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TEST BANK FOR PEDIATRIC NURSING- A CASE-BASED APPROACHED 1ST EDITION TAGHER KNAPP
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TEST BANK FOR PEDIATRICNURSING- A CASE-BASED
APPROACHED 1ST EDITION
TAGHER KNAPP
Pediatric Nursing – A Case-Based Approach 1st Edition Tagher Knapp Test
Bank
Chapter 1: Bronchiolitis
• Which intervention is appropriate for the infant hospitalized with bronchiolitis?
• Position on the side with neck slightly flexed.
• Administer antibiotics as ordered.
• Restrict oral and parenteral fluids if tachypneic.
• Give cool, humidified oxygen. ANS: 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.
• 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?
• Reverse isolation
• Airborne isolation
• Contact Precautions
• 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.
• A child has a chronic cough and diffuse wheezing during the expiratory
phase of respiration. This suggests what condition?
• Asthma
• Pneumonia
• Bronchiolitis
• Foreign body in trachea ANS: 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.
• Which nursing diagnosis is most appropriate for an infant with acute
bronchiolitis due to respiratory syncytial virus (RSV)?
• Activity Intolerance
• Decreased Cardiac Output
• Pain, Acute
• 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
• The nurse is caring for a child hospitalized for status asthmaticus. Which
assessment finding suggests that the childs condition is worsening?
• Hypoventilation
• Thirst
• Bradycardia
• 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.
• Which finding is expected when assessing a child hospitalized for asthma?
• Inspiratory stridor
• Harsh, barky cough
• Wheezing
• Rhinorrhea ANS: 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.
• 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?
• Allergic rhinitis
• Bronchitis
• Asthma
• Sinusitis ANS: 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.
• What is a common trigger for asthma attacks in children?
• Febrile episodes
• Dehydration
• Exercise
• Seizures ANS: 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.
• The practitioner changes the medications for the child with asthma to
salmeterol (Serevent). The mother asks the nurse what this drug will do.
The nurse explains that salmeterol (Serevent) is used to treat asthma
because the drug produces which characteristic?
• Decreases inflammation
• Decreases mucous production
• Controls allergic rhinitis
• Dilates the bronchioles
Correct Answer: 4
Rationale 1: Salmeterol (Serevent) is a long-acting beta2-agonist that acts
by bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease
mucous production, and antihistamines control allergic rhinitis.
Rationale 2: Salmeterol (Serevent) is a long-acting beta2-agonist that acts
by bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease
mucous production, and antihistamines control allergic rhinitis.
Rationale 3: Salmeterol (Serevent) is a long-acting beta2-agonist that acts
by bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease
mucous production, and antihistamines control allergic rhinitis.
Rationale 4: Salmeterol (Serevent) is a long-acting beta2-agonist that acts
by bronchodilating. Steroids are anti-inflammatory, anticholinergics decrease
mucous production, and antihistamines control allergic rhinitis.
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