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Hesi Asthma Case Study with Answers 2025

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Hesi Asthma Case Study

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lOMoARcPSD|14985576




Asthma


Question 1 of 26
Which of the school nurse’s observations are consistent with the diagnosis of
bronchitis?
A dry cough that becomes productive.

Rationale: Bronchitis is characterized by a dry hacking cough that becomes productive
over 2-3 days

Reference: Hockenberry, M., & Wilson, D. (2015). Wong's nursing care of infants and
children (10th ed., p. 1188). Elsevier, St. Louis: MO.
A dry, hacking cough that becomes productive in 2 to 3 days is characteristic of
bronchitis. The cough associated with asthma is nonproductive.

The absence of fever or sore throat.
Bronchitis is typically caused by a virus and is accompanied by a low grade fever and a
sore throat. Fever is not associated with asthma.
Exercise intolerance.
Bronchitis resolves in 5 to 10 days and chronic exercise intolerance is not a feature. It is
a feature of poorly-controlled asthma.
Response to β2-agonists.
As a viral illness, bronchitis responds to symptomatic treatment: antipyretics,
analgesics, and humidity. In young children, response to β2-agonists is often used as a
diagnostic tool for asthma.
Question 2 of 26
The child's caregiver asks the school nurse to explain the pulmonary function test.
Which of the following information is accurate?
Pulmonary function tests are only accurate in children ages 8 and older who can
blow a big breath out.
Although a large exhalation is required to perform the test, children as young as age 5
are able to perform pulmonary function tests. Interpretation is adjusted based on
gender, age, and height.
While helpful, pulmonary functions tests are an expensive alternative to careful
history and physical assessment.
Pulmonary functions tests are the most objective measure for the diagnosis of asthma.
Pulmonary function tests are used to detect airflow limitation even when no
symptoms are clinically evident.

Rationale: Pulmonary function tests provide an objective method of evaluating the
presence and degree of lung disease and response to therapy.

, lOMoARcPSD|14985576




Wilson, D., Hockenberry, M. (2019). Wong's nursing care of infants and children (11th
ed., p. 924). St. Louis, MO: Elsevier.
Symptoms in children with asthma are typically seasonal or nocturnal and are often not
evident on physical examination. Pulmonary function tests are able used to detect
effects of airway inflammation that may otherwise be undetectable.
Pulmonary function tests are of use at the time of diagnosis so the client will need no
further testing.
Pulmonary function tests are performed periodically to assess response to treatment or
to determine the need to change therapy.
Question 3 of 26
The child fails to adhere to the proper administration of his asthma medication and
experiences symptoms of moderate persistent asthma. Based on the Asthma
Classification in Children which symptoms would be expected to occur?
Continual symptoms throughout the day.
Continual symptoms are an indication of severe persistent asthma.

Wilson, D., Hockenberry, M. (2019). Wong's nursing care of infants and children (11th
ed., p. 929). St. Louis, MO, Elsevier.
Nighttime cough more than once a week but not nightly.

Wilson, D., Hockenberry, M. (2019). Wong's nursing care of infants and children (11th
ed., p. 929). St. Louis, MO, Elsevier.
Nocturnal cough more than once a week is a feature of moderate, persistent asthma as
are daily symptoms and interference with physical activity.

A common symptom of asthma is coughing in the absence of a respiratory tract
infection, especially at night.

Wilson, D., Hockenberry, M. (2019). Wong's Nursing Care of Infants and Children. (11th
ed.) St. Louis, MO, Elsevier Inc., p. 929.
Symptoms more than two times a week, but less than one time a day
This describes mild persistent asthma.

Wilson, D., Hockenberry, M. (2019). Wong's nursing care of infants and children (11th
ed., p. 929). St. Louis, MO, Elsevier.
Symptoms less than 2 days a week and does not interfere with activity.
This describes intermittent asthma.

Wilson, D., Hockenberry, M. (2019). Wong's nursing care of infants and children (11th
ed., p. 929). St. Louis, MO, Elsevier.
Question 4 of 26
In developing plan of care goals, the school nurse recognizes what level of activity is
appropriate for children with asthma?
Sports involving running are contraindicated because of the potential for airway
constriction.

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