https://qwivy.com/

Pediatric Nursing – A Case-Based

Approach 1st Edition Tagher Knapp

Test Bank

Chapter 1: Bronchiolitis

1. 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.

ANS: D

Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from

tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree

angle and the neck slightly extended to maintain an open airway and decrease pressure on the

diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a

secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is

tachypneic, fluids are given parenterally to prevent dehydration.

2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial

virus (RSV). The nurse knows that a child infected with this virus requires what type of

isolation?

a. Reverse isolation

b. Airborne isolation

c. Contact Precautions

d. Standard Precautions

ANS: C

RSV is transmitted through droplets. In addition to Standard Precautions and hand washing,

Contact Precautions are required. Caregivers must use gloves and gowns when entering the

room. Care is taken not to touch their own eyes or mucous membranes with a contaminated

gloved hand. Children are placed in a private room or in a room with other children with RSV

infections. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other

children need to be protected from exposure to the virus. The virus is not airborne.

3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration.

This suggests what condition?

a. Asthma

b. Pneumonia

c. Bronchiolitis

d. Foreign body in trachea

ANS: A

 1 / 4

https://qwivy.com/

Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset,

fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial

virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe

stridor.

4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to

respiratory syncytial virus (RSV)?

a. Activity Intolerance

b. Decreased Cardiac Output

c. Pain, Acute

d. Tissue Perfusion, Ineffective (peripheral)

ANS. A

Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply

and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is

not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by

this respiratory-disease process.

Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply

and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is

not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by

this respiratory-disease process.

Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply

and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is

not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by

this respiratory-disease process.

Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply

and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is

not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by

this respiratory-disease process.

Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen

supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis.

Pain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not

affected by this respiratory-disease process.

Chapter 2: Asthma

1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding

suggests that the childs condition is worsening?

a. Hypoventilation

b. Thirst

c. Bradycardia

d. Clubbing

ANS: A

 2 / 4

https://qwivy.com/

The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability,

and increased heart and respiratory rate. As the child tires from the increased work of breathing

hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for

signs of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sign of

hypoxia; tachycardia is. Clubbing develops over a period of months in response to hypoxia. The

presence of clubbing does not indicate the childs condition is worsening.

2. Which finding is expected when assessing a child hospitalized for asthma?

a. Inspiratory stridor

b. Harsh, barky cough

c. Wheezing

d. Rhinorrhea

ANS: C

Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of

croup. A harsh, barky cough is characteristic of croup. Rhinorrhea is not associated with asthma.

3. 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 these symptoms are characteristic of which respiratory condition?

a. Allergic rhinitis

b. Bronchitis

c. Asthma

d. Sinusitis

ANS: D

Sinusitis is characterized by signs and symptoms of a cold that do not improve after 14 days, a

low-grade fever, nasal congestion and purulent nasal discharge, headache, tenderness, a feeling

of fullness over the affected sinuses, halitosis, and a cough that increases when the child is lying

down. The classic symptoms of allergic rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and

palate, and sneezing. Symptoms occur as long as the child is exposed to the allergen. Bronchitis

is characterized by a gradual onset of rhinitis and a cough that is initially nonproductive but may

change to a loose cough. The manifestations of asthma may vary, with wheezing being a classic

sign. The symptoms presented in the question do not suggest asthma.

4. What is a common trigger for asthma attacks in children?

a. Febrile episodes

b. Dehydration

c. Exercise

d. Seizures

ANS: C

 3 / 4

https://qwivy.com/

Exercise is one of the most common triggers for asthma attacks, particularly in school-age

children. Febrile episodes are consistent with other problems, for example, seizures. Dehydration

occurs as a result of diarrhea; it does not trigger asthma attacks. Viral infections are triggers for

asthma. Seizures can result from a too-rapid intravenous infusion of theophyllinea therapy for

asthma.

5.The practitioner changes the medications for the child with asthma to salmeterol (Serevent).

The mother asks the nurse what this drug will do. The nurse explains that salmeterol (Serevent)

is used to treat asthma because the drug produces which characteristic?

1. Decreases inflammation

2. Decreases mucous production

3. Controls allergic rhinitis

4. Dilates the bronchioles

Correct Answer: 4

Rationale 1: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.

Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines

control allergic rhinitis.

Rationale 2: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.

Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines

control allergic rhinitis.

Rationale 3: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.

Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines

control allergic rhinitis.

Rationale 4: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.

Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines

control allergic rhinitis.

Global Rationale: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by

bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease mucous production,

and antihistamines control allergic rhinitis.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 20.6 Create a nursing care plan for a child with a common acute

respiratory condition.

6.Following parental teaching, the nurse is evaluating the parents understanding of

environmental control for their childs asthma management. Which statement by the parents

indicates appropriate understanding of the teaching?

1. We will replace the carpet in our childs bedroom with tile.

2. Were glad the dog can continue to sleep in our childs room.

3. Well be sure to use the fireplace often to keep the house warm in the winter.

4. Well keep the plants in our childs room dusted.

Correct Answer: 1

Powered by qwivy(www.qwivy.org)

 4 / 4

Pediatric Nursing A Case-Based Approach 1st Edition Tagher Knapp Test Bank Full Test Bank All chapters All pages