, Pediatric jNursing j– jA jCase-Based jApproach j1st jEdition jTagher jKnapp jTest jBank
Chapter j1: j Bronchiolitis
1. Which jintervention jis jappropriate jfor jthe jinfant jhospitalized jwith jbronchiolitis?
a. Position jon jthe jside jwith jneck jslightly jflexed.
b. Administer jantibiotics jas jordered.
c. Restrict joral jand jparenteral jfluids jif jtachypneic.
d. Give jcool, jhumidified
joxygen.jANS: jD
Cool, jhumidified joxygen jis jgiven jto jrelieve jdyspnea, jhypoxemia, jand jinsensible jfluid jloss jfrom
tachypnea. jThe jinfant jshould jbe jpositioned jwith jthe jhead jand jchest jelevated jat ja j30- jto j40-
degreejangle jand jthe jneck jslightly jextended jto jmaintain jan jopen jairway jand jdecrease jpressure
jon jthe jdiaphragm. j The jetiology jof jbronchiolitis jis jviral. jAntibiotics jare jgiven jonly jif j there jis
ja jsecondary jbacterial jinfection. jTachypnea jincreases jinsensible jfluid jloss. jIf jthe jinfant jis
jtachypneic, jfluids jare jgiven jparenterally jto jprevent jdehydration.
2. An jinfant jwith jbronchiolitis jis jhospitalized. jThe jcausative jorganism jis jrespiratory
jsyncytialjvirus j(RSV). jThe jnurse jknows jthat ja jchild jinfected jwith jthis jvirus jrequires jwhat
jtype jof jisolation?
a. Reverse jisolation
b. Airborne jisolation
c. Contact jPrecautions
d. Standard
jPrecautionsjANS: jC
RSV jis jtransmitted jthrough jdroplets. jIn jaddition jto jStandard jPrecautions jand jhand jwashing,
Contact jPrecautions jare jrequired. jCaregivers jmust juse jgloves jand jgowns jwhen jentering jthe
jroom. jCare jis jtaken jnot jto jtouch jtheir jown jeyes jor jmucous jmembranes jwith ja jcontaminated
jgloved jhand. jChildren jare jplaced jin ja jprivate jroom jor jin ja jroom jwith jother jchildren jwith
jRSV jinfections. jReverse jisolation jfocuses jon jkeeping jbacteria jaway jfrom jthe jinfant. jWith
jRSV, jotherjchildren jneed jto jbe jprotected jfrom jexposure jto jthe jvirus. jThe jvirus jis jnot
jairborne.
3. A jchild jhas ja jchronic jcough jand jdiffuse jwheezing jduring jthe jexpiratory jphase jof
jrespiration.jThis jsuggests jwhat jcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign jbody jin
jtracheajANS: jA
Asthma jmay jhave jthese jchronic jsigns jand jsymptoms. jPneumonia jappears jwith jan jacute jonset,
fever, jand jgeneral jmalaise. jBronchiolitis jis jan jacute jcondition jcaused jby jrespiratory jsyncytial
,virus. jForeign jbody jin jthe jtrachea joccurs jwith jacute jrespiratory jdistress jor jfailure jand
jmaybejstridor.
4. Which jnursing jdiagnosis jis jmost jappropriate jfor jan jinfant jwith jacute jbronchiolitis
jdue jtojrespiratory jsyncytial jvirus j(RSV)?
a. Activity jIntolerance
b. Decreased jCardiac jOutput
c. Pain, jAcute
d. Tissue jPerfusion, jIneffective
j(peripheral)jANS. jA
Rationale j1: jActivity jintolerance jis ja jproblem jbecause jof jthe jimbalance jbetween joxygen
jsupplyjand jdemand. jCardiac joutput jis jnot jcompromised jduring jan jacute jphase jof
jbronchiolitis. jPain jis jnot jusually jassociated jwith jacute jbronchiolitis. jTissue jperfusion
j(peripheral) jis jnot jaffected jby jthis jrespiratory-disease jprocess.
Rationale j2: jActivity jintolerance jis ja jproblem jbecause jof jthe jimbalance jbetween joxygen
jsupplyjand jdemand. jCardiac joutput jis jnot jcompromised jduring jan jacute jphase jof
jbronchiolitis. jPain jis jnot jusually jassociated jwith jacute jbronchiolitis. jTissue jperfusion
j(peripheral) jis jnot jaffected jby jthis jrespiratory-disease jprocess.
