Test Bank For
Pediatric
Nursing A Case-
Based Approach
1st Edition
Tagher Knapp
, PediatrichNursingh–hAhCase-BasedhApproachh1sthEditionhTagherhKnapphTesthBank
Chapterh1:h Bronchiolitis
1. Whichhinterventionhishappropriatehforhthehinfanthhospitalizedhwithhbronchiolitis?
a. Positionhonhthehsidehwithhneckhslightlyhflexed.
b. Administerhantibioticshashordered.
c. Restricthoralhandhparenteralhfluidshifhtachypneic.
d. Givehcool,hhumidifiedhoxygen
.hANS:hD
Cool,hhumidifiedhoxygenhishgivenhtohrelievehdyspnea,hhypoxemia,handhinsensiblehfluidhlosshfrom
tachypnea.hThehinfanthshouldhbehpositionedhwithhthehheadhandhchesthelevatedhathah30-htoh40-
degreehanglehandhthehneckhslightlyhextendedhtohmaintainhanhopenhairwayhandhdecreasehpressureh
onhthehdiaphragm.hThehetiologyhofhbronchiolitishishviral.hAntibioticsharehgivenhonlyhifhtherehish
ahsecondaryhbacterialhinfection.hTachypneahincreaseshinsensiblehfluidhloss.hIfhthehinfanthishtachy
pneic,hfluidsharehgivenhparenterallyhtohpreventhdehydration.
2. Anhinfanthwithhbronchiolitishishhospitalized.hThehcausativehorganismhishrespiratoryhsyncyt
ialhvirush(RSV).hThehnursehknowshthathahchildhinfectedhwithhthishvirushrequireshwhathtypehof
hisolation?
a. Reversehisolation
b. Airbornehisolation
c. ContacthPrecautions
d. StandardhPrecaution
shANS:hC
RSVhishtransmittedhthroughhdroplets.hInhadditionhtohStandardhPrecautionshandhhandhwashing,
ContacthPrecautionsharehrequired.hCaregivershmusthusehgloveshandhgownshwhenhenteringhthehro
om.hCarehishtakenhnothtohtouchhtheirhownheyeshorhmucoushmembraneshwithhahcontaminatedhglo
vedhhand.hChildrenharehplacedhinhahprivatehroomhorhinhahroomhwithhotherhchildrenhwithhRSVhi
nfections.hReversehisolationhfocuseshonhkeepinghbacteriahawayhfromhthehinfant.hWithhRSV,hoth
erhchildrenhneedhtohbehprotectedhfromhexposurehtohthehvirus.hThehvirushishnothairborne.
3. Ahchildhhashahchronichcoughhandhdiffusehwheezinghduringhthehexpiratoryhphasehofhrespirati
on.hThishsuggestshwhathcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignhbodyhinhtrache
ahANS:hA
Asthmahmayhhavehthesehchronichsignshandhsymptoms.hPneumoniahappearshwithhanhacutehonset,
fever,handhgeneralhmalaise.hBronchiolitishishanhacutehconditionhcausedhbyhrespiratoryhsyncytial
,virus.hForeignhbodyhinhthehtracheahoccurshwithhacutehrespiratoryhdistresshorhfailurehandhma
ybehstridor.
4. Whichhnursinghdiagnosishishmosthappropriatehforhanhinfanthwithhacutehbronchiolitishdue
htohrespiratoryhsyncytialhvirush(RSV)?
a. ActivityhIntolerance
b. DecreasedhCardiachOutput
c. Pain,hAcute
d. TissuehPerfusion,hIneffectiveh(peripheral
)hANS.hA
Rationaleh1:hActivityhintolerancehishahproblemhbecausehofhthehimbalancehbetweenhoxygenhsup
plyhandhdemand.hCardiachoutputhishnothcompromisedhduringhanhacutehphasehofhbronchiolitis.hPa
inhishnothusuallyhassociatedhwithhacutehbronchiolitis.hTissuehperfusionh(peripheral)hishnothaffect
edhbyhthishrespiratory-diseasehprocess.
Rationaleh2:hActivityhintolerancehishahproblemhbecausehofhthehimbalancehbetweenhoxygenhsup
plyhandhdemand.hCardiachoutputhishnothcompromisedhduringhanhacutehphasehofhbronchiolitis.hPa
inhishnothusuallyhassociatedhwithhacutehbronchiolitis.hTissuehperfusionh(peripheral)hishnothaffect
edhbyhthishrespiratory-diseasehprocess.
