Test Bank For Pediatric Nursing- A Case-Based
Approach
2nd Edition by Tagher Knapp
Chapters 1 - 34 | A ll Chapters
*
,
,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,*humidifie
d*oxygen.*ANSWER:*D
Cool,*humidified*oxygen*is*given*to*relieve*dyspnea,*hypoxemia,*and*insensible*fluid*loss*from*t
achypnea.*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*seco
ndary*bacterial*infection.*Tachypnea*increases*insensible*fluid*loss.*If*the*infant*is*tachypneic,*flui
ds*are*given*parenterally*to*prevent*dehydration.
2. An*infant*with*bronchiolitis*is*hospitalized.*The*causative*organism*is*respiratory*sy
ncytial*virus*(RSV).*The*nurse*knows*that*a*child*infected*with*this*virus*requires*wha
t*type*of*isolation?
a. Reverse*isolation
b. Airborne*isolation
c. Contact* Precautions
d. Standard*Precaution
s*ANSWER:*C
RSV* is*transmitted* through* droplets.* In*addition*to*Standard* Precautions* and*hand* washing,*Co
ntact*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*ha
nd.*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*n
eed*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*respirati
on.*This*suggests*what*condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign*body*i
n*trachea*ANSWER:*A
Asthma*may*have*these* chronic*signs*and*symptoms.*Pneumonia*appears*with*an*acute*onset,*fev
er,*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*t
his*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* n
ot*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*t
his*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* n
ot*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* affect
ed*by*this*respiratory-disease*process.
Chapter*2:*Asthma
1. The*nurse*is*caring*for*a*child*hospitalized*for*status*asthmaticus.*Which*assessm
ent*finding*suggests*that*the*childs*condition*is*worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
Approach
2nd Edition by Tagher Knapp
Chapters 1 - 34 | A ll Chapters
*
,
,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,*humidifie
d*oxygen.*ANSWER:*D
Cool,*humidified*oxygen*is*given*to*relieve*dyspnea,*hypoxemia,*and*insensible*fluid*loss*from*t
achypnea.*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*seco
ndary*bacterial*infection.*Tachypnea*increases*insensible*fluid*loss.*If*the*infant*is*tachypneic,*flui
ds*are*given*parenterally*to*prevent*dehydration.
2. An*infant*with*bronchiolitis*is*hospitalized.*The*causative*organism*is*respiratory*sy
ncytial*virus*(RSV).*The*nurse*knows*that*a*child*infected*with*this*virus*requires*wha
t*type*of*isolation?
a. Reverse*isolation
b. Airborne*isolation
c. Contact* Precautions
d. Standard*Precaution
s*ANSWER:*C
RSV* is*transmitted* through* droplets.* In*addition*to*Standard* Precautions* and*hand* washing,*Co
ntact*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*ha
nd.*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*n
eed*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*respirati
on.*This*suggests*what*condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign*body*i
n*trachea*ANSWER:*A
Asthma*may*have*these* chronic*signs*and*symptoms.*Pneumonia*appears*with*an*acute*onset,*fev
er,*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*t
his*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* n
ot*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*t
his*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* n
ot*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* affect
ed*by*this*respiratory-disease*process.
Chapter*2:*Asthma
1. The*nurse*is*caring*for*a*child*hospitalized*for*status*asthmaticus.*Which*assessm
ent*finding*suggests*that*the*childs*condition*is*worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
