Pediatric Respiratory: Practice Test 2 (Units 8-13) - Questions
with Correct Answers
100 questions
1. Before stepping up asthma therapy for poor control, the nurse should first check:
A. The child's shoe size
B. Inhaler technique, adherence and exposure to triggers
C. Whether the child likes the inhaler color
D. The weather forecast only
Correct Answer: B. Inhaler technique, adherence and exposure to triggers
Rationale: Poor technique, missed doses and ongoing exposures are common reasons for poor
control and should be addressed before adding medication. The other factors are irrelevant.
2. Children of all ages using a metered-dose inhaler should use:
A. No spacer, to get the drug faster
B. The inhaler held 30 cm from the mouth
C. The inhaler while lying flat
D. A spacer or valved holding chamber
Correct Answer: D. A spacer or valved holding chamber
Rationale: A spacer reduces coordination problems and oropharyngeal deposition, increasing
lung delivery. Without a spacer, children deposit much of the drug in the mouth, and distance
or lying flat reduces delivery.
,3. A written asthma action plan should include:
A. Only the child's favorite foods
B. Only the pharmacy phone number
C. Daily medications, how to recognize worsening asthma, what medicine to take and when to
seek emergency care
D. Only the school schedule
Correct Answer: C. Daily medications, how to recognize worsening asthma, what medicine to
take and when to seek emergency care
Rationale: Action plans guide families and schools through daily care and escalating symptoms,
reducing emergency visits. The other items do not guide asthma management.
4. A peak flow meter is used at home to:
A. Measure oxygen saturation
B. Monitor changes in airway obstruction compared with the child's personal best
C. Deliver medication
D. Diagnose pneumonia
Correct Answer: B. Monitor changes in airway obstruction compared with the child's personal
best
Rationale: Comparing readings with the personal best helps detect worsening asthma before
symptoms become severe. It does not measure saturation, deliver drugs or diagnose infection.
,5. A school-age child refuses to use an inhaler at school because classmates tease her. The nurse
can help by:
A. Arranging a private place to use the inhaler and educating staff, while encouraging the child
to stay on treatment
B. Telling her to skip the medicine at school
C. Asking teachers to hold the inhaler in another building
D. Telling her teasing is her fault
Correct Answer: A. Arranging a private place to use the inhaler and educating staff, while
encouraging the child to stay on treatment
Rationale: Privacy and support reduce embarrassment while keeping her safe. Skipping
medicine or delaying access is dangerous, and blaming the child is harmful.
6. A child who uses albuterol before every recess but has no other symptoms most likely needs:
A. Review of whether symptoms reflect exercise-induced bronchoconstriction or poorly
controlled asthma, and adjustment of the plan
B. No review because daily use is normal
C. Antibiotics
D. Removal from recess permanently
Correct Answer: A. Review of whether symptoms reflect exercise-induced
bronchoconstriction or poorly controlled asthma, and adjustment of the plan
Rationale: Frequent pre-exercise use may be appropriate for exercise-induced symptoms but
can mask poor control, so the plan should be reviewed. It is not automatically normal, infection
is not suggested, and activity should continue.
, 7. When a young child uses a metered-dose inhaler with a spacer and mask, the parent should:
A. Spray all puffs at once into the spacer
B. Remove the mask after one breath
C. Hold the mask with a tight seal and let the child take about 5 to 6 normal breaths after each
puff
D. Let the child cry into the mask to breathe deeper
Correct Answer: C. Hold the mask with a tight seal and let the child take about 5 to 6 normal
breaths after each puff
Rationale: Several tidal breaths empty the chamber with each actuation, and a good seal
prevents leaks. Multiple puffs at once reduce delivery, one breath is not enough, and crying
reduces deposition in the lungs.
8. When asking a child to demonstrate inhaler technique, the nurse is using:
A. A diagnostic test
B. A sedation assessment
C. The teach-back or return demonstration method to confirm correct use
D. A hearing screen
Correct Answer: C. The teach-back or return demonstration method to confirm correct use
Rationale: Watching the child use the device reveals errors that verbal questions miss and
allows immediate correction. It is not a diagnostic, sedation or hearing test.
