Chapter 19. Respiratory Tract and Mediastinum
1. A nurse in the labor and delivery room is assessing respirations on a
newborn. The nurse understands that which change in the respiratory
system occurs postnatally?
a. Respirations are stimulated by hypoxemia.
b. It takes up to 48 hours for most of the alveoli to
expand. c. Surfactant in the lungs interferes with lung
expansion.
d. Pulmonary blood flow decreases after birth.
ANS: A
A postnatal change in the respiratory system is the stimulation of respiration by hypoxemia,
hypercarbia, cold, tactile stimulation, and a possible decrease in the concentration of
prostaglandin E2. Inflation of the normal lung is complete within a few breaths, and most
alveoli have expanded within the first hour of life. Surfactant in the lungs lowers surface
tension and facilitates lung expansion. Pulmonary blood flow increases after birth.
2. Which information should the nurse teach families about reducing exposure to pollens
and dust?
a. Replace wood and tile floors with wall-to-wall
carpeting. b. Do not use an air conditioner.
c. Put dust-proof covers on pillows and
mattresses. d. Keep humidity in the house above
60%.
ANS: C
Covering mattresses and pillows with dust-proof covers will reduce exposure to dust. Carpets
retain dust. To reduce exposure to dust, carpeting should be replaced with wood, tile, slate, or
,vinyl. These floors can be cleaned easily. For anyone with pollen allergies, it is best to keep
windows closed and to run the air conditioner. A humidity level above 60% promotes dust
mites. It is recommended that household humidity be kept between 40% and 50% to reduce
dust mites inside the house.
, 3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion
with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The
nurse recognizes these symptoms are characteristic of which respiratory condition?
a. Allergic 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 congestion and purulent nasal discharge, headache, tenderness, a
feeling of fullness over the affected sinuses, halitosis, and a cough 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 cough that is initially
nonproductive but may change to a loose cough. The manifestations of asthma may vary, with
wheezing being a classic sign. The symptoms presented in the question do not suggest asthma.
4. The child with chronic otitis media with effusion should be evaluated for which problem?
a. Brain abscess
b. Meningitis
c. Hearing loss
d. Perforation of the tympanic membrane
ANS: C
Chronic otitis media with effusion is the most common cause of hearing loss in children.
The infection of acute otitis media can spread to surrounding tissues, causing a brain abscess
or meningitis. Inflammation and pressure from acute otitis media may result in perforation
of the tympanic membrane.
1. A nurse in the labor and delivery room is assessing respirations on a
newborn. The nurse understands that which change in the respiratory
system occurs postnatally?
a. Respirations are stimulated by hypoxemia.
b. It takes up to 48 hours for most of the alveoli to
expand. c. Surfactant in the lungs interferes with lung
expansion.
d. Pulmonary blood flow decreases after birth.
ANS: A
A postnatal change in the respiratory system is the stimulation of respiration by hypoxemia,
hypercarbia, cold, tactile stimulation, and a possible decrease in the concentration of
prostaglandin E2. Inflation of the normal lung is complete within a few breaths, and most
alveoli have expanded within the first hour of life. Surfactant in the lungs lowers surface
tension and facilitates lung expansion. Pulmonary blood flow increases after birth.
2. Which information should the nurse teach families about reducing exposure to pollens
and dust?
a. Replace wood and tile floors with wall-to-wall
carpeting. b. Do not use an air conditioner.
c. Put dust-proof covers on pillows and
mattresses. d. Keep humidity in the house above
60%.
ANS: C
Covering mattresses and pillows with dust-proof covers will reduce exposure to dust. Carpets
retain dust. To reduce exposure to dust, carpeting should be replaced with wood, tile, slate, or
,vinyl. These floors can be cleaned easily. For anyone with pollen allergies, it is best to keep
windows closed and to run the air conditioner. A humidity level above 60% promotes dust
mites. It is recommended that household humidity be kept between 40% and 50% to reduce
dust mites inside the house.
, 3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion
with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The
nurse recognizes these symptoms are characteristic of which respiratory condition?
a. Allergic 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 congestion and purulent nasal discharge, headache, tenderness, a
feeling of fullness over the affected sinuses, halitosis, and a cough 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 cough that is initially
nonproductive but may change to a loose cough. The manifestations of asthma may vary, with
wheezing being a classic sign. The symptoms presented in the question do not suggest asthma.
4. The child with chronic otitis media with effusion should be evaluated for which problem?
a. Brain abscess
b. Meningitis
c. Hearing loss
d. Perforation of the tympanic membrane
ANS: C
Chronic otitis media with effusion is the most common cause of hearing loss in children.
The infection of acute otitis media can spread to surrounding tissues, causing a brain abscess
or meningitis. Inflammation and pressure from acute otitis media may result in perforation
of the tympanic membrane.
