NUR 1020 vSim Brittany Long:
Comprehensive Exam with correct
answers and rationale updated 2026
graded A+
Section 1: Initial Assessment & Triage (Questions 1-20)
1. Upon entering the room of Brittany Long, a 10-year-old with suspected asthma exacerbation,
what is the priority nursing assessment?
A. Auscultating bowel sounds
B. Checking capillary refill
C. Assessing respiratory rate and effort
D. Asking about allergy history
Answer: C
Rationale: Airway and breathing are the priority (ABCs). Assessing respiratory rate and effort
determines the severity of the exacerbation immediately.
2. Brittany is using accessory muscles to breathe. What does this indicate?
A. Mild respiratory distress
B. Moderate to severe respiratory distress
C. Normal breathing pattern for a child
D. Improvement in condition
Answer: B
Rationale: Use of accessory muscles (neck, intercostal) indicates increased work of breathing and
moderate to severe distress.
3. Which position is most appropriate for Brittany during respiratory distress?
A. Supine
B. Prone
,C. High Fowler's
D. Trendelenburg
Answer: C
Rationale: High Fowler's position maximizes lung expansion and eases the work of breathing.
4. When measuring oxygen saturation (SpO2) on a pediatric patient, where is the best placement for
the probe?
A. Earlobe
B. Toe
C. Finger
D. Forehead
Answer: C
Rationale: The finger is the standard site for pediatric patients unless perfusion is poor, in which case
a toe or earlobe may be used.
5. Brittany's SpO2 is 88% on room air. What is the immediate nursing action?
A. Document the finding
B. Administer oxygen as prescribed
C. Encourage deep breathing
D. Recheck in 30 minutes
Answer: B
Rationale: An SpO2 below 92% in a pediatric patient requires immediate oxygen supplementation to
prevent hypoxia.
6. Which sound would you expect to hear upon auscultation during an asthma exacerbation?
A. Crackles
B. Stridor
C. Wheezing
D. Pleural friction rub
Answer: C
Rationale: Wheezing is the hallmark sound of asthma, caused by air moving through narrowed
airways.
, 7. If wheezing disappears suddenly in a severe asthma patient, what might this indicate?
A. The patient is sleeping
B. Airflow has ceased (Silent Chest)
C. The medication worked instantly
D. The lungs are clear
Answer: B
Rationale: A "silent chest" indicates severe obstruction where not enough air is moving to create
sound; this is a medical emergency.
8. What is the normal respiratory rate range for a 10-year-old child?
A. 10-15 breaths/min
B. 18-30 breaths/min
C. 30-40 breaths/min
D. 40-50 breaths/min
Answer: B
Rationale: The expected respiratory rate for a school-age child (6-12 years) is approximately 18-30
breaths per minute.
9. Brittany reports a "tight feeling" in her chest. How should the nurse document this?
A. Chest pain
B. Chest tightness
C. Angina
D. Dyspnea
Answer: B
Rationale: Documenting the patient's exact words ("chest tightness") is accurate for asthma
symptoms.
10. Which vital sign is most critical to monitor continuously during an acute asthma attack?
A. Blood Pressure
B. Temperature
C. Oxygen Saturation
Comprehensive Exam with correct
answers and rationale updated 2026
graded A+
Section 1: Initial Assessment & Triage (Questions 1-20)
1. Upon entering the room of Brittany Long, a 10-year-old with suspected asthma exacerbation,
what is the priority nursing assessment?
A. Auscultating bowel sounds
B. Checking capillary refill
C. Assessing respiratory rate and effort
D. Asking about allergy history
Answer: C
Rationale: Airway and breathing are the priority (ABCs). Assessing respiratory rate and effort
determines the severity of the exacerbation immediately.
2. Brittany is using accessory muscles to breathe. What does this indicate?
A. Mild respiratory distress
B. Moderate to severe respiratory distress
C. Normal breathing pattern for a child
D. Improvement in condition
Answer: B
Rationale: Use of accessory muscles (neck, intercostal) indicates increased work of breathing and
moderate to severe distress.
3. Which position is most appropriate for Brittany during respiratory distress?
A. Supine
B. Prone
,C. High Fowler's
D. Trendelenburg
Answer: C
Rationale: High Fowler's position maximizes lung expansion and eases the work of breathing.
4. When measuring oxygen saturation (SpO2) on a pediatric patient, where is the best placement for
the probe?
A. Earlobe
B. Toe
C. Finger
D. Forehead
Answer: C
Rationale: The finger is the standard site for pediatric patients unless perfusion is poor, in which case
a toe or earlobe may be used.
5. Brittany's SpO2 is 88% on room air. What is the immediate nursing action?
A. Document the finding
B. Administer oxygen as prescribed
C. Encourage deep breathing
D. Recheck in 30 minutes
Answer: B
Rationale: An SpO2 below 92% in a pediatric patient requires immediate oxygen supplementation to
prevent hypoxia.
6. Which sound would you expect to hear upon auscultation during an asthma exacerbation?
A. Crackles
B. Stridor
C. Wheezing
D. Pleural friction rub
Answer: C
Rationale: Wheezing is the hallmark sound of asthma, caused by air moving through narrowed
airways.
, 7. If wheezing disappears suddenly in a severe asthma patient, what might this indicate?
A. The patient is sleeping
B. Airflow has ceased (Silent Chest)
C. The medication worked instantly
D. The lungs are clear
Answer: B
Rationale: A "silent chest" indicates severe obstruction where not enough air is moving to create
sound; this is a medical emergency.
8. What is the normal respiratory rate range for a 10-year-old child?
A. 10-15 breaths/min
B. 18-30 breaths/min
C. 30-40 breaths/min
D. 40-50 breaths/min
Answer: B
Rationale: The expected respiratory rate for a school-age child (6-12 years) is approximately 18-30
breaths per minute.
9. Brittany reports a "tight feeling" in her chest. How should the nurse document this?
A. Chest pain
B. Chest tightness
C. Angina
D. Dyspnea
Answer: B
Rationale: Documenting the patient's exact words ("chest tightness") is accurate for asthma
symptoms.
10. Which vital sign is most critical to monitor continuously during an acute asthma attack?
A. Blood Pressure
B. Temperature
C. Oxygen Saturation
