Pediatric Respiratory: Exam 3 - Questions with Correct
Answers
100 questions
1. Nasal flaring in an infant indicates:
A. Normal sleep breathing
B. Nasal infection only
C. An attempt to reduce airway resistance and increase air intake during distress
D. Excess sedation
Correct Answer: C. An attempt to reduce airway resistance and increase air intake during
distress
Rationale: Widening the nostrils lowers resistance in the nasal passages, so flaring is a sign of
increased work of breathing. It is not normal at rest, is not specific to nasal infection, and does
not reflect sedation.
2. Children have less developed collateral ventilation channels between alveoli, which means
that:
A. Infections cannot spread
B. They never develop atelectasis
C. Oxygen moves faster between alveoli
D. Mucus plugging more easily causes atelectasis
Correct Answer: D. Mucus plugging more easily causes atelectasis
Rationale: Pores of Kohn and other channels are fewer in young children, so when a small
airway is blocked, air cannot bypass it and the area collapses. This does not stop infection, does
not prevent atelectasis, and limits rather than speeds gas movement.
,3. Young children usually do not produce sputum for culture because:
A. Their lungs make no mucus
B. Sputum is always sterile in children
C. Coughing is absent in children
D. They tend to swallow secretions rather than expectorate them
Correct Answer: D. They tend to swallow secretions rather than expectorate them
Rationale: Children under about 6 years usually swallow sputum, so samples are hard to obtain
and other tests are used. Their airways do produce mucus, sputum is not always sterile, and
children cough readily.
4. The normal resting respiratory rate of a school-age child (6 to 12 years) is approximately:
A. 18 to 30 breaths per minute
B. 40 to 60 breaths per minute
C. 8 to 10 breaths per minute
D. 50 to 70 breaths per minute
Correct Answer: A. 18 to 30 breaths per minute
Rationale: Respiratory rate falls with age, and school-age children usually breathe about 18 to
30 times a minute. Rates of 40 to 70 are tachypneic at this age, and 8 to 10 is too slow.
5. Bradycardia in a hypoxic infant is an ominous sign because:
A. It shows the infant is calming
B. It often precedes cardiopulmonary arrest
C. It is a normal response to fever
D. It indicates improved oxygenation
Correct Answer: B. It often precedes cardiopulmonary arrest
Rationale: In children, hypoxia causes bradycardia late in its course, and it frequently signals
imminent arrest that needs immediate ventilation. It is not calming, is not a fever response, and
does not reflect improvement.
,6. When assessing a toddler with respiratory symptoms, the nurse should generally perform
which part of the exam first?
A. Observation and auscultation while the child sits calmly on the parent's lap
B. Examination of the throat with a tongue blade
C. Measurement of temperature rectally
D. Placing the child supine on the exam table alone
Correct Answer: A. Observation and auscultation while the child sits calmly on the parent's
lap
Rationale: Starting with the least invasive steps keeps the child calm and allows accurate
breathing assessment. Throat and rectal procedures are upsetting and are done last, and
separating a toddler from the parent increases distress and work of breathing.
7. Wheezing that is heard mainly on expiration usually indicates narrowing of the:
A. Nasopharynx
B. Larynx above the vocal cords
C. Esophagus
D. Lower airways, such as the bronchi and bronchioles
Correct Answer: D. Lower airways, such as the bronchi and bronchioles
Rationale: Intrathoracic airways narrow further during expiration, producing expiratory wheeze
in conditions such as asthma and bronchiolitis. Nasal and laryngeal obstruction produce snoring
or stridor, and the esophagus is not an airway.
, 8. A 3-year-old's respiratory rate is 52 breaths per minute while calm and afebrile. The nurse
should:
A. Recognize tachypnea for age and assess further for respiratory distress
B. Document it as normal for a toddler
C. Recount only after the child cries
D. Ignore it if the child is playing
Correct Answer: A. Recognize tachypnea for age and assess further for respiratory distress
Rationale: A rate above about 40 in a calm preschooler is tachypneic and warrants a full
assessment. It is not normal, crying would raise the rate further, and a playing child can still be
ill.
9. A child being treated for strep pharyngitis can return to school when:
A. The 10-day course is finished
B. Fever has resolved and at least 12 hours of antibiotic therapy have been completed
C. Symptoms started 24 hours ago
D. The rash has fully disappeared
Correct Answer: B. Fever has resolved and at least 12 hours of antibiotic therapy have been
completed
Rationale: After about 12 hours of antibiotics and without fever, the child is no longer
considered contagious. Waiting for the course to end is unnecessary, timing from symptom
onset is not the criterion, and rash can persist.
10. Adenoid hypertrophy in a child commonly causes:
A. Mouth breathing, snoring and nasal speech
B. Wheezing on expiration
C. Barking cough
D. Clubbing
Correct Answer: A. Mouth breathing, snoring and nasal speech
Rationale: Enlarged adenoids block the back of the nose, causing mouth breathing, snoring and
a hyponasal voice. Wheezing, barking cough and clubbing reflect other problems.
