Unit 4

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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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

Question 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?
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 panreatic enzymes with meals.”
E. “Give your child foods high in fat.”

Answer 24

A B D

Question 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 B C

Question 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: A, B, D

Answer 26

A B D

Question 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

Question 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

Question 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

Question 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 B C