Pediatric Nursing-A Case-
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Test Bank: Pediatric Nursing-A Case-Based Approach 1st Edition Tagher Knapp
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Chapterg1:g Bronchiolitis
1. Whichginterventiongisgappropriategforgtheginfantghospitalizedgwithgbronchiolitis?
a. Positiongongthegsidegwithgneckgslightlygflexed.
b. Administergantibioticsgasgordered.
c. Restrictgoralgandgparenteralgfluidsgifgtachypneic.
d. Givegcool,ghumidifiedgoxygen.g
ANS:gD
Cool,ghumidifiedgoxygengisggivengtogrelievegdyspnea,ghypoxemia,gandginsensiblegfluidglossgfrom
tachypnea.gTheginfantgshouldgbegpositionedgwithgthegheadgandgchestgelevatedgatgag30-gtog40-
degreeganglegandgthegneckgslightlygextendedgtogmaintaingangopengairwaygandgdecreasegpressuregongt
hegdiaphragm.gThegetiologygofgbronchiolitisg isgviral.gAntibioticsgareggivengonlygifgtheregisgagseconda
rygbacterialginfection.gTachypneagincreasesginsensiblegfluidgloss.gIfgtheginfantgisgtachypneic,gfluidsga
reggivengparenterallygtogpreventgdehydration.
2. Anginfantgwithgbronchiolitisgisghospitalized.gThegcausativegorganismgisgrespiratorygsyncytialgv
irusg(RSV).gThegnursegknowsgthatgagchildginfectedgwithgthisgvirusgrequiresgwhatgtypegof
isolation?
a. Reversegisolation
b. Airbornegisolation
c. ContactgPrecautions
d. StandardgPrecautionsg
ANS:gC
RSVgisgtransmittedgthroughgdroplets.gIngadditiongtogStandardgPrecautionsgandghandgwashing,
ContactgPrecautionsgaregrequired.gCaregiversgmustgusegglovesgandggownsgwhengenteringgthegroom
.gCaregisgtakengnotgtogtouchgtheirgowngeyesgorgmucousgmembranesgwithgagcontaminatedgglovedghan
d.gChildrengaregplacedgingagprivategroomgorgingagroomgwithgothergchildrengwithgRSVginfections.gRe
versegisolationgfocusesgongkeepinggbacteriagawaygfromgtheginfant.gWithgRSV,gothergchildrengneedgt
ogbegprotectedgfromgexposuregtogthegvirus.gThegvirusgisgnotgairborne.
3. Agchildghasgagchronicgcoughgandgdiffusegwheezinggduringgthegexpiratorygphasegofgrespiration.
Thisgsuggestsgwhatgcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreigngbodygingtracheag
ANS:gA
Asthmagmayghavegthesegchronicgsignsgandgsymptoms.gPneumoniagappearsgwithgangacutegonset,
fever,gandggeneralgmalaise.gBronchiolitisgisgangacutegconditiongcausedgbygrespiratorygsyncytial
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virus.gForeigngbodygingthegtracheagoccursgwithgacutegrespiratorygdistressgorgfailuregandgmaybegst
ridor.
4. Whichgnursinggdiagnosisgisgmostgappropriategforganginfantgwithgacutegbronchiolitisgduegtogr
espiratorygsyncytialgvirusg(RSV)?
a. ActivitygIntolerance
b. DecreasedgCardiacgOutput
c. Pain,gAcute
d. TissuegPerfusion,gIneffectiveg(peripheral)g
ANS.gA
Rationaleg1:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnot
gusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgr
espiratory-diseasegprocess.
Rationaleg2:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnot
gusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgr
espiratory-diseasegprocess.
Rationaleg3:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnotg
usuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgre
spiratory-diseasegprocess.
Rationaleg4:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnot
gusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgr
espiratory-diseasegprocess.
GlobalgRationale:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsu
pplygandgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaing
isgnotgusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbyg
thisgrespiratory-diseasegprocess.
Chapterg2:gAsthma
1. Thegnursegisgcaringgforgagchildghospitalizedgforgstatusgasthmaticus.gWhichgassessmentgfindinggs
uggestsgthatgthegchildsgconditiongisgworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbingg
ANS:gA
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Thegnursegwouldgassessgthegchildgforgsignsgofghypoxia,gincludinggrestlessness,gfatigue,girritability,ga
ndgincreasedgheartgandgrespiratorygrate.gAsgthegchildgtiresgfromgthegincreasedgworkgofgbreathingghy
poventilationgoccursgleadinggtogincreasedgcarbongdioxideglevels.gThegnursegwouldgbegalertgforgsign
sgofghypoxia.gThirstgwouldgreflectgthegchildsghydrationgstatus.gBradycardiagisgnotgagsigngofghypoxia
;gtachycardiagis.gClubbinggdevelopsgovergagperiodgofgmonthsgingresponsegtoghypoxia.gThegpresenceg
ofgclubbinggdoesgnotgindicategthegchildsgconditiongisgworsening.
