TESTBANK
PediatricNursing,ACase-Based
Approach,1stEditionByTagher
Knapp
, PediatricNursing,ACase-BasedApproach,1stEditionByTagherKnapp
Chapter1:Bronchiolitis
1. Whichinterventionisappropriatefortheinfanthospitalizedwithbronchiolitis?
a. Positiononthesidewithneckslightlyflexed.
b. Administerantibioticsasordered.
c. Restrictoralandparenteralfluidsiftachypneic.
d. Givecool,humidifiedoxygen.ANS:D
Cool,humidifiedoxygenisgiventorelievedyspnea,hypoxemia,andinsensiblefluidlossfrom
tachypnea.Theinfantshouldbepositionedwiththeheadandchestelevatedata30-to40-degreeangle andthe
neck slightly extended to maintain an open airway and decrease pressure on the diaphragm. The etiology of
bronchiolitisisviral.Antibioticsaregivenonlyifthereisasecondarybacterialinfection.
Tachypnea increases insensible fluid loss. If the infant is tachypneic, fluids are givenparenterally to
preventdehydration.
2. Aninfantwithbronchiolitisishospitalized.Thecausativeorganismisrespiratorysyncytial
virus(RSV).Thenurseknows that achildinfectedwiththisvirusrequireswhattypeofisolation?
b
a. Reverseisolation
b. Airborneisolation
c. ContactPrecautions
d. StandardPrecautionsANS:C
RSVistransmittedthroughdroplets.InadditiontoStandardPrecautionsandhandwashing,
ContactPrecautionsarerequired.Caregiversmustuseglovesandgownswhenenteringtheroom.Careis taken
not to touch their own eyes or mucous membranes with a contaminated gloved hand. Childrenare placed in
aprivateroomor ina roomwithotherchildren withRSVinfections.Reverse isolation
, PediatricNursing,ACase-BasedApproach,1stEditionByTagherKnapp
focusesonkeepingbacteriaawayfromtheinfant.WithRSV,otherchildrenneedtobeprotected
fromexposure to thevirus. Thevirus is not airborne.
3. Achildhasachroniccoughanddiffusewheezingduringtheexpiratoryphaseofrespiration.
Thissuggestswhatcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. ForeignbodyintracheaANS:A
Asthmamayhavethesechronicsignsandsymptoms.Pneumoniaappearswithanacute onset,fever,
andgeneralmalaise.Bronchiolitisisanacuteconditioncausedbyrespiratorysyncytial
virus.Foreignbodyinthetracheaoccurswithacuterespiratorydistressorfailureandmaybestridor.
4. Whichnursingdiagnosisismostappropriateforaninfantwithacutebronchiolitisdue
torespiratorysyncytialvirus(RSV)?
a. ActivityIntolerance
b. DecreasedCardiacOutput
c. Pain,Acute
d. TissuePerfusion,Ineffective(peripheral)ANS.A
Rationale1:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
demand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnot
usuallyassociatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythis
respiratory-diseaseprocess.
Rationale2:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
demand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnot
usuallyassociatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythis
respiratory-diseaseprocess.
, PediatricNursing,ACase-BasedApproach,1stEditionByTagherKnapp
Rationale3:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
demand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnot
usuallyassociatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythis
respiratory-diseaseprocess.
Rationale4:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
demand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnot
usuallyassociatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythis
respiratory-diseaseprocess.
GlobalRationale:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupply
anddemand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusually
associatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythisrespiratory-disease
process.
Chapter2:Asthma
1. Thenurseiscaringforachildhospitalizedforstatusasthmaticus.Whichassessment
findingsuggests thatthechilds conditionisworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. ClubbingANS:A
Thenursewouldassessthechildforsignsofhypoxia,includingrestlessness,fatigue,irritability,and increased
heartandrespiratoryrate.Asthechildtiresfromtheincreasedworkofbreathinghypoventilation occurs
leadingto increased carbondioxide levels. Thenursewouldbe alert forsignsof