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 slig htly
̣ extended to maintain an open airway and decrease pressure on the
̣ The etiologỵ of bronchiolitis is viral. Antibiotics are given
diaphragm. ̣ only if there is a
secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is
tachypneic, fluids are giveṇ 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 througḥ 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 cougḥ and diffuse wheezing ̣ during ̣ the expiratory phase of respiration.
This sugg̣ ests
̣ what condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreigṇ 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. Foreigṇ 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 nurse is caring ̣ for a child hospitalized for status asthmaticus. Which assessment finding ̣
sugg̣ ests
̣ that the childs condition is worsening?̣
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing ̣
ANS: A
,The nurse would assess the child for signṣ of hypoxia, including ̣ restlessness, fatigue,
̣ irritability,
and increased heart and respiratory rate. As the child tires from the increased work of breathing ̣
hypoventilation occurs leading ̣ to increased carbon dioxide levels. The nurse would be alert for
signs
̣ of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sigṇ of
hypoxia; tachycardia is. Clubbing ̣ develops over a period of months in response to hypoxia. The
presence of clubbing ̣ does not indicate the childs condition is worsening.̣
2. Which finding ̣ is expected when assessing ̣ a child hospitalized for asthma?
a. Inspiratory stridor
b. Harsh, barky cougḥ
c. Wheezing ̣
d. Rhinorrhea
ANS: C
Wheezing ̣ is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
croup. A harsh, barky cougḥ is characteristic of croup. Rhinorrhea is not associated with asthma.
3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion ̣ with
purulent nasal drainage,̣ facial tenderness, and a coug h
̣ that increases during ̣ sleep. The nurse
recognizes
̣ these symptoms are characteristic of which respiratory condition?
a. Allergic̣ rhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
ANS: D
Sinusitis is characterized by signs ̣ and symptoms of a cold that do not improve after 14 days, a
low-grade
̣ fever, nasal cong estion
̣ and purulent nasal discharge, ̣ headache, tenderness, a feeling ̣
of fullness over the affected sinuses, halitosis, and a cougḥ that increases when the child is lying ̣
down. The classic symptoms of allergic ̣ rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and
palate, and sneezing.̣ Symptoms occur as long ̣ as the child is exposed to the allergen. ̣ Bronchitis
is characterized by a gradual
̣ onset of rhinitis and a coug h
̣ that is initially nonproductive but may
changẹ to a loose cough. ̣ The manifestations of asthma may vary, with wheezing ̣ being ̣ classic
a
̣ The symptoms presented in the question do not sugg̣ est
sign. ̣ asthma.
4. What is a common trigg̣ er ̣ for asthma attacks in children?
a. Febrile episodes
b. Dehydration
c. Exercise
d. Seizures
ANS: C
, Exercise is one of the most common trigg̣ erṣ for asthma attacks, particularly in school-agẹ
children. Febrile episodes are consistent with other problems, for example, seizures. Dehydration
occurs as a result of diarrhea; it does not trigg̣ er
̣ asthma attacks. Viral infections are trigg̣ ers
̣ for
asthma. Seizures can result from a too-rapid intravenous infusion of theophyllinea therapy for
asthma.
5. The practitioner changes
̣ the medications for the child with asthma to salmeterol (Serevent).
The mother asks the nurse what this drug ̣ will do. The nurse explains that salmeterol (Serevent)
is used to treat asthma because the drug ̣ produces which characteristic?
1. Decreases inflammation
2. Decreases mucous production
3. Controls allergic ̣ rhinitis
4. Dilates the bronchioles
Correct Answer: 4
Rationale 1: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic
̣ rhinitis.
Rationale 2: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic ̣ rhinitis.
Rationale 3: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic ̣ rhinitis.
Rationale 4: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic ̣ rhinitis.
Global Rationale: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by
bronchodilating.̣ Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production,
and antihistamines control allergic ̣ rhinitis.
Cognitive
̣ Level: Analyzing ̣
Client Need: Physiological ̣ Integrity
̣
Client Need Sub: Pharmacological ̣ and Parenteral Therapies
Nursing/Integ
̣ rated
̣ Concepts: Nursing ̣ Process: Implementation
Learning ̣ Outcome: LO 20.6 Create a nursing ̣ care plan for a child with a common acute
respiratory condition.
6. Following ̣ parental teaching,̣ the nurse is evaluating ̣ the parents understanding ̣ of
environmental control for their childs asthma management.
̣ Which statement by the parents
indicates appropriate understanding ̣ of the teaching?̣
1. We will replace the carpet in our childs bedroom with tile.
2. Were glad
̣ the dog ̣ can continue to sleep in our childs room.
3. Well be sure to use the fireplace often to keep the house warm in the winter.
4. Well keep the plants in our childs room dusted.
Correct Answer: 1
̣ 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 slig htly
̣ extended to maintain an open airway and decrease pressure on the
̣ The etiologỵ of bronchiolitis is viral. Antibiotics are given
diaphragm. ̣ only if there is a
secondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is
tachypneic, fluids are giveṇ 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 througḥ 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 cougḥ and diffuse wheezing ̣ during ̣ the expiratory phase of respiration.
