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Pediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test Bank

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Pediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test BankPediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test BankPediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test BankPediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test BankPediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test BankPediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test BankPediatric Nursing – A Case-Based Approach, 2nd Edition, Tagher & Knapp – Complete Test Bank

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




Chapter 1: Bronchiolitis sg s g




1. Which intervention is appropriate for the infant hospitalized with bronchiolitis?
sg sg sg sg sg sg sg sg sg




a. Position on the side with neck slightly flexed. sg sg sg sg sg sg sg




b. Administer antibiotics as ordered. sg sg sg




c. Restrict oral and parenteral fluids if tachypneic. sg sg sg sg sg sg




d. Give cool, humidifiedoxygen. sg gs gs




ANS: D
sg sg




Cool, humidified oxygen is given to relieve dyspnea, hypoxemia, and insensible fluid loss from
sg sg sg sg sg sg sg sg sg sg sg sg sg




tachypnea. The infant should be positioned with the head and chest elevated at a 30- to 40-degree
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




angle and the neck slightly extended to maintain an open airway and decrease pressure on the
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




diaphragm. The etiology of bronchiolitis is viral. Antibiotics are given only if there is a secondary
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




bacterial infection. Tachypnea increases insensible fluid loss. If the infant is tachypneic, fluids are
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




given parenterally to prevent dehydration.
sg sg sg sg sg




2. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial
sg sg sg sg sg sg sg sg sg sg sg




virus (RSV). The nurse knows that a child infected with this virus requires what type of
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




isolation?
sg




a. Reverse isolation sg




b. Airborne isolation sg




c. Contact Precautions sg




d. StandardPrecautions gs




ANS: C
sg sg




RSV is transmitted through droplets. In addition to Standard Precautions and hand washing,
sg sg sg sg sg sg sg sg sg sg sg sg




Contact Precautions are required. Caregivers must use gloves and gowns when entering the room.
sg sg sg sg sg sg sg sg sg sg sg sg sg




Care is taken not to touch their own eyes or mucous membranes with a contaminated gloved hand.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




Children are placed in a private room or in a room with other children with RSV infections.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




Reverse isolation focuses on keeping bacteria away from the infant. With RSV, other children need
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




to be protected from exposure to the virus. The virus is not airborne.
sg sg sg sg sg sg sg sg sg sg sg sg sg




3. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




This suggests what condition?
sg sg sg sg




a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignbodyintrachea gs gs gs




ANS: A
sg sg




Asthma may have these chronic signs and symptoms. Pneumonia appears with an acute onset,
sg sg sg sg sg sg sg sg sg sg sg sg sg




fever, and general malaise. Bronchiolitis is an acute condition caused by respiratory syncytial
sg sg sg sg sg sg sg sg sg sg sg sg

,virus. Foreign body in the trachea occurs with acute respiratory distress or failure and maybe stridor.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




4. Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to
sg sg sg sg sg sg sg sg sg sg sg sg sg




respiratory syncytial virus (RSV)?
sg sg sg sg




a. Activity Intolerance sg




b. Decreased Cardiac Output sg sg




c. Pain, Acute sg




d. TissuePerfusion, Ineffective(peripheral) gs gs gs




ANS. A
sg sg




Rationale 1: Activity intolerance is a problem because of the imbalance between oxygen supply and
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
sg sg sg sg sg sg sg sg sg sg sg sg sg




respiratory-disease process.
sg sg




Rationale 2: Activity intolerance is a problem because of the imbalance between oxygen supply and
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
sg sg sg sg sg sg sg sg sg sg sg sg sg




respiratory-disease process.
sg sg




Rationale 3: Activity intolerance is a problem because of the imbalance between oxygen supply
sg sg sg sg sg sg sg sg sg sg sg sg sg




and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
sg sg sg sg sg sg sg sg sg sg sg sg sg




respiratory-disease process.
sg sg




Rationale 4: Activity intolerance is a problem because of the imbalance between oxygen supply
sg sg sg sg sg sg sg sg sg sg sg sg sg




and demand. Cardiac output is not compromised during an acute phase of bronchiolitis. Pain is not
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not affected by this
sg sg sg sg sg sg sg sg sg sg sg sg sg




respiratory-disease process.
sg sg




Global Rationale: Activity intolerance is a problem because of the imbalance between oxygen
sg sg sg sg sg sg sg sg sg sg sg sg




supply and demand. Cardiac output is not compromised during an acute phase of bronchiolitis.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




Pain is not usually associated with acute bronchiolitis. Tissue perfusion (peripheral) is not
sg sg sg sg sg sg sg sg sg sg sg sg sg




affected by this respiratory-disease process.
sg sg sg sg sg




Chapter 2: Asthma sg sg




1. The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding
sg sg sg sg sg sg sg sg sg sg sg sg sg




suggests that the childs condition is worsening?
sg sg sg sg sg sg sg




a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
sg ANS: A sg

,The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability,
sg sg sg sg sg sg sg sg sg sg sg sg sg




and increased heart and respiratory rate. As the child tires from the increased work of breathing
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




hypoventilation occurs leading to increased carbon dioxide levels. The nurse would be alert for
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




signs of hypoxia. Thirst would reflect the childs hydration status. Bradycardia is not a sign of
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




hypoxia; tachycardia is. Clubbing develops over a period of months in response to hypoxia. The
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




presence of clubbing does not indicate the childs condition is worsening.
sg sg sg sg sg sg sg sg sg sg sg




