Ricci 40 Pt.2

Question 1

1. The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child’s hypoxia?
   A. Pulmonary function test
   B. Pulse oximetry
   C. Peak expiratory flow
   D. Chest radiograph

Answer 1

B. Pulse oximetry

Question 2

2. The nurse is discussing discharge instructions with the parents of a 6-year-old who had a tonsillectomy. What is the most important thing to stress?
   A. Administer analgesics.
   B. Encourage the child to drink liquids.
   C. Inspect the throat for bleeding.
   D. Apply an ice collar.

Answer 2

C. Inspect the throat for bleeding.

Question 3

3. A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason?
   A. Improve gas exchange
   B. Bypass the obstruction
   C. Hasten air reabsorption
   D. Prevent hypoxemia

Answer 3

C. Hasten air reabsorption

Question 4

4. Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized?
   A. Fever
   B. Oxygen saturation level of 96%
   C. Tachypnea with retractions
   D. Pale skin color

Answer 4

C. Tachypnea with retractions

Question 5

5. The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, what would be least appropriate for the nurse to perform?
   A. Providing 100% oxygen
   B. Visualizing the throat
   C. Having the child sit forward
   D. Auscultating for lung sounds

Answer 5

B. Visualizing the throat

Question 6

6. The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which drug would the nurse identify as an adjunct to a β2-adrenergic agonist for treatment of bronchospasm?
   A. Ipratropium
   B. Montelukast
   C. Cromolyn
   D. Theophylline

Answer 6

A. Ipratropium

Question 7

7. The nurse is caring for a 3-year-old girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which action?
   A. Suctioning a tracheostomy tube
   B. Administering drugs with a nebulizer
   C. Providing tracheostomy care
   D. Suctioning with a bulb syringe

Answer 7

A. Suctioning a tracheostomy tube

Question 8

8. The nurse is examining a 5-year-old. Which sign or symptom is a reliable first indication of respiratory illness in children?
   A. Slow, irregular breathing
   B. A bluish tinge to the lips
   C. Increasing lethargy
   D. Rapid, shallow breathing

Answer 8

D. Rapid, shallow breathing

Question 9

9. A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used?
   A. Simple mask
   B. Venturi mask
   C. Nasal cannula
   D. Oxygen hood

Answer 9

A. Simple mask

Question 10

10. A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which finding?
    A. Children’s demand for oxygen is lower than that of adults.
    B. Children develop hypoxemia more rapidly than adults do.
    C. An increase in oxygen saturation leads to a much larger decrease in pO2.
    D. Children’s bronchi are wider in diameter than those of an adult.

Answer 10

B. Children develop hypoxemia more rapidly than adults do.

Question 11

11. The nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. The nurse would most likely suspect sinusitis in which child?
    A. A 2-year-old with thin watery nasal discharge
    B. A 3-year-old with sneezing and coughing
    C. A 5-year-old with nasal congestion and sore throat
    D. A 7-year-old with halitosis and thick, yellow nasal discharge

Answer 11

D. A 7-year-old with halitosis and thick, yellow nasal discharge

Question 12

12. A parent asks the nurse about immunizing her 7-month-old daughter against the flu. Which response by the nurse would be most appropriate?
    A. “She really doesn’t need the vaccine until she reaches 1 year of age.”
    B. “She will probably receive it the next time she is to get her routine shots.”
    C. “Since your daughter is older than 6 months, she should get the vaccine every year.”
    D. “The vaccine has many side effects, so she wouldn’t get it until she’s ready to go to school.”

Answer 12

C. “Since your daughter is older than 6 months, she should get the vaccine every year.”

Question 13

13. A child with a pneumothorax has a chest tube attached to a water seal system. When assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. What would the nurse do first?
    A. Notify the physician.
    B. Apply an occlusive dressing.
    C. Clamp the chest tube.
    D. Perform a respiratory assessment.

Answer 13

C. Clamp the chest tube.

Question 14

14. A nurse is preparing a teaching plan for the family of a child with allergic rhinitis. When describing the immune reaction that occurs, the nurse would identify the role of which immunoglobulin?
    A. IgA
    B. IgE
    C. IgG
    D. IgM

Answer 14

B. IgE

Question 15

15. A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?
    A. Salmeterol
    B. Albuterol
    C. Ipratropium
    D. Cromolyn

Answer 15

B. Albuterol

Question 16

16. The nurse is preparing to perform a physical examination of a child with asthma. Which technique would the nurse be least likely to perform?
    A. Inspection
    B. Palpation
    C. Percussion
    D. Auscultation

Answer 16

B. Palpation

Question 17

17. A nursing instructor is preparing a class on chronic lung disease. What information would the instructor include when describing this disorder?
    A. It is a result of cystic fibrosis.
    B. It is seen most commonly in premature infants.
    C. It typically affects females more often than males.
    D. It is characterized by bradypnea.