This sugg̣ ests
̣ what condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreigṇ 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. Foreigṇ 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 nurse is caring ̣ for a child hospitalized for status asthmaticus. Which assessment finding ̣
sugg̣ ests
̣ that the childs condition is worsening?̣
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing ̣
ANS: A
,The nurse would assess the child for signṣ of hypoxia, including ̣ restlessness, fatigue,
̣ irritability,
and increased heart and respiratory rate. As the child tires from the increased work of breathing ̣
hypoventilation occurs leading ̣ to increased carbon dioxide levels. The nurse would be alert for
signs
̣ of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sigṇ of
hypoxia; tachycardia is. Clubbing ̣ develops over a period of months in response to hypoxia. The
presence of clubbing ̣ does not indicate the childs condition is worsening.̣
2. Which finding ̣ is expected when assessing ̣ a child hospitalized for asthma?
a. Inspiratory stridor
b. Harsh, barky cougḥ
c. Wheezing ̣
d. Rhinorrhea
ANS: C
Wheezing ̣ is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
croup. A harsh, barky cougḥ is characteristic of croup. Rhinorrhea is not associated with asthma.
3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion ̣ with
purulent nasal drainage,̣ facial tenderness, and a coug h
̣ that increases during ̣ sleep. The nurse
recognizes
̣ these symptoms are characteristic of which respiratory condition?
a. Allergic̣ rhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
ANS: D
Sinusitis is characterized by signs ̣ and symptoms of a cold that do not improve after 14 days, a
low-grade
̣ fever, nasal cong estion
̣ and purulent nasal discharge, ̣ headache, tenderness, a feeling ̣
of fullness over the affected sinuses, halitosis, and a cougḥ that increases when the child is lying ̣
down. The classic symptoms of allergic ̣ rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and
palate, and sneezing.̣ Symptoms occur as long ̣ as the child is exposed to the allergen. ̣ Bronchitis
is characterized by a gradual
̣ onset of rhinitis and a coug h
̣ that is initially nonproductive but may
changẹ to a loose cough. ̣ The manifestations of asthma may vary, with wheezing ̣ being ̣ classic
a
̣ The symptoms presented in the question do not sugg̣ est
sign. ̣ asthma.
4. What is a common trigg̣ er ̣ for asthma attacks in children?
a. Febrile episodes
b. Dehydration
c. Exercise
d. Seizures
ANS: C
, Exercise is one of the most common trigg̣ erṣ for asthma attacks, particularly in school-agẹ
children. Febrile episodes are consistent with other problems, for example, seizures. Dehydration
occurs as a result of diarrhea; it does not trigg̣ er
̣ asthma attacks. Viral infections are trigg̣ ers
̣ for
asthma. Seizures can result from a too-rapid intravenous infusion of theophyllinea therapy for
asthma.
5. The practitioner changes
̣ the medications for the child with asthma to salmeterol (Serevent).
The mother asks the nurse what this drug ̣ will do. The nurse explains that salmeterol (Serevent)
is used to treat asthma because the drug ̣ produces which characteristic?
1. Decreases inflammation
2. Decreases mucous production
3. Controls allergic ̣ rhinitis
4. Dilates the bronchioles
Correct Answer: 4
Rationale 1: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic
̣ rhinitis.
Rationale 2: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic ̣ rhinitis.
Rationale 3: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic ̣ rhinitis.
Rationale 4: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by bronchodilating.̣
Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production, and antihistamines
control allergic ̣ rhinitis.
Global Rationale: Salmeterol (Serevent) is a long-acting ̣ ̣ beta2-agonist ̣ that acts by
bronchodilating.̣ Steroids are anti-inflammatory, anticholinergics ̣ decrease mucous production,
and antihistamines control allergic ̣ rhinitis.
Cognitive
̣ Level: Analyzing ̣
Client Need: Physiological ̣ Integrity
̣
Client Need Sub: Pharmacological ̣ and Parenteral Therapies
Nursing/Integ
̣ rated
̣ Concepts: Nursing ̣ Process: Implementation
Learning ̣ Outcome: LO 20.6 Create a nursing ̣ care plan for a child with a common acute
respiratory condition.
6. Following ̣ parental teaching,̣ the nurse is evaluating ̣ the parents understanding ̣ of
environmental control for their childs asthma management.
̣ Which statement by the parents
indicates appropriate understanding ̣ of the teaching?̣
1. We will replace the carpet in our childs bedroom with tile.
2. Were glad
̣ the dog ̣ can continue to sleep in our childs room.
3. Well be sure to use the fireplace often to keep the house warm in the winter.
4. Well keep the plants in our childs room dusted.
Correct Answer: 1