9. A peak flow reading in the green zone (80 to 100 percent of personal best) means:
A. Take a reliever and call the provider
B. Seek emergency care
C. Asthma is under control; continue daily controller medications
D. Stop all medications
Correct Answer: C. Asthma is under control; continue daily controller medications
Rationale: The green zone indicates good control, so usual medicines continue. Calling for help
is for lower zones, and controllers should not be stopped.
with Correct Answers
100 questions
1. Before stepping up asthma therapy for poor control, the nurse should first check:
A. The child's shoe size
B. Inhaler technique, adherence and exposure to triggers
C. Whether the child likes the inhaler color
D. The weather forecast only
Correct Answer: B. Inhaler technique, adherence and exposure to triggers
Rationale: Poor technique, missed doses and ongoing exposures are common reasons for poor
control and should be addressed before adding medication. The other factors are irrelevant.
2. Children of all ages using a metered-dose inhaler should use:
A. No spacer, to get the drug faster
B. The inhaler held 30 cm from the mouth
C. The inhaler while lying flat
D. A spacer or valved holding chamber
Correct Answer: D. A spacer or valved holding chamber
Rationale: A spacer reduces coordination problems and oropharyngeal deposition, increasing
lung delivery. Without a spacer, children deposit much of the drug in the mouth, and distance
or lying flat reduces delivery.
,3. A written asthma action plan should include:
A. Only the child's favorite foods
B. Only the pharmacy phone number
C. Daily medications, how to recognize worsening asthma, what medicine to take and when to
seek emergency care
D. Only the school schedule
Correct Answer: C. Daily medications, how to recognize worsening asthma, what medicine to
take and when to seek emergency care
Rationale: Action plans guide families and schools through daily care and escalating symptoms,
reducing emergency visits. The other items do not guide asthma management.
4. A peak flow meter is used at home to:
A. Measure oxygen saturation
B. Monitor changes in airway obstruction compared with the child's personal best
C. Deliver medication
D. Diagnose pneumonia
Correct Answer: B. Monitor changes in airway obstruction compared with the child's personal
best
Rationale: Comparing readings with the personal best helps detect worsening asthma before
symptoms become severe. It does not measure saturation, deliver drugs or diagnose infection.
,5. A school-age child refuses to use an inhaler at school because classmates tease her. The nurse
can help by:
A. Arranging a private place to use the inhaler and educating staff, while encouraging the child
to stay on treatment
B. Telling her to skip the medicine at school
C. Asking teachers to hold the inhaler in another building
D. Telling her teasing is her fault
Correct Answer: A. Arranging a private place to use the inhaler and educating staff, while
encouraging the child to stay on treatment
Rationale: Privacy and support reduce embarrassment while keeping her safe. Skipping
medicine or delaying access is dangerous, and blaming the child is harmful.
6. A child who uses albuterol before every recess but has no other symptoms most likely needs:
A. Review of whether symptoms reflect exercise-induced bronchoconstriction or poorly
controlled asthma, and adjustment of the plan
B. No review because daily use is normal
C. Antibiotics
D. Removal from recess permanently
Correct Answer: A. Review of whether symptoms reflect exercise-induced
bronchoconstriction or poorly controlled asthma, and adjustment of the plan
Rationale: Frequent pre-exercise use may be appropriate for exercise-induced symptoms but
can mask poor control, so the plan should be reviewed. It is not automatically normal, infection
is not suggested, and activity should continue.
, 7. When a young child uses a metered-dose inhaler with a spacer and mask, the parent should:
A. Spray all puffs at once into the spacer
B. Remove the mask after one breath
C. Hold the mask with a tight seal and let the child take about 5 to 6 normal breaths after each
puff
D. Let the child cry into the mask to breathe deeper
Correct Answer: C. Hold the mask with a tight seal and let the child take about 5 to 6 normal
breaths after each puff
Rationale: Several tidal breaths empty the chamber with each actuation, and a good seal
prevents leaks. Multiple puffs at once reduce delivery, one breath is not enough, and crying
reduces deposition in the lungs.
8. When asking a child to demonstrate inhaler technique, the nurse is using:
A. A diagnostic test
B. A sedation assessment
C. The teach-back or return demonstration method to confirm correct use
D. A hearing screen
Correct Answer: C. The teach-back or return demonstration method to confirm correct use
Rationale: Watching the child use the device reveals errors that verbal questions miss and
allows immediate correction. It is not a diagnostic, sedation or hearing test.
9. A peak flow reading in the green zone (80 to 100 percent of personal best) means:
A. Take a reliever and call the provider
B. Seek emergency care
C. Asthma is under control; continue daily controller medications
D. Stop all medications
Correct Answer: C. Asthma is under control; continue daily controller medications
Rationale: The green zone indicates good control, so usual medicines continue. Calling for help
is for lower zones, and controllers should not be stopped.
