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
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 pnurse pis pcaring pfor pa pchild phospitalized pfor pstatus pasthmaticus. pWhich passessment
pfinding psuggests pthat pthe pchilds pcondition pis pworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
pANS: pA
,The pnurse pwould passess pthe pchild pfor psigns pof phypoxia, pincluding prestlessness, pfatigue,
pirritability, pand pincreased pheart pand prespiratory prate. pAs pthe pchild ptires pfrom pthe
pincreased pwork pof pbreathing phypoventilation poccurs pleading pto pincreased pcarbon pdioxide
plevels. pThe pnurse pwould pbe palert pfor psigns pof phypoxia. pThirst pwould preflect pthe pchilds
phydration pstatus. pBradycardia pis pnot pa psign pof phypoxia; ptachycardia pis. pClubbing
pdevelops pover pa pperiod pof pmonths pin presponse pto phypoxia. pThe ppresence pof pclubbing
pdoes pnot pindicate pthe pchilds pcondition pis pworsening.
2. Which pfinding pis pexpected pwhen passessing pa pchild phospitalized pfor pasthma?
a. Inspiratory pstridor
b. Harsh, pbarky pcough
c. Wheezing
d. Rhinorrhea
pANS: pC
Wheezing pis pa pclassic pmanifestation pof pasthma. pInspiratory pstridor pis pa pclinical pmanifestation pof
croup. pA pharsh, pbarky pcough pis pcharacteristic pof pcroup. pRhinorrhea pis pnot passociated pwith pasthma.
3. A pchild phas phad pcold psymptoms pfor pmore pthan p2 pweeks, pa pheadache, pnasal
pcongestion pwith ppurulent pnasal pdrainage, pfacial ptenderness, pand pa pcough pthat pincreases
pduring psleep. pThe pnurse precognizes pthese psymptoms pare pcharacteristic pof pwhich
prespiratory pcondition?
a. Allergic prhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
pANS: pD
Sinusitis pis pcharacterized pby psigns pand psymptoms pof pa pcold pthat pdo pnot pimprove pafter p14 pdays, pa
low-grade pfever, pnasal pcongestion pand ppurulent pnasal pdischarge, pheadache, ptenderness, pa
pfeeling pof pfullness pover pthe paffected psinuses, phalitosis, pand pa pcough pthat pincreases pwhen
pthe pchild pis plying pdown. pThe pclassic psymptoms pof pallergic prhinitis pare pwatery prhinorrhea,
pitchy pnose, peyes, pears, pand ppalate, pand psneezing. pSymptoms poccur pas plong pas pthe pchild
pis pexposed pto pthe pallergen. pBronchitis pis pcharacterized pby pa pgradual ponset pof prhinitis pand
pa pcough pthat pis pinitially pnonproductive pbut pmay pchange pto pa ploose pcough. pThe
pmanifestations pof pasthma pmay pvary, pwith pwheezing pbeing pa pclassic psign. pThe psymptoms
ppresented pin pthe pquestion pdo pnot psuggest pasthma.
4. What pis pa pcommon ptrigger pfor pasthma pattacks pin pchildren?
a. Febrile pepisodes
b. Dehydration
c. Exercise
d. Seizures
pANS: pC
, Exercise pis pone pof pthe pmost pcommon ptriggers pfor pasthma pattacks, pparticularly pin pschool-
age pchildren. pFebrile pepisodes pare pconsistent pwith pother pproblems, pfor pexample, pseizures.
pDehydration poccurs pas pa presult pof pdiarrhea; pit pdoes pnot ptrigger pasthma pattacks. pViral
pinfections pare ptriggers pfor pasthma. pSeizures pcan presult pfrom pa ptoo-rapid pintravenous
pinfusion pof ptheophyllinea ptherapy pfor pasthma.
5. The ppractitioner pchanges pthe pmedications pfor pthe pchild pwith pasthma pto psalmeterol
p(Serevent). pThe pmother pasks pthe pnurse pwhat pthis pdrug pwill pdo. pThe pnurse pexplains pthat
psalmeterol p(Serevent) pis pused pto ptreat pasthma pbecause pthe pdrug pproduces pwhich
pcharacteristic?
1. Decreases pinflammation
2. Decreases pmucous pproduction
3. Controls pallergic prhinitis
4. Dilates pthe pbronchioles
Correct pAnswer: p4
Rationale p1: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Rationale p2: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Rationale p3: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Rationale p4: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Global pRationale: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Cognitive pLevel: pAnalyzing
Client pNeed: pPhysiological pIntegrity
Client pNeed pSub: pPharmacological pand pParenteral pTherapies
Nursing/Integrated pConcepts: pNursing pProcess: pImplementation
Learning pOutcome: pLO p20.6 pCreate pa pnursing pcare pplan pfor pa pchild pwith pa pcommon
pacute prespiratory pcondition.
6. Following pparental pteaching, pthe pnurse pis pevaluating pthe pparents punderstanding pof
penvironmental pcontrol pfor ptheir pchilds pasthma pmanagement. pWhich pstatement pby pthe
pparents pindicates pappropriate punderstanding pof pthe pteaching?
