Test Bank For
Pediatric Nursing- A Case-Based
Approach 2nd Edition
By Catherine Gannon Tagher And Lisa
Marie Knapp (Chapters 1-8)
Chapter 1: Bronchiolitis
1. Which Intervention Is Appropriate For The Infant Hospitalized With Bronchiolitis?
A. Position On The Side With Neck Slightly Flexed.
B. Administer Antibiotics As Ordered.
C. Restrict Oral And Parenteral Fluids If Tachypneic.
D. Give Cool, Humidified Oxygen.
Answer: 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
Answer: 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
1|Page
,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
Answer: 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 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.
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,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 Child’s Condition Is Worsening?
A. Hypoventilation
B. Thirst
C. Bradycardia
D. Clubbing
Answer: A
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 Child’s 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 Child’s 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. Rhinorrhea
Answer: 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. Sinusitis
Answer: D
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, 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. Seizures
Answer: C
Exercise Is One Of The Most Common Triggers For Asthma Attacks, Particularly In School-Age
Children. Febrile Episodes Are Consistent With Other Problems, For Example, Seizures.
Dehydration Occurs As A Result Of Diarrhea; It Does Not Trigger Asthma Attacks. Viral
Infections Are Triggers For Asthma.
Seizures Can Result From A Too-Rapid Intravenous Infusion Of Theophyllinea Therapy For
Asthma.
5. The Practitioner Changes The Medications For The Child With Asthma To Salmeterol
(Serevent). The Mother Asks The Nurse What This Drug Will Do. The Nurse Explains That
Salmeterol (Serevent) Is Used To Treat Asthma Because The Drug Produces Which
Characteristic?
1. Decreases Inflammation
2. Decreases Mucous Production
3. Controls Allergic Rhinitis
4. Dilates The Bronchioles Correct Answer: 4
Rationale 1: Salmeterol (Serevent) Is A Long-Acting Beta2-Agonist That Acts By
Bronchodilating. Steroids Are Anti-Inflammatory, Anticholinergics Decrease Mucous
Production, And Antihistamines Control Allergic Rhinitis.
Rationale 2: Salmeterol (Serevent) Is A Long-Acting Beta2-Agonist That Acts By
Bronchodilating. Steroids Are Anti-Inflammatory, Anticholinergics Decrease Mucous
Production, And Antihistamines Control Allergic Rhinitis.
Rationale 3: Salmeterol (Serevent) Is A Long-Acting Beta2-Agonist That Acts By
Bronchodilating. Steroids Are Anti-Inflammatory, Anticholinergics Decrease Mucous
Production, And Antihistamines Control Allergic Rhinitis.
4|Page
Pediatric Nursing- A Case-Based
Approach 2nd Edition
By Catherine Gannon Tagher And Lisa
Marie Knapp (Chapters 1-8)
Chapter 1: Bronchiolitis
1. Which Intervention Is Appropriate For The Infant Hospitalized With Bronchiolitis?
A. Position On The Side With Neck Slightly Flexed.
B. Administer Antibiotics As Ordered.
C. Restrict Oral And Parenteral Fluids If Tachypneic.
D. Give Cool, Humidified Oxygen.
Answer: 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
Answer: 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
1|Page
,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
Answer: 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 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.
2|Page
,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 Child’s Condition Is Worsening?
A. Hypoventilation
B. Thirst
C. Bradycardia
D. Clubbing
Answer: A
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 Child’s 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 Child’s 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. Rhinorrhea
Answer: 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. Sinusitis
Answer: D
3|Page
, 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. Seizures
Answer: C
Exercise Is One Of The Most Common Triggers For Asthma Attacks, Particularly In School-Age
Children. Febrile Episodes Are Consistent With Other Problems, For Example, Seizures.
Dehydration Occurs As A Result Of Diarrhea; It Does Not Trigger Asthma Attacks. Viral
Infections Are Triggers For Asthma.
Seizures Can Result From A Too-Rapid Intravenous Infusion Of Theophyllinea Therapy For
Asthma.
5. The Practitioner Changes The Medications For The Child With Asthma To Salmeterol
(Serevent). The Mother Asks The Nurse What This Drug Will Do. The Nurse Explains That
Salmeterol (Serevent) Is Used To Treat Asthma Because The Drug Produces Which
Characteristic?
1. Decreases Inflammation
2. Decreases Mucous Production
3. Controls Allergic Rhinitis
4. Dilates The Bronchioles Correct Answer: 4
Rationale 1: Salmeterol (Serevent) Is A Long-Acting Beta2-Agonist That Acts By
Bronchodilating. Steroids Are Anti-Inflammatory, Anticholinergics Decrease Mucous
Production, And Antihistamines Control Allergic Rhinitis.
Rationale 2: Salmeterol (Serevent) Is A Long-Acting Beta2-Agonist That Acts By
Bronchodilating. Steroids Are Anti-Inflammatory, Anticholinergics Decrease Mucous
Production, And Antihistamines Control Allergic Rhinitis.
Rationale 3: Salmeterol (Serevent) Is A Long-Acting Beta2-Agonist That Acts By
Bronchodilating. Steroids Are Anti-Inflammatory, Anticholinergics Decrease Mucous
Production, And Antihistamines Control Allergic Rhinitis.
4|Page
