Test bank for pediatric nursing , a case based approach,

Pediatric Nursing, A Case-Based Approach, 2nd Edition By Tagher Knapp




TEST BANK
Pediatric Nursing, A Case-
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Chapter 1: Bronchiolitis

, Pediatric Nursing, A Case-Based Approach, 2nd Edition By Tagher Knapp


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. ANS: D

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 angle
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and the neck slightly extended to maintain an open airway and decrease pressure on the diaphragm.
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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
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prevent dehydration. u
2.
a
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus
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(RSV). The nurse knows that a child infected with this virus requires what type of isolation?
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a. Reverse isolation
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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.

, Pediatric Nursing, A Case-Based Approach, 2nd Edition By Tagher Knapp


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
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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

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virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stridor.
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4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to
a
respiratory syncytial virus (RSV)?
b
a.

b.
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Activity Intolerance
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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
respiratorydisease 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
respiratorydisease 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
respiratorydisease process.

, Pediatric Nursing, A Case-Based Approach, 2nd Edition By Tagher Knapp


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
respiratorydisease 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
respiratorydisease process.




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Chapter 2: Asthma g tgh
1.
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The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding
suggests that the childs condition is worsening?
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a. Hypoventilation
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b. Thirst



c. Bradycardia

d. Clubbing ANS: 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 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.