1. We pwill preplace pthe pcarpet pin pour pchilds pbedroom pwith ptile.
2. Were pglad pthe pdog pcan pcontinue pto psleep pin pour pchilds proom.
3. Well pbe psure pto puse pthe pfireplace poften pto pkeep pthe phouse pwarm pin pthe pwinter.
4. Well pkeep pthe pplants pin pour pchilds proom pdusted.
Correct pAnswer: p1
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
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 pnurse pis pcaring pfor pa pchild phospitalized pfor pstatus pasthmaticus. pWhich passessment
pfinding psuggests pthat pthe pchilds pcondition pis pworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
pANS: pA
,The pnurse pwould passess pthe pchild pfor psigns pof phypoxia, pincluding prestlessness, pfatigue,
pirritability, pand pincreased pheart pand prespiratory prate. pAs pthe pchild ptires pfrom pthe
pincreased pwork pof pbreathing phypoventilation poccurs pleading pto pincreased pcarbon pdioxide
plevels. pThe pnurse pwould pbe palert pfor psigns pof phypoxia. pThirst pwould preflect pthe pchilds
phydration pstatus. pBradycardia pis pnot pa psign pof phypoxia; ptachycardia pis. pClubbing
pdevelops pover pa pperiod pof pmonths pin presponse pto phypoxia. pThe ppresence pof pclubbing
pdoes pnot pindicate pthe pchilds pcondition pis pworsening.
2. Which pfinding pis pexpected pwhen passessing pa pchild phospitalized pfor pasthma?
a. Inspiratory pstridor
b. Harsh, pbarky pcough
c. Wheezing
d. Rhinorrhea
pANS: pC
Wheezing pis pa pclassic pmanifestation pof pasthma. pInspiratory pstridor pis pa pclinical pmanifestation pof
croup. pA pharsh, pbarky pcough pis pcharacteristic pof pcroup. pRhinorrhea pis pnot passociated pwith pasthma.
3. A pchild phas phad pcold psymptoms pfor pmore pthan p2 pweeks, pa pheadache, pnasal
pcongestion pwith ppurulent pnasal pdrainage, pfacial ptenderness, pand pa pcough pthat pincreases
pduring psleep. pThe pnurse precognizes pthese psymptoms pare pcharacteristic pof pwhich
prespiratory pcondition?
a. Allergic prhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
pANS: pD
Sinusitis pis pcharacterized pby psigns pand psymptoms pof pa pcold pthat pdo pnot pimprove pafter p14 pdays, pa
low-grade pfever, pnasal pcongestion pand ppurulent pnasal pdischarge, pheadache, ptenderness, pa
pfeeling pof pfullness pover pthe paffected psinuses, phalitosis, pand pa pcough pthat pincreases pwhen
pthe pchild pis plying pdown. pThe pclassic psymptoms pof pallergic prhinitis pare pwatery prhinorrhea,
pitchy pnose, peyes, pears, pand ppalate, pand psneezing. pSymptoms poccur pas plong pas pthe pchild
pis pexposed pto pthe pallergen. pBronchitis pis pcharacterized pby pa pgradual ponset pof prhinitis pand
pa pcough pthat pis pinitially pnonproductive pbut pmay pchange pto pa ploose pcough. pThe
pmanifestations pof pasthma pmay pvary, pwith pwheezing pbeing pa pclassic psign. pThe psymptoms
ppresented pin pthe pquestion pdo pnot psuggest pasthma.
4. What pis pa pcommon ptrigger pfor pasthma pattacks pin pchildren?
a. Febrile pepisodes
b. Dehydration
c. Exercise
d. Seizures
pANS: pC
, Exercise pis pone pof pthe pmost pcommon ptriggers pfor pasthma pattacks, pparticularly pin pschool-
age pchildren. pFebrile pepisodes pare pconsistent pwith pother pproblems, pfor pexample, pseizures.
pDehydration poccurs pas pa presult pof pdiarrhea; pit pdoes pnot ptrigger pasthma pattacks. pViral
pinfections pare ptriggers pfor pasthma. pSeizures pcan presult pfrom pa ptoo-rapid pintravenous
pinfusion pof ptheophyllinea ptherapy pfor pasthma.
5. The ppractitioner pchanges pthe pmedications pfor pthe pchild pwith pasthma pto psalmeterol
p(Serevent). pThe pmother pasks pthe pnurse pwhat pthis pdrug pwill pdo. pThe pnurse pexplains pthat
psalmeterol p(Serevent) pis pused pto ptreat pasthma pbecause pthe pdrug pproduces pwhich
pcharacteristic?
1. Decreases pinflammation
2. Decreases pmucous pproduction
3. Controls pallergic prhinitis
4. Dilates pthe pbronchioles
Correct pAnswer: p4
Rationale p1: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Rationale p2: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Rationale p3: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Rationale p4: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Global pRationale: pSalmeterol p(Serevent) pis pa plong-acting pbeta2-agonist pthat pacts pby
pbronchodilating. pSteroids pare panti-inflammatory, panticholinergics pdecrease pmucous
pproduction, pand pantihistamines pcontrol pallergic prhinitis.
Cognitive pLevel: pAnalyzing
Client pNeed: pPhysiological pIntegrity
Client pNeed pSub: pPharmacological pand pParenteral pTherapies
Nursing/Integrated pConcepts: pNursing pProcess: pImplementation
Learning pOutcome: pLO p20.6 pCreate pa pnursing pcare pplan pfor pa pchild pwith pa pcommon
pacute prespiratory pcondition.
6. Following pparental pteaching, pthe pnurse pis pevaluating pthe pparents punderstanding pof
penvironmental pcontrol pfor ptheir pchilds pasthma pmanagement. pWhich pstatement pby pthe
pparents pindicates pappropriate punderstanding pof pthe pteaching?
1. We pwill preplace pthe pcarpet pin pour pchilds pbedroom pwith ptile.
2. Were pglad pthe pdog pcan pcontinue pto psleep pin pour pchilds proom.
3. Well pbe psure pto puse pthe pfireplace poften pto pkeep pthe phouse pwarm pin pthe pwinter.
4. Well pkeep pthe pplants pin pour pchilds proom pdusted.
Correct pAnswer: p1
