidate for which treatment?
    A. Pancreatic enzymes
    B. Cool humidified oxygen
    C. Erythromycin intravenously
    D. Intermittent positive pressure ventilation

Answer 31

B. Cool humidified oxygen

Question 32

32. Which statement, if made by parents of a child with cystic fibrosis, indicates that they understood the nurses teaching on pancreatic enzyme replacement?
    A. Enzymes will improve my childs breathing.
    B. I should give the enzymes 1 hour after meals.
    C. Enzymes should be given with meals and snacks.
    D. The enzymes are stopped if my child begins wheezing.

Answer 32

C. Enzymes should be given with meals and snacks.

Question 33

33. Which vitamin supplements are necessary for children with cystic fibrosis?
    A. Vitamin C and calcium
    B. Vitamin B6 and B12
    C. Magnesium
    D. Vitamins A, D, E, and K

Answer 33

D. Vitamins A, D, E, and K