2. Which finding is expected when assessing a child hospitalized for asthma?
sg sg sg sg sg sg sg sg sg sg




a. Inspiratory stridor sg




b. Harsh, barky cough sg sg




c. Wheezing
d. Rhinorrhea
ANS: C
sg sg




Wheezing is a classic manifestation of asthma. Inspiratory stridor is a clinical manifestation of
sg sg sg sg sg sg sg sg sg sg sg sg sg




croup. A harsh, barky cough is characteristic of croup. Rhinorrhea is not associated with asthma.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse
sg sg sg sg sg sg sg sg sg sg sg sg sg sg




recognizes these symptoms are characteristic of which respiratory condition?
sg sg sg sg sg sg sg sg sg




a. Allergic rhinitis sg




b. Bronchitis
c. Asthma
d. Sinusitis
ANS: D
sg sg




Sinusitis is characterized by signs and symptoms of a cold that do not improve after 14 days, a
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




low-grade fever, nasal congestion and purulent nasal discharge, headache, tenderness, a feeling of
sg sg sg sg sg sg sg sg sg sg sg sg




fullness over the affected sinuses, halitosis, and a cough that increases when the child is lying
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




down. The classic symptoms of allergic rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




palate, and sneezing. Symptoms occur as long as the child is exposed to the allergen. Bronchitis is
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




characterized by a gradual onset of rhinitis and a cough that is initially nonproductive but may
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




change to a loose cough. The manifestations of asthma may vary, with wheezing being a classic
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




sign. The symptoms presented in the question do not suggest asthma.
sg sg sg sg sg sg sg sg sg sg sg




4. What is a common trigger for asthma attacks in children?
sg sg sg sg sg sg sg sg sg




a. Febrile episodes sg




b. Dehydration
c. Exercise
d. Seizures
sg ANS: C sg

, Exercise is one of the most common triggers for asthma attacks, particularly in school-age
sg sg sg sg sg sg sg sg sg sg sg sg sg




children. Febrile episodes are consistent with other problems, for example, seizures. Dehydration
sg sg sg sg sg sg sg sg sg sg sg sg




occurs as a result of diarrhea; it does not trigger asthma attacks. Viral infections are triggers for
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




asthma. Seizures can result from a too-rapid intravenous infusion of theophyllinea therapy for
sg sg sg sg sg sg sg sg sg sg sg sg sg




asthma.
sg




5. The practitioner changes the medications for the child with asthma to salmeterol (Serevent).
sg sg sg sg sg sg sg sg sg sg sg sg




sg The mother asks the nurse what this drug will do. The nurse explains that salmeterol (Serevent) is
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




sg used to treat asthma because the drug produces which characteristic?
sg sg sg sg sg sg sg sg sg




1. Decreases inflammation sg




2. Decreases mucous production sg sg




3. Controls allergic rhinitis sg sg




4. Dilates the bronchioles sg sg




Correct Answer: 4 sg sg




Rationale 1: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.
sg sg sg sg sg sg sg sg sg sg sg




Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines
sg sg sg sg sg sg sg sg sg




control allergic rhinitis.
sg sg sg




Rationale 2: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.
sg sg sg sg sg sg sg sg sg sg sg




Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines
sg sg sg sg sg sg sg sg sg




control allergic rhinitis.
sg sg sg




Rationale 3: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.
sg sg sg sg sg sg sg sg sg sg sg




Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines
sg sg sg sg sg sg sg sg sg




control allergic rhinitis.
sg sg sg




Rationale 4: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by bronchodilating.
sg sg sg sg sg sg sg sg sg sg sg




Steroids are anti-inflammatory, anticholinergics decrease mucous production, and antihistamines
sg sg sg sg sg sg sg sg sg




control allergic rhinitis.
sg sg sg




Global Rationale: Salmeterol (Serevent) is a long-acting beta2-agonist that acts by
sg sg sg sg sg sg sg sg sg sg




bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease mucous production, and
sg sg sg sg sg sg sg sg sg




antihistamines control allergic rhinitis.
sg sg sg sg




Cognitive Level: Analyzing sg sg




Client Need: Physiological Integrity
sg sg sg




Client Need Sub: Pharmacological and Parenteral Therapies
sg sg sg sg sg sg




Nursing/Integrated Concepts: Nursing Process: Implementation sg sg sg sg




Learning Outcome: LO 20.6 Create a nursing care plan for a child with a common acute
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




respiratory condition.
sg sg




6. Following parental teaching, the nurse is evaluating the parents understanding of sg sg sg sg sg sg sg sg sg sg




sg environmental control for their childs asthma management. Which statement by the parents sg sg sg sg sg sg sg sg sg sg sg




sg indicates appropriate understanding of the teaching?
sg sg sg sg sg




1. We will replace the carpet in our childs bedroom with tile.
sg sg sg sg sg sg sg sg sg sg




2. Were glad the dog can continue to sleep in our childs room.
sg sg sg sg sg sg sg sg sg sg sg




3. Well be sure to use the fireplace often to keep the house warm in the winter.
sg sg sg sg sg sg sg sg sg sg sg sg sg sg sg




4. Well keep the plants in our childs room dusted.
sg sg sg sg sg sg sg sg




Correct Answer: 1 sg sg

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