Question 1
Which statement by the nurse accurately describes the difference between the respiratory
systems of a child and an adult?
1. The nares in children are larger in size, shallow in depth, underdeveloped, and less easily
occluded.
2. The larynx and the glottis are lower in the younger child’s neck, which makes the child
more prone to aspiration.
3. The epiglottis in the younger child is longer and flaccid, making it more susceptible to
swelling that may lead to airway occlusion.
4. There are fewer functional muscles in the neck, and the decreased amount of soft tissue
makes the child more susceptible to infection and edema.
Answer
3. The epiglottis in the younger child is longer and flaccid, making it more susceptible to
swelling that may lead to airway occlusion.
Rationale
The pediatric epiglottis is longer, narrower, and more flaccid than that of an adult. Because of
this anatomy, swelling can occur more easily and may quickly obstruct the airway. Children have
smaller airways overall, so even minor inflammation can significantly impair airflow. This
anatomical difference increases the risk for respiratory compromise during illness.
Question 2
A pediatric nurse is performing a respiratory assessment on an 18-month-old child. The nurse
most likely uses which recommended techniques?
1. Assess breath sounds by listening to all lung fields and alternating sides for comparison
2. Assess the resonance of the lungs and underlying organs by using auscultation
3. Assess the child’s respiratory status when fully awake and active
4. Assess for normal breath sounds using palpation
Answer
1. Assess breath sounds by listening to all lung fields and alternating sides for comparison
Rationale
Accurate respiratory assessment requires auscultation of all lung fields while comparing one side
to the other. This allows the nurse to identify asymmetrical breath sounds or abnormal findings.
, Resonance is assessed by percussion, not auscultation. Respiratory assessments are best
performed when the child is quiet or asleep, and breath sounds are evaluated through
auscultation rather than palpation.
Question 3
The pediatric nurse recognizes that normal breath sounds are equal bilaterally in intensity,
rhythm, and pitch. Which respiratory sign may indicate that a child is hypoxic?
1. Stridor
2. Anxiety
3. Rhonchi
4. Crackles
Answer
2. Anxiety
Rationale
Anxiety is often an early sign of hypoxia in children. As oxygen levels decrease, the child may
become restless, agitated, or fearful. Behavioral changes frequently occur before more severe
signs of respiratory failure develop. Stridor, rhonchi, and crackles are abnormal breath sounds
but are not specific indicators of hypoxia.
Question 4
Which should the nurse anticipate when providing care to a child who aspirated a foreign body
(FB)?
1. CT scan
2. Chest x-ray
3. Fluoroscopy
4. Bronchoscopy
Answer
4. Bronchoscopy
Rationale
Bronchoscopy is commonly used to directly visualize and remove an aspirated foreign body
from the airway. It allows the provider to identify the location of the obstruction and remove it
safely. Airway maintenance is the priority when foreign body aspiration occurs. Bronchoscopy is
considered the definitive diagnostic and therapeutic procedure.