9/26/23,u4:56uP PediatricuNursing-uAuCase-
M BaseduApproachu1stuEditionuTagheruKnappuTestu…
PediatricuNursingu–uAuCase-BaseduApproachu1stuEditionuTagheruKnappuTestuBank
Chapteru1:u Bronchiolitis
1. Whichuinterventionuisuappropriateuforutheuinfantuhospitalizeduwithubronchiolitis?
a. Positionuonutheusideuwithuneckuslightlyuflexed.
b. Administeruantibioticsuasuordered.
c. Restrictuoraluanduparenteralufluidsuifutachypneic.
d. Giveucool,uhumidifieduoxyge
n.uANS:uD
Cool,uhumidifieduoxygenuisugivenutourelieveudyspnea,uhypoxemia,uanduinsensibleufluidulossufrom
tachypnea.uTheuinfantushouldubeupositioneduwithutheuheaduanduchestuelevateduatuau30-
utou40-
degreeuangleuandutheuneckuslightlyuextendedutoumaintainuanuopenuairwayuandudecreaseupre
ssureuonutheudiaphragm.uTheuetiologyuofubronchiolitisuisuviral.uAntibioticsuareugivenuonlyui
futhereuisua
secondaryubacterialuinfection.uTachypneauincreasesuinsensibleufluiduloss.uIfutheuin
fantuisutachypneic,ufluidsuareugivenuparenterallyutoupreventudehydration.
2. Anuinfantuwithubronchiolitisuisuhospitalized.uTheucausativeuorganismuisurespiratoryusy
ncytialuvirusu(RSV).uTheunurseuknowsuthatuauchilduinfecteduwithuthisuvirusurequiresuw
hatutypeuofuisolation?
a. Reverseuisolation
b. Airborneuisolation
c. ContactuPrecautions
d. StandarduPrecaution
suANS:uC
RSVuisutransmitteduthroughudroplets.uInuadditionutouStandarduPrecautionsuanduhanduwashing,
ContactuPrecautionsuareurequired.uCaregiversumustuuseuglovesuandugownsuwhenuentering
utheuroom.uCareuisutakenunotutoutouchutheiruownueyesuorumucousumembranesuwithuauco
ntaminatedugloveduhand.uChildrenuareuplaceduinuauprivateuroomuoruinuauroomuwithuothe
ruchildrenuwithuRSVuinfections.uReverseuisolationufocusesuonukeepingubacteriauawayufro
mutheuinfant.uWithuRSV,uotheruchildrenuneedutoubeuprotectedufromuexposureutoutheuvirus.
uTheuvirusuisunotuairborne.
3. Auchilduhasuauchronicucoughuandudiffuseuwheezinguduringutheuexpiratoryuphaseuofure
spiration.uThisusuggestsuwhatucondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignubodyuinutrach
eauANS:uA
Asthmaumayuhaveutheseuchronicusignsuandusymptoms.uPneumoniauappearsuwithuanuacuteuonset,
fever,uandugeneralumalaise.uBronchiolitisuisuanuacuteuconditionucausedubyurespiratoryusyncytial
virus.uForeignubodyuinutheutracheauoccursuwithuacuteurespiratoryudistressuorufailureuan
dumaybeustridor.
4. Whichunursingudiagnosisuisumostuappropriateuforuanuinfantuwithuacuteubronchiolitis
udueutourespiratoryusyncytialuvirusu(RSV)?
a. ActivityuIntolerance
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b. DecreaseduCardiacuOutput
c. Pain,uAcute
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virus.uForeignubodyuinutheutracheauoccursuwithuacuteurespiratoryudistressuorufailureuan
dumaybeustridor.
4. Whichunursingudiagnosisuisumostuappropriateuforuanuinfantuwithuacuteubronchiolitis
udueutourespiratoryusyncytialuvirusu(RSV)?
a. ActivityuIntolerance
b. DecreaseduCardiacuOutput
c. Pain,uAcute
d. TissueuPerfusion,uIneffectiveu(peripher
al)uANS.uA
Rationaleu1:uActivityuintoleranceuisuauproblemubecauseuofutheuimbalanceubetweenuoxygenusupply
andudemand.uCardiacuoutputuisunotucompromiseduduringuanuacuteuphaseuofubronchiolitis.
uPainuisunotuusuallyuassociateduwithuacuteubronchiolitis.uTissueuperfusionu(peripheral)uis
unotuaffectedubyuthisurespiratory-diseaseuprocess.
Rationaleu2:uActivityuintoleranceuisuauproblemubecauseuofutheuimbalanceubetweenuoxygen
usupplyuandudemand.uCardiacuoutputuisunotucompromiseduduringuanuacuteuphaseuofubronc
hiolitis.uPainuisunotuusuallyuassociateduwithuacuteubronchiolitis.uTissueuperfusionu(periphe
ral)uisunotuaffectedubyuthisurespiratory-diseaseuprocess.
Rationaleu3:uActivityuintoleranceuisuauproblemubecauseuofutheuimbalanceubetweenuoxygen
usupplyuandudemand.uCardiacuoutputuisunotucompromiseduduringuanuacuteuphaseuofubronc
hiolitis.uPainuisunotuusuallyuassociateduwithuacuteubronchiolitis.uTissueuperfusionu(periphe
ral)uisunotuaffectedubyuthisurespiratory-diseaseuprocess.