Answers
100 questions
1. Nasal flaring in an infant indicates:
A. Normal sleep breathing
B. Nasal infection only
C. An attempt to reduce airway resistance and increase air intake during distress
D. Excess sedation
Correct Answer: C. An attempt to reduce airway resistance and increase air intake during
distress
Rationale: Widening the nostrils lowers resistance in the nasal passages, so flaring is a sign of
increased work of breathing. It is not normal at rest, is not specific to nasal infection, and does
not reflect sedation.
2. Children have less developed collateral ventilation channels between alveoli, which means
that:
A. Infections cannot spread
B. They never develop atelectasis
C. Oxygen moves faster between alveoli
D. Mucus plugging more easily causes atelectasis
Correct Answer: D. Mucus plugging more easily causes atelectasis
Rationale: Pores of Kohn and other channels are fewer in young children, so when a small
airway is blocked, air cannot bypass it and the area collapses. This does not stop infection, does
not prevent atelectasis, and limits rather than speeds gas movement.
,3. Young children usually do not produce sputum for culture because:
A. Their lungs make no mucus
B. Sputum is always sterile in children
C. Coughing is absent in children
D. They tend to swallow secretions rather than expectorate them
Correct Answer: D. They tend to swallow secretions rather than expectorate them
Rationale: Children under about 6 years usually swallow sputum, so samples are hard to obtain
and other tests are used. Their airways do produce mucus, sputum is not always sterile, and
children cough readily.
4. The normal resting respiratory rate of a school-age child (6 to 12 years) is approximately:
A. 18 to 30 breaths per minute
B. 40 to 60 breaths per minute
C. 8 to 10 breaths per minute
D. 50 to 70 breaths per minute
Correct Answer: A. 18 to 30 breaths per minute
Rationale: Respiratory rate falls with age, and school-age children usually breathe about 18 to
30 times a minute. Rates of 40 to 70 are tachypneic at this age, and 8 to 10 is too slow.
5. Bradycardia in a hypoxic infant is an ominous sign because:
A. It shows the infant is calming
B. It often precedes cardiopulmonary arrest
C. It is a normal response to fever
D. It indicates improved oxygenation
Correct Answer: B. It often precedes cardiopulmonary arrest
Rationale: In children, hypoxia causes bradycardia late in its course, and it frequently signals
imminent arrest that needs immediate ventilation. It is not calming, is not a fever response, and
does not reflect improvement.
,6. When assessing a toddler with respiratory symptoms, the nurse should generally perform
which part of the exam first?
A. Observation and auscultation while the child sits calmly on the parent's lap
B. Examination of the throat with a tongue blade
C. Measurement of temperature rectally
D. Placing the child supine on the exam table alone
Correct Answer: A. Observation and auscultation while the child sits calmly on the parent's
lap
Rationale: Starting with the least invasive steps keeps the child calm and allows accurate
breathing assessment. Throat and rectal procedures are upsetting and are done last, and
separating a toddler from the parent increases distress and work of breathing.
7. Wheezing that is heard mainly on expiration usually indicates narrowing of the:
A. Nasopharynx
B. Larynx above the vocal cords
C. Esophagus
D. Lower airways, such as the bronchi and bronchioles
Correct Answer: D. Lower airways, such as the bronchi and bronchioles
Rationale: Intrathoracic airways narrow further during expiration, producing expiratory wheeze
in conditions such as asthma and bronchiolitis. Nasal and laryngeal obstruction produce snoring
or stridor, and the esophagus is not an airway.
, 8. A 3-year-old's respiratory rate is 52 breaths per minute while calm and afebrile. The nurse
should:
A. Recognize tachypnea for age and assess further for respiratory distress
B. Document it as normal for a toddler
C. Recount only after the child cries
D. Ignore it if the child is playing
Correct Answer: A. Recognize tachypnea for age and assess further for respiratory distress
Rationale: A rate above about 40 in a calm preschooler is tachypneic and warrants a full
assessment. It is not normal, crying would raise the rate further, and a playing child can still be
ill.
9. A child being treated for strep pharyngitis can return to school when:
A. The 10-day course is finished
B. Fever has resolved and at least 12 hours of antibiotic therapy have been completed
C. Symptoms started 24 hours ago
D. The rash has fully disappeared
Correct Answer: B. Fever has resolved and at least 12 hours of antibiotic therapy have been
completed
Rationale: After about 12 hours of antibiotics and without fever, the child is no longer
considered contagious. Waiting for the course to end is unnecessary, timing from symptom
onset is not the criterion, and rash can persist.
10. Adenoid hypertrophy in a child commonly causes:
A. Mouth breathing, snoring and nasal speech
B. Wheezing on expiration
C. Barking cough
D. Clubbing
Correct Answer: A. Mouth breathing, snoring and nasal speech
Rationale: Enlarged adenoids block the back of the nose, causing mouth breathing, snoring and
a hyponasal voice. Wheezing, barking cough and clubbing reflect other problems.
