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Peds Respiratory NCLEX 2022 with complete solution

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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 that these symptoms are characteristic of which respiratory condition? a. Allergic rhinitis b. Bronc...

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  • April 8, 2022
  • 19
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers
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Peds Respiratory NCLEX

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 that these symptoms are characteristic of which respiratory condition?
a. Allergic rhinitis
b. Bronchitis
c. Asthma
d. Sinusitis Correct answer- ANS: D
Feedback
A 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.
B Bronchitis is characterized by a gradual onset of rhinitis and a cough that is
initially nonproductive but may change to a loose cough.
C The manifestations of asthma may vary, with wheezing being a classic sign. The
symptoms presented in the question do not suggest asthma.
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.

For which problem should the child with chronic otitis media with effusion be
evaluated?
a. Brain abscess
b. Meningitis
c. Hearing loss
d. Perforation of the tympanic membrane Correct answer- ANS: C
Feedback
A The infection of acute otitis media can spread to surrounding tissues, causing a
brain abscess.
B The infection of acute otitis media can spread to surrounding tissues, causing
meningitis.
C Chronic otitis media with effusion is the most common cause of hearing loss in
children.
D Inflammation and pressure from acute otitis media may result in perforation of

,the tympanic membrane.

The nurse expects the initial plan of care for a 9-month-old child with an acute otitis
media
infection to include
a. symptomatic treatment and observation for 48 to 72 hours after diagnosis
b. an oral antibiotic, such as amoxicillin, five times a day for 7 days
c. pneumococcal conjugate vaccine
d. myringotomy with tympanoplasty tubes Correct answer- ANS: A
Feedback
A Select children 6 months of age or older with acute otitis media are treated by
initiating symptomatic treatment and observation for 48 to 72 hours.
B Acute otitis media may be treated with a 5- to 10-day course of oral antibiotics.
When treatment is indicated, amoxicillin at a divided dose of 80 to 90 mg/kg/day
given either every 8 or 12 hours for 5 to 10 days may be ordered.
C Pneumococcal conjugate vaccine helps to prevent ear infections but is not
included in the initial plan of care for a child with acute otitis media.
D Surgical intervention is considered when the child has persistent ear infection
despite antibiotic therapy or with otitis media with effusion that persists for more
than 3 months and is associated with hearing loss.

Which statement made by a parent indicates an understanding about treatment of
streptococcal pharyngitis?
a. "I guess my child will need to have his tonsils removed."
b. "A couple of days of rest and some ibuprofen will take care of this."
c. "I should give the penicillin three times a day for 10 days."
d. "I am giving my child prednisone to decrease the swelling of the tonsils." Correct
answer- ANS: C
Feedback
A Surgical removal of the tonsils is a controversial issue. It may be warranted in
cases of recurrent tonsillitis. It is not indicated for the treatment of acute
tonsillitis.
B Comfort measures such as rest and analgesics are indicated, but these will not
treat the bacterial infection.
C Streptococcal pharyngitis is best treated with oral penicillin two to three times
daily for 10 days.
D Corticosteroids are not used in the treatment of streptococcal pharyngitis.

The father of an infant calls the nurse to his son's room because he is "making a strange
noise." A diagnosis of laryngomalacia is made. What does the nurse expect to find on

, assessment?
a. Stridor
b. High-pitched cry
c. Nasal congestion
d. Spasmodic cough Correct answer- ANS: A
Feedback
A Stridor is usually present at birth but may begin as late as 2 months. Symptoms
increase when the infant is supine or crying.
B High-pitched cries are consistent with neurologic abnormalities and are not
usually respiratory in nature.
C Nasal congestion is nonspecific in relation to laryngomalacia.
D Spasmodic cough is associated with croup; it is not a common symptom of
laryngomalacia.

The nurse should assess a child who has had a tonsillectomy for
a. Frequent swallowing
b. Inspiratory stridor
c. Rhonchi
d. Elevated white blood cell count Correct answer- ANS: A
Feedback
A Frequent swallowing is indicative of postoperative bleeding.
B Inspiratory stridor is characteristic of croup.
C Rhonchi are lower airway sounds indicating pneumonia.
D Assessment of blood cell counts is part of a preoperative workup.

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing
manifestation of spasmodic croup?
a. Wheezing is heard audibly.
b. It has a harsh, barky cough.
c. It is bacterial in nature.
d. The child has a high fever. Correct answer- ANS: B
Feedback
A Wheezing is not a distinguishing manifestation of croup. It can accompany
conditions such as asthma or bronchiolitis.
B Spasmodic croup is viral in origin; is usually preceded by several days of
symptoms of upper respiratory tract infection; often begins at night; and is
marked by a harsh, metallic, barky cough; sore throat; inspiratory stridor; and
hoarseness.
C Spasmodic croup is viral in origin.
D A high fever is not usually present.

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