Chapter 23: The Child with Respiratory Dysfunction
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 b-hemolytic streptococcal infections.
2. A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?
a. Dyspnea
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 upright position.
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, Chapter 23: The Child with Respiratory Dysfunction
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.
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.
2
, Chapter 23: The Child with Respiratory Dysfunction
5. Which is an appropriate nursing intervention when caring for an infant with an upper respiratory tract
infection and elevated temperature?
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, Chapter 23: The Child with Respiratory Dysfunction
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 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.
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.
7. It is generally recommended that a child with acute streptococcal pharyngitis can return to school:
4
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 b-hemolytic streptococcal infections.
2. A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?
a. Dyspnea
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 upright position.
1
, Chapter 23: The Child with Respiratory Dysfunction
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.
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.
2
, Chapter 23: The Child with Respiratory Dysfunction
5. Which is an appropriate nursing intervention when caring for an infant with an upper respiratory tract
infection and elevated temperature?
3
, Chapter 23: The Child with Respiratory Dysfunction
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 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.
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.
7. It is generally recommended that a child with acute streptococcal pharyngitis can return to school:
4