2. Whichgfindinggisgexpectedgwhengassessinggagchildghospitalizedgforgasthma?
a. Inspiratorygstridor
b. Harsh,gbarkygcough
c. Wheezing
d. Rhinorrheag
ANS:gC
Wheezinggisgagclassicgmanifestationgofgasthma.gInspiratorygstridorgisgagclinicalgmanifestationgof
croup.gAgharsh,gbarkygcoughgisgcharacteristicgofgcroup.gRhinorrheagisgnotgassociatedgwithgasthma.
3. Agchildghasghadgcoldgsymptomsgforgmoregthang2gweeks,gagheadache,gnasalgcongestiongwithgp
urulentgnasalgdrainage,gfacialgtenderness,gandgagcoughgthatgincreasesgduringgsleep.gThegnursegre
cognizesgthesegsymptomsgaregcharacteristicgofgwhichgrespiratorygcondition?
a. Allergicgrhinitis
b. Bronchitis
c. Asthma
d. Sinusitisg
ANS:gD
Sinusitisgisgcharacterizedgbygsignsgandgsymptomsgofgagcoldgthatgdognotgimprovegafterg14gdays,ga
low-
gradegfever,gnasalgcongestiongandgpurulentgnasalgdischarge,gheadache,gtenderness,gagfeelinggofgfull
nessgovergthegaffectedgsinuses,ghalitosis,gandgagcoughgthatgincreasesgwhengthegchildgisglyinggdown.gT
hegclassicgsymptomsgofgallergicgrhinitisgaregwaterygrhinorrhea,gitchygnose,geyes,gears,gandgpalate,gan
dgsneezing.gSymptomsgoccurgasglonggasgthegchildgisgexposedgtogthegallergen.gBronchitisgisgcharacter
izedgbygaggradualgonsetgofgrhinitisgandgagcoughgthatgisginitiallygnonproductivegbutgmaygchangegtogagl
oosegcough.gThegmanifestationsgofgasthmagmaygvary,gwithgwheezinggbeinggagclassicgsign.gThegsym
ptomsgpresentedgingthegquestiongdognotgsuggestgasthma.
4. Whatgisgagcommongtriggergforgasthmagattacksgingchildren?
a. Febrilegepisodes
b. Dehydration
c. Exercise
d. Seizuresg
ANS:gC
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Test Bank: Pediatric Nursing-A Case-Based Approach 1st Edition Tagher Knapp
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Chapterg1:g Bronchiolitis
1. Whichginterventiongisgappropriategforgtheginfantghospitalizedgwithgbronchiolitis?
a. Positiongongthegsidegwithgneckgslightlygflexed.
b. Administergantibioticsgasgordered.
c. Restrictgoralgandgparenteralgfluidsgifgtachypneic.
d. Givegcool,ghumidifiedgoxygen.g
ANS:gD
Cool,ghumidifiedgoxygengisggivengtogrelievegdyspnea,ghypoxemia,gandginsensiblegfluidglossgfrom
tachypnea.gTheginfantgshouldgbegpositionedgwithgthegheadgandgchestgelevatedgatgag30-gtog40-
degreeganglegandgthegneckgslightlygextendedgtogmaintaingangopengairwaygandgdecreasegpressuregongt
hegdiaphragm.gThegetiologygofgbronchiolitisg isgviral.gAntibioticsgareggivengonlygifgtheregisgagseconda
rygbacterialginfection.gTachypneagincreasesginsensiblegfluidgloss.gIfgtheginfantgisgtachypneic,gfluidsga
reggivengparenterallygtogpreventgdehydration.
2. Anginfantgwithgbronchiolitisgisghospitalized.gThegcausativegorganismgisgrespiratorygsyncytialgv
irusg(RSV).gThegnursegknowsgthatgagchildginfectedgwithgthisgvirusgrequiresgwhatgtypegof
isolation?
a. Reversegisolation
b. Airbornegisolation
c. ContactgPrecautions
d. StandardgPrecautionsg
ANS:gC
RSVgisgtransmittedgthroughgdroplets.gIngadditiongtogStandardgPrecautionsgandghandgwashing,
ContactgPrecautionsgaregrequired.gCaregiversgmustgusegglovesgandggownsgwhengenteringgthegroom
.gCaregisgtakengnotgtogtouchgtheirgowngeyesgorgmucousgmembranesgwithgagcontaminatedgglovedghan
d.gChildrengaregplacedgingagprivategroomgorgingagroomgwithgothergchildrengwithgRSVginfections.gRe
versegisolationgfocusesgongkeepinggbacteriagawaygfromgtheginfant.gWithgRSV,gothergchildrengneedgt
ogbegprotectedgfromgexposuregtogthegvirus.gThegvirusgisgnotgairborne.
