Exam (elaborations)
Child with Respiratory Dysfunction
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Child with Respiratory Dysfunction
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_______________ANS:
7.5
The correct calculation is:
33 lb/2.2 kg = 15 kg
Chapter 26.The Child with Respiratory Dysfunction
h a
MULTIPLE CHOICE
T a
1. Why are cool-mist vaporizers rather than steam vaporizers recommended in the home
treatment of respiratory infections?
a. They are safer.
b. They are less expensive.
e b
b e
c. Respiratory secretions are dried by steam vaporizers.
d. A more comfortable environment is produced.
ANS: A
H a
Cool-mist vaporizers are safer than steam vaporizers, and little evidence exists to show any
advantages to steam. The cost of cool-mist and steam vaporizers is comparable. Steam loosens
secretions, not dries them. Both cool-mist vaporizers and steam vaporizers may promote a more
comfortable environment, but cool-mist vaporizers have decreased risk for burns and growth of
organisms.
DIF: Cognitive Level: Understanding REF: MCS: 1165
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
,2. Decongestant nose drops are recommended for a 10-month-old infant with an upper
respiratory tract infection. Instructions for nose drops should include which information?
a. Do not use for more than 3 days.
b. Keep drops to use again for nasal congestion.
c. Administer drops after feedings and at bedtime.
d. Give two drops every 5 minutes until nasal congestion subsides.
ANS: A
h a
Vasoconstrictive nose drops such as Neo-Synephrine should not be used for more than 3 days to
Ta
avoid rebound congestion. Drops should be discarded after one illness and not used for other
children because they may become contaminated with bacteria. Drops administered before
feedings are more helpful. Two drops are administered to cause vasoconstriction in the anterior
mucous membranes. An additional two drops are instilled 5 to 10 minutes later for the posterior
DIF: Cognitive Level: Applying REF: MCS: 1170
e b
mucous membranes. No further doses should be given.
b e
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
H a
3. The parent of an infant with nasopharyngitis should be instructed to notify the health
professional if the infant shows signs or symptoms of which condition?
a. Has a cough
b. Becomes fussy
c. Shows signs of an earache
d. Has a fever higher than 37.5 C (99 F)
ANS: C
If an infant with nasopharyngitis shows signs of an earache, it may indicate respiratory
complications and possibly secondary bacterial infection. The health professional should be
,contacted to evaluate the infant. Cough can be a sign of nasopharyngitis. Irritability is common
in an infant with a viral illness. Fever is common in viral illnesses.
DIF: Cognitive Level: Applying REF: MCS: 1171
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
prevent which condition?
h a
4. It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to
a. Otitis media
b. Diabetes insipidus (DI)
c. Nephrotic syndrome
d. Acute rheumatic fever
Ta
ANS: D
e b
e
Group A hemolytic streptococcal infection is a brief illness with varying symptoms. It is
essential that pharyngitis caused by this organism be treated with appropriate antibiotics to avoid
b
the sequelae of acute rheumatic fever and acute glomerulonephritis. The cause of otitis media is
a
either viral or other bacterial organisms. DI is a disorder of the posterior pituitary. Infections
such as meningitis or encephalitis, not streptococcal pharyngitis, can cause DI.
H
Glomerulonephritis, not nephrotic syndrome, can result from acute streptococcal pharyngitis.
DIF: Cognitive Level: Understanding REF: MCS: 1171 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
5. When caring for a child after a tonsillectomy, what intervention should the nurse do?
a. Watch for continuous swallowing.
b. Encourage gargling to reduce discomfort.
c. Apply warm compresses to the throat.
, d. Position the child on the back for sleeping.
ANS: A
Continuous swallowing, especially while sleeping, is an early sign of bleeding. The child
swallows the blood that is trickling from the operative site. Gargling is discouraged because it
could irritate the operative site. Ice compresses are recommended to reduce inflammation. The
child should be positioned on the side or abdomen to facilitate drainage of secretions.
DIF: Cognitive Level: Applying REF: MCS: 1174
h a
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
6. What statement best represents infectious mononucleosis?
a. Herpes simplex type 2 is the principal cause.
T a
b
b. A complete blood count shows a characteristic leukopenia.
c. A short course of ampicillin is used when pharyngitis is present.
e
d. Clinical signs and symptoms and blood tests are both needed to establish the
e
diagnosis.
ANS: D
a b
The characteristics of the diseasemalaise, sore throat, lymphadenopathy, central nervous system
manifestations, and skin lesionsare similar to presenting signs and symptoms in other diseases.
H
Hematologic analysis (heterophil antibody and monospot) can help confirm the diagnosis.
However, not all young children develop the expected laboratory findings. Herpes-like Epstein-
Barr virus is the principal cause. Usually, an increase in lymphocytes is observed. Penicillin, not
ampicillin, is indicated. Ampicillin is linked with a discrete macular eruption in infectious
mononucleosis.
DIF: Cognitive Level: Understanding REF: MCS: 1176
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
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