TEST BANK FOR
PEDIATRIC NURSING – A CASE-BASED APPROACH 1ST
EDITION
BY TAGHER KNAPP
,TABLE OF CONTENTS
CHAPTER 1: BRONCHIOLITIS ............................................................................................................. 4
CHAPTER 2: ASTHMA.......................................................................................................................... 6
CHAPTER 3: ULNAR FRACTURE ....................................................................................................... 13
CHAPTER 4: URINARY TRACT INFECTION AND PYELONEPHRITIS ........................................... 17
CHAPTER 5: GASTROENTERITIS, FEVER, AND DEHYDRATION ................................................. 26
CHAPTER 6: LEUKEMIA .................................................................................................................... 48
CHAPTER 7: HEART FAILURE .......................................................................................................... 54
CHAPTER 8: FAILURE TO THRIVE................................................................................................... 60
CHAPTER 9: TONIC-CLONIC SEIZURES ......................................................................................... 62
CHAPTER 10: DIABETES MELLITUS TYPE 1 ..................................................................................... 67
CHAPTER 11: SECOND-DEGREE BURNS .......................................................................................... 74
CHAPTER 12: SICKLE CELL ANEMIA ................................................................................................ 78
CHAPTER 13: ATTENTION DEFICIT HYPERACTIVITY DISORDER ............................................... 82
CHAPTER 14: OBESITY ....................................................................................................................... 83
CHAPTER 15: CARE OF THE NEWBORN AND INFANT ................................................................. 87
CHAPTER 16: CARE OF THE TODDLER ........................................................................................... 97
CHAPTER 17: CARE OF THE PRESCHOOLER ................................................................................. 107
CHAPTER 18: CARE OF THE SCHOOL-AGE CHILD ...................................................................... 126
CHAPTER 19: CARE OF THE ADOLESCENT ................................................................................... 134
CHAPTER 20: ALTERATIONS IN RESPIRATORY FUNCTION ....................................................... 142
CHAPTER 21: ALTERATIONS IN CARDIAC FUNCTION ................................................................ 178
CHAPTER 22: ALTERATIONS IN NEUROLOGICAL AND SENSORY FUNCTION ....................... 195
CHAPTER 23: ALTERATIONS IN GASTROINTESTINAL FUNCTION .......................................... 206
CHAPTER 24: ALTERATIONS IN GENITOURINARY FUNCTION ................................................ 223
CHAPTER 25: ALTERATIONS IN HEMATOLOGICAL FUNCTION ............................................... 241
CHAPTER 26: ONCOLOGICAL DISORDERS.................................................................................. 259
CHAPTER 27: ALTERATIONS IN MUSCULOSKELETAL FUNCTION .......................................... 279
CHAPTER 28: ALTERATIONS IN NEUROMUSCULAR FUNCTION ............................................. 309
CHAPTER 29: ALTERATIONS IN INTEGUMENTARY FUNCTION ...............................................323
CHAPTER 30: ALTERATIONS IN IMMUNE FUNCTION ............................................................... 344
CHAPTER 31: ALTERATIONS IN ENDOCRINE FUNCTION ......................................................... 354
CHAPTER 32: GENETIC DISORDERS.............................................................................................. 376
,CHAPTER 33: ALTERATIONS IN COGNITION AND MENTAL HEALTH .................................... 387
CHAPTER 34: PEDIATRIC EMERGENCIES ..................................................................................... 406
,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 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.
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 CHILDS 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
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.
2. NWHICH 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
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.
PEDIATRIC NURSING – A CASE-BASED APPROACH 1ST
EDITION
BY TAGHER KNAPP
,TABLE OF CONTENTS
CHAPTER 1: BRONCHIOLITIS ............................................................................................................. 4
CHAPTER 2: ASTHMA.......................................................................................................................... 6
CHAPTER 3: ULNAR FRACTURE ....................................................................................................... 13
CHAPTER 4: URINARY TRACT INFECTION AND PYELONEPHRITIS ........................................... 17
CHAPTER 5: GASTROENTERITIS, FEVER, AND DEHYDRATION ................................................. 26
CHAPTER 6: LEUKEMIA .................................................................................................................... 48
CHAPTER 7: HEART FAILURE .......................................................................................................... 54
CHAPTER 8: FAILURE TO THRIVE................................................................................................... 60
CHAPTER 9: TONIC-CLONIC SEIZURES ......................................................................................... 62
CHAPTER 10: DIABETES MELLITUS TYPE 1 ..................................................................................... 67
CHAPTER 11: SECOND-DEGREE BURNS .......................................................................................... 74
CHAPTER 12: SICKLE CELL ANEMIA ................................................................................................ 78
CHAPTER 13: ATTENTION DEFICIT HYPERACTIVITY DISORDER ............................................... 82
CHAPTER 14: OBESITY ....................................................................................................................... 83
CHAPTER 15: CARE OF THE NEWBORN AND INFANT ................................................................. 87
CHAPTER 16: CARE OF THE TODDLER ........................................................................................... 97
CHAPTER 17: CARE OF THE PRESCHOOLER ................................................................................. 107
CHAPTER 18: CARE OF THE SCHOOL-AGE CHILD ...................................................................... 126
CHAPTER 19: CARE OF THE ADOLESCENT ................................................................................... 134
CHAPTER 20: ALTERATIONS IN RESPIRATORY FUNCTION ....................................................... 142
CHAPTER 21: ALTERATIONS IN CARDIAC FUNCTION ................................................................ 178
CHAPTER 22: ALTERATIONS IN NEUROLOGICAL AND SENSORY FUNCTION ....................... 195
CHAPTER 23: ALTERATIONS IN GASTROINTESTINAL FUNCTION .......................................... 206
CHAPTER 24: ALTERATIONS IN GENITOURINARY FUNCTION ................................................ 223
CHAPTER 25: ALTERATIONS IN HEMATOLOGICAL FUNCTION ............................................... 241
CHAPTER 26: ONCOLOGICAL DISORDERS.................................................................................. 259
CHAPTER 27: ALTERATIONS IN MUSCULOSKELETAL FUNCTION .......................................... 279
CHAPTER 28: ALTERATIONS IN NEUROMUSCULAR FUNCTION ............................................. 309
CHAPTER 29: ALTERATIONS IN INTEGUMENTARY FUNCTION ...............................................323
CHAPTER 30: ALTERATIONS IN IMMUNE FUNCTION ............................................................... 344
CHAPTER 31: ALTERATIONS IN ENDOCRINE FUNCTION ......................................................... 354
CHAPTER 32: GENETIC DISORDERS.............................................................................................. 376
,CHAPTER 33: ALTERATIONS IN COGNITION AND MENTAL HEALTH .................................... 387
CHAPTER 34: PEDIATRIC EMERGENCIES ..................................................................................... 406
,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 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.
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 CHILDS 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
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.
2. NWHICH 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
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.
