RICCI CHAPTER 40 EXAM QUESTIONS
AND ANSWERS
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 - Correct Answers -Answer: B
Rationale: Pulse oximetry is a useful tool for determining the extent of hypoxia. It can be
used by
the nurse for continuous or intermittent monitoring. Pulmonary function testing
measures
respiratory flow and lung volumes and is indicated for asthma, cystic fibrosis, and
chronic lung
disease. Peak expiratory flow testing is used to monitor the adequacy of asthma control.
Chest
radiographs can show hyperinflation, atelectasis, pneumonia, foreign bodies, pleural
effusion,
and abnormal heart or lung size.
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. - Correct Answers -Answer: C
Rationale: Inspecting the throat for bleeding is the most important discharge information
to give
the parents. Hemorrhage is unusual postoperatively but may occur any time from the
immediate
postoperative period to as late as 10 days after surgery. The nurse should inspect the
throat for
bleeding. Mucus tinged with blood may be expected, but fresh blood in the secretions
indicates
bleeding. Administering analgesics, encouraging fluids and applying an ice color are
important
but not as important as assessing for bleeding.
, 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?" - Correct Answers -Answer:
A
Rationale: Tuberculosis is a highly contagious disease. Most children contract it from an
infected
immediate household member. When taking the health history, the nurse should ask
about
symptoms such as malaise, weight loss, anorexia, chest tightness and a cough. The
child's cough
from tuberculosis is described as progressing slowly over several weeks and months
rather than
having an acute onset. Asking about the production from the cough is a way to
determine if
hemoptysis has occurred. Asking about being around anyone coughing is a way to
determine if
the child has been exposed to anyone with tuberculosis. Coughing only at night could
be related
to other respiratory disorders such as asthma.
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." - Correct Answers -Answer: A, B, D
Rationale: Children with cystic fibrosis (CF) have trouble digesting and absorbing
nutrients.
They tend to be underweight. For optimal health, their diets should be high in calories
and high
in protein, with the supplementation of fat soluble vitamins and pancreatic enzymes.
This diet helps with growth and the optimal nutrients. The fat soluble vitamins (vitamins
A, D, E and K)
are needed, because children with CF have trouble absorbing fat and need the vitamin
supplementation to aid in fat absorption. Water soluble vitamins (the B vitamins and
vitamin C)
do not aid in fat absorption. The child should not have a high-fat diet, because the extra
fat is
AND ANSWERS
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 - Correct Answers -Answer: B
Rationale: Pulse oximetry is a useful tool for determining the extent of hypoxia. It can be
used by
the nurse for continuous or intermittent monitoring. Pulmonary function testing
measures
respiratory flow and lung volumes and is indicated for asthma, cystic fibrosis, and
chronic lung
disease. Peak expiratory flow testing is used to monitor the adequacy of asthma control.
Chest
radiographs can show hyperinflation, atelectasis, pneumonia, foreign bodies, pleural
effusion,
and abnormal heart or lung size.
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. - Correct Answers -Answer: C
Rationale: Inspecting the throat for bleeding is the most important discharge information
to give
the parents. Hemorrhage is unusual postoperatively but may occur any time from the
immediate
postoperative period to as late as 10 days after surgery. The nurse should inspect the
throat for
bleeding. Mucus tinged with blood may be expected, but fresh blood in the secretions
indicates
bleeding. Administering analgesics, encouraging fluids and applying an ice color are
important
but not as important as assessing for bleeding.
, 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?" - Correct Answers -Answer:
A
Rationale: Tuberculosis is a highly contagious disease. Most children contract it from an
infected
immediate household member. When taking the health history, the nurse should ask
about
symptoms such as malaise, weight loss, anorexia, chest tightness and a cough. The
child's cough
from tuberculosis is described as progressing slowly over several weeks and months
rather than
having an acute onset. Asking about the production from the cough is a way to
determine if
hemoptysis has occurred. Asking about being around anyone coughing is a way to
determine if
the child has been exposed to anyone with tuberculosis. Coughing only at night could
be related
to other respiratory disorders such as asthma.
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." - Correct Answers -Answer: A, B, D
Rationale: Children with cystic fibrosis (CF) have trouble digesting and absorbing
nutrients.
They tend to be underweight. For optimal health, their diets should be high in calories
and high
in protein, with the supplementation of fat soluble vitamins and pancreatic enzymes.
This diet helps with growth and the optimal nutrients. The fat soluble vitamins (vitamins
A, D, E and K)
are needed, because children with CF have trouble absorbing fat and need the vitamin
supplementation to aid in fat absorption. Water soluble vitamins (the B vitamins and
vitamin C)
do not aid in fat absorption. The child should not have a high-fat diet, because the extra
fat is