Rationaleu4:uActivityuintoleranceuisuauproblemubecauseuofutheuimbalanceubetweenuoxygen
usupplyuandudemand.uCardiacuoutputuisunotucompromiseduduringuanuacuteuphaseuofubronc
hiolitis.uPainuisunotuusuallyuassociateduwithuacuteubronchiolitis.uTissueuperfusionu(periphe
ral)uisunotuaffectedubyuthisurespiratory-diseaseuprocess.
GlobaluRationale:uActivityuintoleranceuisuauproblemubecauseuofutheuimbalanceubetweenu
oxygenusupplyuandudemand.uCardiacuoutputuisunotucompromiseduduringuanuacuteuphaseu
ofubronchiolitis.uPainuisunotuusuallyuassociateduwithuacuteubronchiolitis.uTissueuperfusion
u(peripheral)uisunotuaffectedubyuthisurespiratory-diseaseuprocess.
Chapteru2:uAsthma
1. Theunurseuisucaringuforuauchilduhospitalizeduforustatusuasthmaticus.uWhichuassessment
ufindingusuggestsuthatutheuchildsuconditionuisuworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
uANS:uA
Theunurseuwoulduassessutheuchilduforusignsuofuhypoxia,uincludingurestlessness,ufatigue,uirri
tability,uanduincreaseduheartuandurespiratoryurate.uAsutheuchildutiresufromutheuincreaseduw
orkuofubreathinguhypoventilationuoccursuleadingutouincreaseducarbonudioxideulevels.uTheu
nurseuwouldubeualertuforusignsuofuhypoxia.uThirstuwouldureflectutheuchildsuhydrationustat
us.uBradycardiauisunotuausignuofuhypoxia;utachycardiauis.uClubbingudevelopsuoveruauperio
duofumonthsuinuresponseutouhypoxia.uTheupresenceuofuclubbingudoesunotuindicateutheuchil
dsuconditionuisuworsening.
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Theunurseuwoulduassessutheuchilduforusignsuofuhypoxia,uincludingurestlessness,ufatigue,uirri
tability,uanduincreaseduheartuandurespiratoryurate.uAsutheuchildutiresufromutheuincreaseduw
orkuofubreathinguhypoventilationuoccursuleadingutouincreaseducarbonudioxideulevels.uTheu
nurseuwouldubeualertuforusignsuofuhypoxia.uThirstuwouldureflectutheuchildsuhydrationustat
us.uBradycardiauisunotuausignuofuhypoxia;utachycardiauis.uClubbingudevelopsuoveruauperio
duofumonthsuinuresponseutouhypoxia.uTheupresenceuofuclubbingudoesunotuindicateutheuchil
dsuconditionuisuworsening.
2. Whichufindinguisuexpecteduwhenuassessinguauchilduhospitalizeduforuasthma?
a. Inspiratoryustridor
b. Harsh,ubarkyucough
c. Wheezing
d. Rhinorrhea
uANS:uC
Wheezinguisuauclassicumanifestationuofuasthma.uInspiratoryustridoruisuauclinicalumanifestationuof
croup.uAuharsh,ubarkyucoughuisucharacteristicuofucroup.uRhinorrheauisunotuassociateduwithuasthma.
3. Auchilduhasuhaducoldusymptomsuforumoreuthanu2uweeks,uauheadache,unasalucongest
ionuwithupurulentunasaludrainage,ufacialutenderness,uanduaucoughuthatuincreasesuduring
usleep.uTheunurseurecognizesutheseusymptomsuareucharacteristicuofuwhichurespiratoryuc
ondition?
a. Allergicurhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
uANS:uD
Sinusitisuisucharacterizedubyusignsuandusymptomsuofuaucolduthatudounotuimproveuafteru14udays,ua
low-
gradeufever,unasalucongestionuandupurulentunasaludischarge,uheadache,utenderness,uaufeelin
guofufullnessuoverutheuaffectedusinuses,uhalitosis,uanduaucoughuthatuincreasesuwhenutheuch
ilduisulyingudown.uTheuclassicusymptomsuofuallergicurhinitisuareuwateryurhinorrhea,uitchyu
nose,ueyes,uears,uandupalate,uandusneezing.uSymptomsuoccuruasulonguasutheuchilduisuexpo
sedutoutheuallergen.uBronchitisuisucharacterizedubyuaugradualuonsetuofurhinitisuanduaucough
uthatuisuinitiallyunonproductiveubutumayuchangeutouaulooseucough.uTheumanifestationsuofu
asthmaumayuvary,uwithuwheezingubeinguauclassicusign.uTheusymptomsupresenteduinutheuq
uestionudounotusuggestuasthma.
4. Whatuisuaucommonutriggeruforuasthmauattacksuinuchildren?
a. Febrileuepisodes
b. Dehydration
c. Exercise
d. Seizures
uANS:uC
Exerciseuisuoneuofutheumostucommonutriggersuforuasthmauattacks,uparticularlyuinuschool-
ageuchildren.uFebrileuepisodesuareuconsistentuwithuotheruproblems,uforuexample,useizures.u
Dehydrationuoccursuasuauresultuofudiarrhea;uitudoesunotutriggeruasthmauattacks.uViraluinfect
ionsuareutriggersuforuasthma.uSeizuresucanuresultufromuautoo-
rapiduintravenousuinfusionuofutheophyllineautherapyuforuasthma.
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