: The Child with Respiratory Dysfunction
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching nursing students about normal physiologic changes in the respiratory
system of toddlers. Which best describes why toddlers have fewer respirator...
WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Chapter 21: The Child with Respiratory Dysfunction
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching nursing students about normal physiologic changes in the respiratory
system of toddlers. Which best describes why toddlers have fewer respiratory tract infections
as they grow older?
a. The amount of lymphoid tissue decreases.
b. Repeated exposure to organisms causes increased immunity.
c. Viral organisms are less prevalent in the population.
d. Secondary infections rarely occur after viral illnesses.
ANS: B
Children have increased immunity after exposure to a virus. The amount of lymphoid tissue
increases as children grow older. Viral organisms are not less prevalent, but older children
have the ability to resist invading organisms. Secondary infections after viral illnesses include
Mycoplasma pneumoniae and group A -hemolytic streptococcal infections.
DIF: Cognitive Level: Understand REF: p. 636
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
2. A nurse is charting that a hospitalized child has labored breathing. Which describes labored
breathing?
a. Dyspnea
NURSINGTB.COM
b. Tachypnea
c. Hypopnea
d. Orthopnea
ANS: A
Dyspnea is labored breathing. Tachypnea is rapid breathing. Hypopnea is breathing that is too
shallow. Orthopnea is difficulty breathing except in an upright position.
DIF: Cognitive Level: Remember REF: p. 639
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
3. Which explains why cool-mist vaporizers rather than steam vaporizers are recommended in
home treatment of childhood respiratory tract infections?
a. They are safer.
b. They are less expensive.
c. Respiratory secretions are dried.
d. A more comfortable environment is produced.
ANS: 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 may promote a more comfortable environment, but cool-mist
vaporizers present decreased risk for burns and growth of organisms.
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
DIF: Cognitive Level: Understand REF: p. 639
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
4. Decongestant nose drops are recommended for a 10-month-old infant with an upper
respiratory tract infection. Instructions for nose drops should include which action?
a. Avoid using for more than 3 days.
b. Keep drops to use again for nasal congestion.
c. Administer drops until nasal congestion subsides.
d. Administer drops after feedings and at bedtime.
ANS: A
Vasoconstrictive nose drops such as phenylephrine (Neo-Synephrine) should not be used for
more than 3 days to avoid rebound congestion. Drops should be discarded after one illness
because they may become contaminated with bacteria. Vasoconstrictive nose drops can have a
rebound effect after 3 days of use. Drops administered before feedings are more helpful.
DIF: Cognitive Level: Apply REF: p. 639
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies
5. Which is an appropriate nursing intervention when caring for an infant with an upper
respiratory tract infection and elevated temperature?
a. Give tepid water baths to reduce fever.
b. Encourage food intake to maintain caloric needs.
c. Have child wear heavy clothing to prevent chilling.
d. Give small amounts of favorite NURSINGTB.COM
fluids frequently to prevent dehydration.
ANS: D
Preventing dehydration by small frequent feedings is an important intervention in the febrile
child. Tepid water baths may induce shivering, which raises temperature. Food should not be
forced; it may result in the child vomiting. The febrile child should be dressed in light, loose
clothing.
DIF: Cognitive Level: Apply REF: p. 640
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
6. The parent of an infant with nasopharyngitis should be instructed to notify the health
professional if the infant displays which clinical manifestation?
a. Fussiness
b. Coughing
c. A fever over 99° F
d. Signs of an earache
ANS: D
If an infant with nasopharyngitis shows signs of an earache, it may mean a secondary bacterial
infection is present and the infant should be referred to a practitioner for evaluation.
Irritability is common in an infant with a viral illness. Cough can be a sign of nasopharyngitis.
Fever is common in viral illnesses.
NURSINGTB.COM
, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
DIF: Cognitive Level: Apply REF: p. 640
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
7. When is it generally recommended that a child with acute streptococcal pharyngitis may
return to school?
a. When sore throat is better.
b. If no complications develop.
c. After taking antibiotics for 24 hours.
d. After taking antibiotics for 3 days.
ANS: C
After children have taken antibiotics for 24 hours, they are no longer contagious to other
children. Sore throat may persist longer than 24 hours after beginning antibiotic therapy, but
the child is no longer considered contagious. Complications may take days to weeks to
develop.
DIF: Cognitive Level: Understand REF: p. 641
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies
8. A child is diagnosed with influenza. Management includes which recommendation?
a. Clear liquid diet for hydration
b. Aspirin to control fever
c. Oseltamivie (Tamiflu)
d. Antibiotics to prevent bacterial infection
ANS: C NURSINGTB.COM
Oseltamivie (Tamiflu) may reduce symptoms related to influenza A if administered within 24
to 48 hours of onset. A clear liquid diet is not necessary for influenza, but maintaining
hydration is important. Aspirin is not recommended in children because of increased risk of
Reye syndrome. Acetaminophen or ibuprofen is a better choice. Preventive antibiotics are not
indicated for influenza unless there is evidence of a secondary bacterial infection.
DIF: Cognitive Level: Apply REF: p. 644
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies
9. How is chronic otitis media with effusion (OME) differentiated from acute otitis media
(AOM)?
a. A fever as high as 40° C (104° F)
b. Severe pain in the ear
c. Nausea and vomiting
d. A feeling of fullness in the ear
ANS: D
OME is characterized by feeling of fullness in the ear or other nonspecific complaints. Fever
is a sign of AOM. OME does not cause severe pain. This may be a sign of AOM. Nausea and
vomiting are associated with otitis media.
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