Answer 17

B. It is seen most commonly in premature infants.

Question 18

18. A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally?
    A. Recombinant human DNase
    B. Bronchodilators
    C. Anti-inflammatory agents
    D. Pancreatic enzymes

Answer 18

D. Pancreatic enzymes

Question 19

19. When performing the physical examination of a child with cystic fibrosis, what would the nurse expect to assess?
    A. Dullness over the lung fields
    B. Increased diaphragmatic excursion
    C. Decreased tactile fremitus
    D. Hyperresonance over the liver

Answer 19

C. Decreased tactile fremitus

Question 20

20. The nurse is preparing to provide tracheostomy care to an infant. After gathering the necessary equipment, what would the nurse do next?
    A. Position the infant supine with a towel roll under the neck.
    B. Cut the new tracheostomy ties to the appropriate length.
    C. Cut the tracheostomy ties from around the tracheostomy tube.
    D. Cleanse around the site of the tracheostomy with the prescribed solution.

Answer 20

A. Position the infant supine with a towel roll under the neck.

Question 21

21. A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. What would the nurse have most likely assessed?
    A. High fever
    B. Dysphagia
    C. Toxic appearance
    D. Inspiratory stridor

Answer 21

D. Inspiratory stridor

Question 22

22. A child has been prescribed a nasal cannula for oxygen delivery. What should the nurse do before applying the cannula?
    A. Assess patency of the nares
    B. Test the oxygen saturation
    C. Add humidification to the delivery device
    D. Assess the lung sounds

Answer 22

A. Assess patency of the nares

Question 23

23. The nurse is obtaining a health history of a child suspected of tuberculosis. What question would the nurse ask first about the child’s cough?
    A. “How long has your child had a cough?”
    B. “Does your child cough only at night?”
    C. “Does your child cough up anything when coughing?”
    D. “Has your child been around anyone who is coughing?”

Answer 23

A. “How long has your child had a cough?”

Question 24

24. The nurse is teaching the parent of a child with cystic fibrosis about nutrition requirements for the child. What should be included in this teaching? Select all that apply
    A. “Give your child high-calorie foods and snacks.”
    B. “Feed your child foods that are high in protein.”
    C. “Administer water soluble vitamins.”
    D. “Give pancreatic enzymes with meals.”
    E. “Give your child foods high in fat.”

Answer 24

A. “Give your child high-calorie foods and snacks.”
B. “Feed your child foods that are high in protein.”
D. “Give pancreatic enzymes with meals.”

Question 25

25. The nurse is preparing a room for a child being transferred out of the intensive care unit. The child has a tracheostomy. What item(s) are essential for the nurse to have available at the bedside in case of emergency? Select all that apply.
    A. A new tracheostomy tube of the same size
    B. A new tracheostomy tube of a smaller size
    C. A bag valve mask
    D. A sterile tracheostomy kit
    E. Cleaning supplies for the tracheostomy

Answer 25

A. A new tracheostomy tube of the same size
B. A new tracheostomy tube of a smaller size
C. A bag valve mask

Question 26

26. A parent with a child who has cystic fibrosis asks the nurse how to determine if the child is receiving an adequate amount of pancreatic enzymes. How should the nurse respond? Select all that apply.
    A. “The dose is adequate when your child is only having 1 to 2 stools per day.”
    B. “The dose is adequate when your child’s weight is improving.”
    C. “The dose prescribed is based on your child’s pancreatic laboratory values so it should be correct.”
    D. “When your child starts to eat more quantity of food you will need to adjust the amount of enzyme pills.”
    E. “You will need to give your child less enzyme pills when high-fat foods are eaten.”

Answer 26

A. “The dose is adequate when your child is only having 1 to 2 stools per day.”
B. “The dose is adequate when your child’s weight is improving.”
D. “When your child starts to eat more quantity of food you will need to adjust the amount of enzyme pills.”

Question 27

27. A child is in the emergency department with an asthma exaccerbation. Upon asucultation the nurse is unable to hear air movement in the lungs. What action should the nurse take first?
    A. Administer a beta-2 adrenergic agonist
    B. Administer oxygen
    C. Start a peripheral IV
    D. Administer corticosteroids

Answer 27

A. Administer a beta-2 adrenergic agonist

Question 28

28. A hospitalized child suddenly begins reporting “my chest hurts,” is tachypneic, and has tachycardia. The nurse auscultates the lung sounds and finds absent breath sounds on one side. After notifying the health care provide what action would the nurse take first?
    A. Prepare for chest tube insertion
    B. Administer oxygen
    C. Obtain oxygen saturation measurement
    D. Prepare for mechanical ventilation

Answer 28

A. Prepare for chest tube insertion

Question 29

29. A child is hospitalized with pneumonia. The nurse assesses an increase in the work of breathing and in the respiratory rate. What intervention should the nurse do first to help this child?
    A. Elevate the head of the bed
    B. Administer oxygen
    C. Notify the health care provider
    D. Obtain oxygen saturation levels

Answer 29

A. Elevate the head of the bed

Question 30

30. An infant with a high respiratory rate is NPO and is receiving IV fluids. What assessment(s) will the nurse make to assure this infant is hydrated? Select all that apply.
    A. Measure skin turgor
    B. Palpate anterior fontanel
    C. Determine urine output
    D. Review electrolyte laboratory results
    E. Assess the lung sounds

Answer 30

A. Measure skin turgor
B. Palpate anterior fontanel
C. Determine urine output