Rationale j3: jActivity jintolerance jis ja jproblem jbecause jof jthe jimbalance jbetween joxygen
jsupplyjand jdemand. jCardiac joutput jis jnot jcompromised jduring jan jacute jphase jof
jbronchiolitis. jPain jis jnot jusually jassociated jwith jacute jbronchiolitis. jTissue jperfusion
j(peripheral) jis jnot jaffected jby jthis jrespiratory-disease jprocess.
Rationale j4: jActivity jintolerance jis ja jproblem jbecause jof jthe jimbalance jbetween joxygen
jsupplyjand jdemand. jCardiac joutput jis jnot jcompromised jduring jan jacute jphase jof
jbronchiolitis. jPain jis jnot jusually jassociated jwith jacute jbronchiolitis. jTissue jperfusion
j(peripheral) jis jnot jaffected jby jthis jrespiratory-disease jprocess.
Global jRationale: jActivity jintolerance jis ja jproblem jbecause jof jthe jimbalance jbetween
joxygenjsupply jand jdemand. jCardiac joutput jis jnot jcompromised jduring jan jacute jphase jof
jbronchiolitis.jPain jis jnot jusually jassociated jwith jacute jbronchiolitis. jTissue jperfusion
j(peripheral) jis jnot jaffected jby jthis jrespiratory-disease jprocess.
Chapter j2: jAsthma
1. The jnurse jis jcaring jfor ja jchild jhospitalized jfor jstatus jasthmaticus. jWhich jassessment
jfindingjsuggests jthat jthe j childs jcondition j is jworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbingj
ANS: jA
, The jnurse jwould jassess jthe jchild jfor jsigns jof jhypoxia, jincluding jrestlessness, jfatigue,
jirritability,jand jincreased jheart jand jrespiratory jrate. jAs jthe jchild jtires jfrom jthe jincreased
jwork jof jbreathing jhypoventilation joccurs jleading jto jincreased jcarbon jdioxide jlevels. jThe
jnurse jwould jbe jalert jfor jsigns jof jhypoxia. jThirst jwould jreflect jthe jchilds jhydration jstatus.
jBradycardia jis jnot ja jsign jof jhypoxia; jtachycardia jis. jClubbing jdevelops jover ja jperiod jof
jmonths jin jresponse jto jhypoxia. jThe jpresence jof jclubbing jdoes jnot jindicate jthe jchilds
jcondition jis jworsening.
2. Which jfinding jis jexpected jwhen jassessing ja jchild jhospitalized jfor jasthma?
a. Inspiratory jstridor
b. Harsh, jbarky jcough
c. Wheezing
d. Rhinorrheaj
ANS: jC
Wheezing jis ja jclassic jmanifestation jof jasthma. jInspiratory jstridor jis ja jclinical jmanifestation jof
croup. jA jharsh, jbarky jcough jis jcharacteristic jof jcroup. jRhinorrhea jis jnot jassociated jwith jasthma.
3. A jchild jhas jhad jcold jsymptoms jfor jmore jthan j2 jweeks, ja jheadache, jnasal jcongestion
jwith jpurulent jnasal jdrainage, jfacial jtenderness, jand ja jcough jthat jincreases jduring jsleep.
jThe jnursejrecognizes jthese jsymptoms jare jcharacteristic jof jwhich jrespiratory jcondition?
a. Allergic jrhinitis
b. Bronchitis
c. Asthma
d. Sinusitisj
ANS: jD
Sinusitis jis jcharacterized jby jsigns jand jsymptoms jof ja jcold jthat jdo jnot jimprove jafter j14 jdays, ja
low-grade jfever, jnasal jcongestion jand jpurulent jnasal jdischarge, jheadache, jtenderness, ja
jfeeling jof jfullness jover jthe jaffected jsinuses, jhalitosis, jand ja jcough jthat jincreases jwhen jthe
jchild jis jlyingjdown. jThe jclassic jsymptoms jof jallergic jrhinitis jare jwatery jrhinorrhea, jitchy
jnose, jeyes, jears, jandjpalate, jand jsneezing. jSymptoms joccur jas jlong jas jthe jchild jis jexposed jto
jthe jallergen. jBronchitis jis jcharacterized jby ja jgradual jonset jof jrhinitis jand ja jcough jthat jis
jinitially jnonproductive jbut jmayjchange jto ja jloose jcough. jThe jmanifestations jof jasthma jmay
jvary, jwith jwheezing jbeing ja jclassic jsign. jThe jsymptoms jpresented jin j the jquestion jdo jnot
jsuggest jasthma.
4. What jis ja jcommon jtrigger jfor jasthma jattacks jin jchildren?
a. Febrile jepisodes
b. Dehydration
c. Exercise
d. Seizuresj
ANS: jC