Pediatric Nursing- A Case-Based Approach
]+ ]+ ]+ ]+
TEST BANK FOR ]+
,Pediatric Nursing- A Case-Based Approach
]+ ]+ ]+ ]+
, Pediatric Nursing- A Case-Based Approach ]+ ]+ ]+ ]+
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. ]+ ]+ ]+ ]
ANSWER: D
+ ]+
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss fro
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
m 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 tachypn
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
eic, 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 is
+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
olation?
a. Reverse isolation ]+
b. Airborne isolation ]+
c. Contact Precautions ]+
d. Standard Precautions ]+ ]
+ANSWER: C ]+
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, C
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ontact Precautions are required. Caregivers must use gloves and gowns when entering the roo
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
m. Care is taken not to touch their own eyes or mucous membranes with a contaminated glove
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
d hand. Children are placed in a private room or in a room with other children with RSV infec
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
tions. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other child
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ren 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 ]+ ]+ ]+ ]
ANSWER: A
+ ]+
Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset, fe
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ver, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
, Pediatric Nursing- A Case-Based Approach ]+ ]+ ]+ ]+
virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stri
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
dor.
4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due t
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
o 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 s
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
upply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. P
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affect
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ed by this respiratory-disease process.
]+ ]+ ]+ ]+
Chapter 2: Asthma ]+ ]+
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment findin
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
g suggests that the childs condition is worsening?
]+ ]+ ]+ ]+ ]+ ]+ ]+
a. Hypoventilation
b. Thirst
c. Bradycardia
]+ ]+ ]+ ]+
TEST BANK FOR ]+
,Pediatric Nursing- A Case-Based Approach
]+ ]+ ]+ ]+
, Pediatric Nursing- A Case-Based Approach ]+ ]+ ]+ ]+
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. ]+ ]+ ]+ ]
ANSWER: D
+ ]+
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss fro
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
m 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 tachypn
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
eic, 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 is
+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
olation?
a. Reverse isolation ]+
b. Airborne isolation ]+
c. Contact Precautions ]+
d. Standard Precautions ]+ ]
+ANSWER: C ]+
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, C
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ontact Precautions are required. Caregivers must use gloves and gowns when entering the roo
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
m. Care is taken not to touch their own eyes or mucous membranes with a contaminated glove
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
d hand. Children are placed in a private room or in a room with other children with RSV infec
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
tions. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other child
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ren 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 ]+ ]+ ]+ ]
ANSWER: A
+ ]+
Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset, fe
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ver, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
, Pediatric Nursing- A Case-Based Approach ]+ ]+ ]+ ]+
virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stri
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
dor.
4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due t
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
o 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 s
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
upply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. P
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affect
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
ed by this respiratory-disease process.
]+ ]+ ]+ ]+
Chapter 2: Asthma ]+ ]+
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment findin
]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+ ]+
g suggests that the childs condition is worsening?
]+ ]+ ]+ ]+ ]+ ]+ ]+
a. Hypoventilation
b. Thirst
c. Bradycardia
