Pediatric Nursing A Case-Based Approach 1stEdition Tagher Knapp Test Bank

, Pediatric Nursing – A Case-Based Approach 1st Edition Tagher Knapp Test Bank
g g g g g g g g g g g




Chapterg1:g Bronchiolitis

1. Whichginterventiongisgappropriategforgtheginfantghospitalizedgwithgbronchiolitis?
a. Positiongongthegsidegwithgneckgslightlygflexed.
b. Administergantibioticsgasgordered.
c. Restrictgoralgandgparenteralgfluidsgifgtachypneic.
d. Givegcool,ghumidifiedgoxygen.g
ANS:gD
Cool,ghumidifiedgoxygengisggivengtogrelievegdyspnea,ghypoxemia,gandginsensiblegfluidglossgfrom
tachypnea.gTheginfantgshouldgbegpositionedgwithgthegheadgandgchestgelevatedgatgag30-gtog40-
degreeganglegandgthegneckgslightlygextendedgtogmaintaingangopengairwaygandgdecreasegpressuregongt
hegdiaphragm.gThegetiologygofgbronchiolitisg isgviral.gAntibioticsgareggivengonlygifgtheregisgagsecond
arygbacterialginfection.gTachypneagincreasesginsensiblegfluidgloss.gIfgtheginfantgisgtachypneic,gfluidsg
areggivengparenterallygtogpreventgdehydration.

2. Anginfantgwithgbronchiolitisgisghospitalized.gThegcausativegorganismgisgrespiratorygsyncytialg
virusg(RSV).gThegnursegknowsgthatgagchildginfectedgwithgthisgvirusgrequiresgwhatgtypegofgisolati
on?
a. Reversegisolation
b. Airbornegisolation
c. ContactgPrecautions
d. StandardgPrecautionsg
ANS:gC
RSVgisgtransmittedgthroughgdroplets.gIngadditiongtogStandardgPrecautionsgandghandgwashing,
ContactgPrecautionsgaregrequired.gCaregiversgmustgusegglovesgandggownsgwhengenteringgthegroom
.gCaregisgtakengnotgtogtouchgtheirgowngeyesgorgmucousgmembranesgwithgagcontaminatedgglovedghan
d.gChildrengaregplacedgingagprivategroomgorgingagroomgwithgothergchildrengwithgRSVginfections.gRe
versegisolationgfocusesgongkeepinggbacteriagawaygfromgtheginfant.gWithgRSV,gothergchildrengneedgt
ogbegprotectedgfromgexposuregtogthegvirus.gThegvirusgisgnotgairborne.

3. Agchildghasgagchronicgcoughgandgdiffusegwheezinggduringgthegexpiratorygphasegofgrespiration.g
Thisgsuggestsgwhatgcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreigngbodygingtracheag
ANS:gA
Asthmagmayghavegthesegchronicgsignsgandgsymptoms.gPneumoniagappearsgwithgangacutegonset,
fever,gandggeneralgmalaise.gBronchiolitisgisgangacutegconditiongcausedgbygrespiratorygsyncytial

,virus.gForeigngbodygingthegtracheagoccursgwithgacutegrespiratorygdistressgorgfailuregandgmaybegstrido
r.
4. Whichgnursinggdiagnosisgisgmostgappropriategforganginfantgwithgacutegbronchiolitisgduegtogr
espiratorygsyncytialgvirusg(RSV)?
a. ActivitygIntolerance
b. DecreasedgCardiacgOutput
c. Pain,gAcute
d. TissuegPerfusion,gIneffectiveg(peripheral)g
ANS.gA
Rationaleg1:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplygan
dgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnotgu
suallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgresp
iratory-diseasegprocess.
Rationaleg2:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplygan
dgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnotgu
suallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgresp
iratory-diseasegprocess.
Rationaleg3:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplygan
dgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnotgu
suallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgresp
iratory-diseasegprocess.
Rationaleg4:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsupplygan
dgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisgnotgu
suallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthisgresp
iratory-diseasegprocess.
GlobalgRationale:gActivitygintolerancegisgagproblemgbecausegofgthegimbalancegbetweengoxygengsup
plygandgdemand.gCardiacgoutputgisgnotgcompromisedgduringgangacutegphasegofgbronchiolitis.gPaingisg
notgusuallygassociatedgwithgacutegbronchiolitis.gTissuegperfusiong(peripheral)gisgnotgaffectedgbygthis
grespiratory-diseasegprocess.




Chapterg2:gAsthma

1. Thegnursegisgcaringgforgagchildghospitalizedgforgstatusgasthmaticus.gWhichgassessmentgfindinggs
uggestsgthatgthegchildsgconditiongisgworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
gANS:gA

, Thegnursegwouldgassessgthegchildgforgsignsgofghypoxia,gincludinggrestlessness,gfatigue,girritability,ga
ndgincreasedgheartgandgrespiratorygrate.gAsgthegchildgtiresgfromgthegincreasedgworkgofgbreathingghyp
oventilationgoccursgleadinggtogincreasedgcarbongdioxideglevels.gThegnursegwouldgbegalertgforgsignsg
ofghypoxia.gThirstgwouldgreflectgthegchildsghydrationgstatus.gBradycardiagisgnotgagsigngofghypoxia;gt
achycardiagis.gClubbinggdevelopsgovergagperiodgofgmonthsgingresponsegtoghypoxia.gThegpresencegofg
clubbinggdoesgnotgindicategthegchildsgconditiongisgworsening.


2. Whichgfindinggisgexpectedgwhengassessinggagchildghospitalizedgforgasthma?
a. Inspiratorygstridor
b. Harsh,gbarkygcough
c. Wheezing
d. Rhinorrhea
gANS:gC

Wheezinggisgagclassicgmanifestationgofgasthma.gInspiratorygstridorgisgagclinicalgmanifestationgof
croup.gAgharsh,gbarkygcoughgisgcharacteristicgofgcroup.gRhinorrheagisgnotgassociatedgwithgasthma.


3. Agchildghasghadgcoldgsymptomsgforgmoregthang2gweeks,gagheadache,gnasalgcongestiongwithgp
urulentgnasalgdrainage,gfacialgtenderness,gandgagcoughgthatgincreasesgduringgsleep.gThegnursegre
cognizesgthesegsymptomsgaregcharacteristicgofgwhichgrespiratorygcondition?
a. Allergicgrhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
gANS:gD

Sinusitisgisgcharacterizedgbygsignsgandgsymptomsgofgagcoldgthatgdognotgimprovegafterg14gdays,ga
low-
gradegfever,gnasalgcongestiongandgpurulentgnasalgdischarge,gheadache,gtenderness,gagfeelinggofgfull
nessgovergthegaffectedgsinuses,ghalitosis,gandgagcoughgthatgincreasesgwhengthegchildgisglyinggdown.g
Thegclassicgsymptomsgofgallergicgrhinitisgaregwaterygrhinorrhea,gitchygnose,geyes,gears,gandgpalate,g
andgsneezing.gSymptomsgoccurgasglonggasgthegchildgisgexposedgtogthegallergen.gBronchitisgisgcharac
terizedgbygaggradualgonsetgofgrhinitisgandgagcoughgthatgisginitiallygnonproductivegbutgmaygchangegtog
agloosegcough.gThegmanifestationsgofgasthmagmaygvary,gwithgwheezinggbeinggagclassicgsign.gThegs
ymptomsgpresentedgingthegquestiongdognotgsuggestgasthma.
4. Whatgisgagcommongtriggergforgasthmagattacksgingchildren?
a. Febrilegepisodes
b. Dehydration
c. Exercise
d. Seizures
gANS:gC