3. Agchildghasgagchronicgcoughgandgdiffusegwheezinggduringgthegexpiratorygphasegofgrespiration.
Thisgsuggestsgwhatgcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreigngbodygingtracheag
ANS:gA
Asthmagmayghavegthesegchronicgsignsgandgsymptoms.gPneumoniagappearsgwithgangacutegonset,
fever,gandggeneralgmalaise.gBronchiolitisgisgangacutegconditiongcausedgbygrespiratorygsyncytial
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virus.gForeigngbodygingthegtracheagoccursgwithgacutegrespiratorygdistressgorgfailuregandgmaybegst
ridor.
4. Whichgnursinggdiagnosisgisgmostgappropriategforganginfantgwithgacutegbronchiolitisgduegtogr
espiratorygsyncytialgvirusg(RSV)?
a. ActivitygIntolerance
b. DecreasedgCardiacgOutput
c. Pain,gAcute
d. TissuegPerfusion,gIneffectiveg(peripheral)g
ANS.gA
Rationaleg1:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnot
gusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgr
espiratory-diseasegprocess.
Rationaleg2:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnot
gusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgr
espiratory-diseasegprocess.
Rationaleg3:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnotg
usuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgre
spiratory-diseasegprocess.
Rationaleg4:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplyga
ndgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnot
gusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgr
espiratory-diseasegprocess.
GlobalgRationale:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsu
pplygandgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaing
isgnotgusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbyg
thisgrespiratory-diseasegprocess.
Chapterg2:gAsthma
1. Thegnursegisgcaringgforgagchildghospitalizedgforgstatusgasthmaticus.gWhichgassessmentgfindinggs
uggestsgthatgthegchildsgconditiongisgworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbingg
ANS:gA
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Thegnursegwouldgassessgthegchildgforgsignsgofghypoxia,gincludinggrestlessness,gfatigue,girritability,ga
ndgincreasedgheartgandgrespiratorygrate.gAsgthegchildgtiresgfromgthegincreasedgworkgofgbreathingghy
poventilationgoccursgleadinggtogincreasedgcarbongdioxideglevels.gThegnursegwouldgbegalertgforgsign
sgofghypoxia.gThirstgwouldgreflectgthegchildsghydrationgstatus.gBradycardiagisgnotgagsigngofghypoxia
;gtachycardiagis.gClubbinggdevelopsgovergagperiodgofgmonthsgingresponsegtoghypoxia.gThegpresenceg
ofgclubbinggdoesgnotgindicategthegchildsgconditiongisgworsening.
2. Whichgfindinggisgexpectedgwhengassessinggagchildghospitalizedgforgasthma?
a. Inspiratorygstridor
b. Harsh,gbarkygcough
c. Wheezing
d. Rhinorrheag
ANS:gC
Wheezinggisgagclassicgmanifestationgofgasthma.gInspiratorygstridorgisgagclinicalgmanifestationgof
croup.gAgharsh,gbarkygcoughgisgcharacteristicgofgcroup.gRhinorrheagisgnotgassociatedgwithgasthma.
3. Agchildghasghadgcoldgsymptomsgforgmoregthang2gweeks,gagheadache,gnasalgcongestiongwithgp
urulentgnasalgdrainage,gfacialgtenderness,gandgagcoughgthatgincreasesgduringgsleep.gThegnursegre
cognizesgthesegsymptomsgaregcharacteristicgofgwhichgrespiratorygcondition?
a. Allergicgrhinitis
b. Bronchitis
c. Asthma
d. Sinusitisg
ANS:gD
Sinusitisgisgcharacterizedgbygsignsgandgsymptomsgofgagcoldgthatgdognotgimprovegafterg14gdays,ga
low-
gradegfever,gnasalgcongestiongandgpurulentgnasalgdischarge,gheadache,gtenderness,gagfeelinggofgfull
nessgovergthegaffectedgsinuses,ghalitosis,gandgagcoughgthatgincreasesgwhengthegchildgisglyinggdown.gT
hegclassicgsymptomsgofgallergicgrhinitisgaregwaterygrhinorrhea,gitchygnose,geyes,gears,gandgpalate,gan
dgsneezing.gSymptomsgoccurgasglonggasgthegchildgisgexposedgtogthegallergen.gBronchitisgisgcharacter
izedgbygaggradualgonsetgofgrhinitisgandgagcoughgthatgisginitiallygnonproductivegbutgmaygchangegtogagl
oosegcough.gThegmanifestationsgofgasthmagmaygvary,gwithgwheezinggbeinggagclassicgsign.gThegsym
ptomsgpresentedgingthegquestiongdognotgsuggestgasthma.
4. Whatgisgagcommongtriggergforgasthmagattacksgingchildren?
a. Febrilegepisodes
b. Dehydration
c. Exercise
d. Seizuresg
ANS:gC
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