TEST BANK
Pediatric Nursing- A Case-Based Approach
2nd Edition by Tagher Knapp
Chapters 1 - 34 | All Chapters
,Pediatric Nursing- A Case-Based Approach
, Pediatric Nursing- A Case-Based Approach
Chapter 1: Bronchiolitis
1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
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a. Position on the side with neck slightly flexed. e e e e e e e
b. Administer antibiotics as ordered. e e e
c. Restrict oral and parenteral fluids if tachypneic. e e e e e e
d. Givecool,humidifiedoxygen. e e e e
ANSWER: D e
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from
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tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree
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angle and the neck slightly extended to maintain an open airway and decrease pressure on the
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diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a secondary
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bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachypneic, fluids are
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given parenterally to prevent dehydration.
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2. An infant with bronchiolitis is hospitalized. The causative organism is respiratorysyncytial
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virus (RSV). The nurse knows that a child infected with this virus requires what type of
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isolation?
a. Reverse isolation e
b. Airborne isolation e
c. Contact Precautions e
d. StandardPrecautions e e
ANSWER: C e
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing, Contact
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Precautions are required. Caregivers must use gloves and gowns when entering the
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room. Care is taken not to touch their own eyes or mucous membranes with a contaminated gloved
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hand. Children are placed in a private room or in a room with other children with RSV infections.
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Reverse isolation focuses on keeping bacteria awayfrom the infant. With RSV, other children need to
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be protected from exposure to the virus. The virus is not airborne.
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3. A child has a chronic cough and diffuse wheezing during the expiratoryphase of respiration.
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This suggests what condition?
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a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignbodyintrachea e e e e
ANSWER: A e
Asthma mayhave these chronic signs and symptoms. Pneumonia appears with an acute onset,
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fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
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, Pediatric Nursing- A Case-Based Approach
virus. Foreign body in the trachea occurs with acute respiratorydistress or failure and maybe stridor.
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4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to
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respiratory syncytial virus (RSV)? e e e
a. Activity Intolerance e
b. Decreased Cardiac Output e e
c. Pain, Acute e
d. TissuePerfusion, Ineffective(peripheral)
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ANS. A e
Rationale 1: Activityintolerance is a problem because of the imbalance between oxygen supply and
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demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
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usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
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respiratory-disease process. e
Rationale 2: Activityintolerance is a problem because of the imbalance between oxygen supply and
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demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
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usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
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respiratory-disease process. e
Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply and
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demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
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usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
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respiratory-disease process. e
Rationale 4: Activityintolerance is a problem because of the imbalance between oxygen supply and
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demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
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usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
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respiratory-disease process. e
Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen supply
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and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
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usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
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respiratory-disease process. e
Chapter 2: Asthma e e
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding
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suggests that the childs condition is worsening?
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a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing