TEST BANK
Pediatric Nursing: A Case-Based Approach
DR. GANNON TAGHER, DR. LISA KNAPP
1st Edition
, 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 the 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 slightly extended to maintain an open airway and
decrease pressure on the diaphragm. The etiology of bronchiolitis is viral. Antibiotics
are given only if there is a secondary bacterial infection. Tachypnea increases
insensible fluid loss. If the infant is tachypneic, fluids are given 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 through 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 cough and diffuse wheezing during the expiratory phase of
respiration. This suggests what condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign 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
1|Pa
,virus. Foreign 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 suggests that the childs condition is worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbin
g ANS: A
2|Pa
, The nurse would assess the child for signs 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 sign 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 cough
c. Wheezing
d. Rhinorrhe
a ANS: C
Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
croup. A harsh, barky cough 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 cough that
increases during sleep. The nurse recognizes these symptoms are characteristic of
which respiratory condition?
a. Allergic rhinitis
b. Bronchitis
c. Asthma
d. Sinusiti
s 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. What is a common trigger for asthma attacks in children?
a. Febrile episodes
b. Dehydration
c. Exercise
d. Seizure
s ANS: C
3|Pa
Pediatric Nursing: A Case-Based Approach
DR. GANNON TAGHER, DR. LISA KNAPP
1st Edition
, 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 the 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 slightly extended to maintain an open airway and
decrease pressure on the diaphragm. The etiology of bronchiolitis is viral. Antibiotics
are given only if there is a secondary bacterial infection. Tachypnea increases
insensible fluid loss. If the infant is tachypneic, fluids are given 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 through 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 cough and diffuse wheezing during the expiratory phase of
respiration. This suggests what condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign 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
1|Pa
,virus. Foreign 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 suggests that the childs condition is worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbin
g ANS: A
2|Pa
, The nurse would assess the child for signs 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 sign 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 cough
c. Wheezing
d. Rhinorrhe
a ANS: C
Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
croup. A harsh, barky cough 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 cough that
increases during sleep. The nurse recognizes these symptoms are characteristic of
which respiratory condition?
a. Allergic rhinitis
b. Bronchitis
c. Asthma
d. Sinusiti
s 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. What is a common trigger for asthma attacks in children?
a. Febrile episodes
b. Dehydration
c. Exercise
d. Seizure
s ANS: C
3|Pa