Rationaleh3:hActivityhintolerancehishahproblemhbecausehofhthehimbalancehbetweenhoxygenhsup
plyhandhdemand.hCardiachoutputhishnothcompromisedhduringhanhacutehphasehofhbronchiolitis.hPa
inhishnothusuallyhassociatedhwithhacutehbronchiolitis.hTissuehperfusionh(peripheral)hishnothaffect
edhbyhthishrespiratory-diseasehprocess.
Rationaleh4:hActivityhintolerancehishahproblemhbecausehofhthehimbalancehbetweenhoxygenhsup
plyhandhdemand.hCardiachoutputhishnothcompromisedhduringhanhacutehphasehofhbronchiolitis.hPa
inhishnothusuallyhassociatedhwithhacutehbronchiolitis.hTissuehperfusionh(peripheral)hishnothaffect
edhbyhthishrespiratory-diseasehprocess.
GlobalhRationale:hActivityhintolerancehishahproblemhbecausehofhthehimbalancehbetweenhoxyge
nhsupplyhandhdemand.hCardiachoutputhishnothcompromisedhduringhanhacutehphasehofhbronchiolit
is.hPainhishnothusuallyhassociatedhwithhacutehbronchiolitis.hTissuehperfusionh(peripheral)hishnoth
affectedhbyhthishrespiratory-diseasehprocess.
Chapterh2:hAsthma
1. Thehnursehishcaringhforhahchildhhospitalizedhforhstatushasthmaticus.hWhichhassessmenthfindi
nghsuggestshthaththehchildshconditionhishworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
hANS:hA
, Thehnursehwouldhassesshthehchildhforhsignshofhhypoxia,hincludinghrestlessness,hfatigue,hirritabili
ty,handhincreasedhhearthandhrespiratoryhrate.hAshthehchildhtireshfromhthehincreasedhworkhofhbreat
hinghhypoventilationhoccurshleadinghtohincreasedhcarbonhdioxidehlevels.hThehnursehwouldhbehal
erthforhsignshofhhypoxia.hThirsthwouldhreflecththehchildshhydrationhstatus.hBradycardiahishnothah
signhofhhypoxia;htachycardiahis.hClubbinghdevelopshoverhahperiodhofhmonthshinhresponsehtohhy
poxia.hThehpresencehofhclubbinghdoeshnothindicatehthehchildshconditionhishworsening.
2. Whichhfindinghishexpectedhwhenhassessinghahchildhhospitalizedhforhasthma?
a. Inspiratoryhstridor
b. Harsh,hbarkyhcough
c. Wheezing
d. Rhinorrhea
hANS:hC
Wheezinghishahclassichmanifestationhofhasthma.hInspiratoryhstridorhishahclinicalhmanifestationhof
croup.hAhharsh,hbarkyhcoughhishcharacteristichofhcroup.hRhinorrheahishnothassociatedhwithhasthma.
3. Ahchildhhashhadhcoldhsymptomshforhmorehthanh2hweeks,hahheadache,hnasalhcongestionhw
ithhpurulenthnasalhdrainage,hfacialhtenderness,handhahcoughhthathincreaseshduringhsleep.hThe
hnursehrecognizeshthesehsymptomsharehcharacteristichofhwhichhrespiratoryhcondition?
a. Allergichrhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
hANS:hD
Sinusitishishcharacterizedhbyhsignshandhsymptomshofhahcoldhthathdohnothimprovehafterh14hdays,ha
low-
gradehfever,hnasalhcongestionhandhpurulenthnasalhdischarge,hheadache,htenderness,hahfeelinghofh
fullnesshoverhthehaffectedhsinuses,hhalitosis,handhahcoughhthathincreaseshwhenhthehchildhishlyingh
down.hThehclassichsymptomshofhallergichrhinitisharehwateryhrhinorrhea,hitchyhnose,heyes,hears,h
andhpalate,handhsneezing.hSymptomshoccurhashlonghashthehchildhishexposedhtohthehallergen.hBro
nchitishishcharacterizedhbyhahgradualhonsethofhrhinitishandhahcoughhthathishinitiallyhnonproducti
vehbuthmayhchangehtohahloosehcough.hThehmanifestationshofhasthmahmayhvary,hwithhwheezingh
beinghahclassichsign.hThehsymptomshpresentedhinhthehquestionhdohnothsuggesthasthma.
4. Whathishahcommonhtriggerhforhasthmahattackshinhchildren?
a. Febrilehepisodes
b. Dehydration
c. Exercise
d. Seizures
hANS:hC
