TestBankForPediatric
g g g
NursingACase-Based
g g
Approach 1st Edition
g g g
Tagher Knapp
g g
, Pediatric Nursing – A Case-Based Approach 1st Edition Tagher Knapp Test Bank
g g g g g g g g g g g
Chapter 1: Bronchiolitis g g
1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
g g g g g g g g g
a. Position on the side with neck slightly flexed. g g g g g g g
b. Administer antibiotics as ordered. g g g
c. Restrict oral and parenteral fluids if tachypneic.
g g g g g g
d. Give cool, humidified oxygen. g g g
gANS: D g
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from
g g g g g g g g g g g g g
tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree
g g g g g g g g g g g g g g g g
gangle and the neck slightly extended to maintain an open airway and decrease pressure on the
g g g g g g g g g g g g g g g
gdiaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a
g g g g g g g g g g g g g g
gsecondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is
g g g g g g g g g g g
gtachypneic, fluids are given parenterally to prevent dehydration.
g g g g g g g
2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial
g g g g g g g g g g g
virus (RSV). The nurse knows that a child infected with this virus requires what type of
g g g g g g g g g g g g g g g g
isolation?
g
a. Reverse isolation g
b. Airborne isolation g
c. Contact Precautions g
d. Standard Precautions g
ANS: C
g g
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing,
g g g g g g g g g g g g
Contact Precautions are required. Caregivers must use gloves and gowns when entering the
g g g g g g g g g g g g
room. Care is taken not to touch their own eyes or mucous membranes with a contaminated
g g g g g g g g g g g g g g g g
gloved hand. Children are placed in a private room or in a room with other children with RSV
g g g g g g g g g g g g g g g g g g
infections. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other
g g g g g g g g g g g g g g
children need to be protected from exposure to the virus. The virus is not airborne.
g g g g g g g g g g g g g g g
3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration.
g g g g g g g g g g g g g g
This suggests what condition?
g g g g
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign body in trachea g g g
ANS: A
g g
Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset,
g g g g g g g g g g g g g
fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
g g g g g g g g g g g g
,virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe
g g g g g g g g g g g g g g
stridor.
g
4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to
g g g g g g g g g g g g g
respiratory syncytial virus (RSV)?
g g g g
a. Activity Intolerance g
b. Decreased Cardiac Output g g
c. Pain, Acute g
d. Tissue Perfusion, Ineffective (peripheral)
g g g
ANS. A
g g
Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen
g g g g g g g g g g g g
supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis.
g g g g g g g g g g g g g g
Pain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not
g g g g g g g g g g g g g
affected by this respiratory-disease process.
g g g g g
Chapter 2: Asthma g g
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding
g g g g g g g g g g g g g
suggests that the childs condition is worsening?
g g g g g g g
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
ANS: A
g g
, The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability,
g g g g g g g g g g g g g
and increased heart and respiratory rate. As the child tires from the increased work of breathing
g g g g g g g g g g g g g g g g
hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for
g g g g g g g g g g g g g g
signs of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sign of
g g g g g g g g g g g g g g g g
hypoxia; tachycardia is. Clubbing develops over a period of months in response to hypoxia. The
g g g g g g g g g g g g g g g
presence of clubbing does not indicate the childs condition is worsening.
g g g g g g g g g g g
2. Which finding is expected when assessing a child hospitalized for asthma?
g g g g g g g g g g
a. Inspiratory stridor g
b. Harsh, barky cough g g
c. Wheezing
d. Rhinorrhea
ANS: C
g g
Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
g g g g g g g g g g g g g
croup. A harsh, barky cough is characteristic of croup. Rhinorrhea is not associated with asthma.
g g g g g g g g g g g g g g
3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with
g g g g g g g g g g g g g g g
purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse
g g g g g g g g g g g g g g
recognizes these symptoms are characteristic of which respiratory condition?
g g g g g g g g g
a. Allergic rhinitis g
b. Bronchitis
c. Asthma
d. Sinusitis
gANS: D g
Sinusitis is characterized by signs and symptoms of a cold that do not improve after 14 days, a
g g g g g g g g g g g g g g g g g
low-grade fever, nasal congestion and purulent nasal discharge, headache, tenderness, a feeling
g g g g g g g g g g g
gof fullness over the affected sinuses, halitosis, and a cough that increases when the child is lying
g g g g g g g g g g g g g g g g
gdown. The classic symptoms of allergic rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and
g g g g g g g g g g g g g g
gpalate, and sneezing. Symptoms occur as long as the child is exposed to the allergen. Bronchitis
g g g g g g g g g g g g g g g
gis characterized by a gradual onset of rhinitis and a cough that is initially nonproductive but may
g g g g g g g g g g g g g g g g
gchange to a loose cough. The manifestations of asthma may vary, with wheezing being a classic
g g g g g g g g g g g g g g g
gsign. The symptoms presented in the question do not suggest asthma.
g g g g g g g g g g
4. What is a common trigger for asthma attacks in children?
g g g g g g g g g
a. Febrile episodes g
b. Dehydration
c. Exercise
d. Seizures
ANS: C
g g
g g g
NursingACase-Based
g g
Approach 1st Edition
g g g
Tagher Knapp
g g
, Pediatric Nursing – A Case-Based Approach 1st Edition Tagher Knapp Test Bank
g g g g g g g g g g g
Chapter 1: Bronchiolitis g g
1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
g g g g g g g g g
a. Position on the side with neck slightly flexed. g g g g g g g
b. Administer antibiotics as ordered. g g g
c. Restrict oral and parenteral fluids if tachypneic.
g g g g g g
d. Give cool, humidified oxygen. g g g
gANS: D g
Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from
g g g g g g g g g g g g g
tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree
g g g g g g g g g g g g g g g g
gangle and the neck slightly extended to maintain an open airway and decrease pressure on the
g g g g g g g g g g g g g g g
gdiaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a
g g g g g g g g g g g g g g
gsecondary bacterial infection. Tachypnea increases insensible fluid loss. If the infant is
g g g g g g g g g g g
gtachypneic, fluids are given parenterally to prevent dehydration.
g g g g g g g
2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial
g g g g g g g g g g g
virus (RSV). The nurse knows that a child infected with this virus requires what type of
g g g g g g g g g g g g g g g g
isolation?
g
a. Reverse isolation g
b. Airborne isolation g
c. Contact Precautions g
d. Standard Precautions g
ANS: C
g g
RSV is transmitted through droplets. In addition to Standard Precautions and hand washing,
g g g g g g g g g g g g
Contact Precautions are required. Caregivers must use gloves and gowns when entering the
g g g g g g g g g g g g
room. Care is taken not to touch their own eyes or mucous membranes with a contaminated
g g g g g g g g g g g g g g g g
gloved hand. Children are placed in a private room or in a room with other children with RSV
g g g g g g g g g g g g g g g g g g
infections. Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other
g g g g g g g g g g g g g g
children need to be protected from exposure to the virus. The virus is not airborne.
g g g g g g g g g g g g g g g
3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration.
g g g g g g g g g g g g g g
This suggests what condition?
g g g g
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign body in trachea g g g
ANS: A
g g
Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset,
g g g g g g g g g g g g g
fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
g g g g g g g g g g g g
,virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe
g g g g g g g g g g g g g g
stridor.
g
4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to
g g g g g g g g g g g g g
respiratory syncytial virus (RSV)?
g g g g
a. Activity Intolerance g
b. Decreased Cardiac Output g g
c. Pain, Acute g
d. Tissue Perfusion, Ineffective (peripheral)
g g g
ANS. A
g g
Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply
g g g g g g g g g g g g g
and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is
g g g g g g g g g g g g g g g
not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by
g g g g g g g g g g g g g
this respiratory-disease process.
g g g
Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen
g g g g g g g g g g g g
supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis.
g g g g g g g g g g g g g g
Pain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not
g g g g g g g g g g g g g
affected by this respiratory-disease process.
g g g g g
Chapter 2: Asthma g g
1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding
g g g g g g g g g g g g g
suggests that the childs condition is worsening?
g g g g g g g
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
ANS: A
g g
, The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability,
g g g g g g g g g g g g g
and increased heart and respiratory rate. As the child tires from the increased work of breathing
g g g g g g g g g g g g g g g g
hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for
g g g g g g g g g g g g g g
signs of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sign of
g g g g g g g g g g g g g g g g
hypoxia; tachycardia is. Clubbing develops over a period of months in response to hypoxia. The
g g g g g g g g g g g g g g g
presence of clubbing does not indicate the childs condition is worsening.
g g g g g g g g g g g
2. Which finding is expected when assessing a child hospitalized for asthma?
g g g g g g g g g g
a. Inspiratory stridor g
b. Harsh, barky cough g g
c. Wheezing
d. Rhinorrhea
ANS: C
g g
Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
g g g g g g g g g g g g g
croup. A harsh, barky cough is characteristic of croup. Rhinorrhea is not associated with asthma.
g g g g g g g g g g g g g g
3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with
g g g g g g g g g g g g g g g
purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse
g g g g g g g g g g g g g g
recognizes these symptoms are characteristic of which respiratory condition?
g g g g g g g g g
a. Allergic rhinitis g
b. Bronchitis
c. Asthma
d. Sinusitis
gANS: D g
Sinusitis is characterized by signs and symptoms of a cold that do not improve after 14 days, a
g g g g g g g g g g g g g g g g g
low-grade fever, nasal congestion and purulent nasal discharge, headache, tenderness, a feeling
g g g g g g g g g g g
gof fullness over the affected sinuses, halitosis, and a cough that increases when the child is lying
g g g g g g g g g g g g g g g g
gdown. The classic symptoms of allergic rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and
g g g g g g g g g g g g g g
gpalate, and sneezing. Symptoms occur as long as the child is exposed to the allergen. Bronchitis
g g g g g g g g g g g g g g g
gis characterized by a gradual onset of rhinitis and a cough that is initially nonproductive but may
g g g g g g g g g g g g g g g g
gchange to a loose cough. The manifestations of asthma may vary, with wheezing being a classic
g g g g g g g g g g g g g g g
gsign. The symptoms presented in the question do not suggest asthma.
g g g g g g g g g g
4. What is a common trigger for asthma attacks in children?
g g g g g g g g g
a. Febrile episodes g
b. Dehydration
c. Exercise
d. Seizures
ANS: C
g g
