Test Bank for Pediatric Nursing a case based Approach 1st Edi
o o o o o o o o o o
on Tagher Knapp 2024
o o o
Chaptero1:o Bronchiolitis
1. Whichointerventionoisoappropriateoforotheoinfantohospitalizedowithobronchiolitis?
a. Positionoonotheosideowithoneckoslightlyoflexed.
b. Administeroantibioticsoasoordered.
c. Restrictooraloandoparenteralofluidsoifotachypneic.
d. Giveocool,ohumidifiedooxygen.o
ANS:oD
Cool,ohumidifiedooxygenoisogivenotoorelieveodyspnea,ohypoxemia,oandoinsensibleofluidolossofrom
tachypnea.oTheoinfantoshouldobeopositionedowithotheoheadoandochestoelevatedoatoao30-otoo40-
degreeoangleoandotheoneckoslightlyoextendedotoomaintainoanoopenoairwayoandodecreaseopressureoonot
heodiaphragm.oTheoetiologyoofobronchiolitisoisoviral.oAntibioticsoareogivenoonlyoifothereoisoaosecond
aryobacterialoinfection.oTachypneaoincreasesoinsensibleofluidoloss.oIfotheoinfantoisotachypneic,ofluids
oareogivenoparenterallyotooprevent odehydration.
2. Anoinfantowithobronchiolitisoisohospitalized.oTheocausativeoorganismoisorespiratoryosyncytialo
viruso(RSV).oTheonurseoknowsothatoaochildoinfectedowithothisovirusorequiresowhatotypeoofoisolati
on?
a. Reverseoisolation
b. Airborneoisolation
c. ContactoPrecautions
d. StandardoPrecautionso
ANS:oC
RSVoisotransmittedothroughodroplets.oInoadditionotooStandardoPrecautionsoandohandowashing,
ContactoPrecautionsoareorequired.oCaregiversomustouseoglovesoandogownsowhenoenteringotheoroom.
oCareoisotakenonototootouchotheiroownoeyes ooromucousomembranes owithoaocontaminatedoglovedohand
.oChildrenoareoplacedoinoaoprivateoroomooroinoaoroomowithootherochildrenowithoRSVoinfections.oReve
rseoisolationofocusesoonokeepingobacteriaoawayofromotheoinfant.oWithoRSV,ootherochildrenoneedotoob
eoprotectedofromoexposureotootheovirus.oTheovirusoisonotoairborne.
3. Aochildohasoaochronicocoughoandodiffuseowheezingoduringotheoexpiratoryophaseooforespiration.o
Thisosuggestsowhatocondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignobodyoinotracheao
ANS:oA
Asthmaomayohaveotheseochronicosignsoandosymptoms.oPneumoniaoappearsowithoanoacuteoonset,
fever,oandogeneralomalaise.oBronchiolitisoisoanoacuteoconditionocausedobyorespiratoryosyncytial
,virus.oForeignobodyoinotheotracheaooccursowithoacuteorespiratoryodistressoorofailureoandomaybeostrido
r.
4. Whichonursingodiagnosisoisomostoappropriateoforoanoinfantowithoacuteobronchiolitisodueotoor
espiratoryosyncytialoviruso(RSV)?
a. ActivityoIntolerance
b. DecreasedoCardiacoOutput
c. Pain,oAcute
d. TissueoPerfusion,oIneffectiveo(peripheral)o
ANS.oA
Rationaleo1:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoan
dodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonotou
suallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisoresp
iratory-diseaseoprocess.
Rationaleo2:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoan
dodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonotou
suallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisoresp
iratory-diseaseoprocess.
Rationaleo3:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoa
ndodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonoto
usuallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisores
piratory-diseaseoprocess.
Rationaleo4:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoan
dodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonotou
suallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisoresp
iratory-diseaseoprocess.
GlobaloRationale:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosu
pplyoandodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoi
sonotousuallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyot
hisorespiratory-diseaseoprocess.
Chaptero2:oAsthma
1. Theonurseoisocaringoforoaochildohospitalizedoforostatusoasthmaticus.oWhichoassessmentofindingos
uggestsothatotheochildsoconditionoisoworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
oANS:oA
,Theonurseowouldoassessotheochildoforosignsoofohypoxia,oincludingorestlessness,ofatigue,oirritability,oa
ndoincreasedoheartoandorespiratoryorate.oAsotheochildotiresofromotheoincreasedoworkoofobreathingohyp
oventilationooccursoleadingotooincreasedocarbonodioxideolevels.oTheonurseowouldobeoalertoforosignso
ofohypoxia.oThirstowouldoreflectotheochildsohydrationostatus.oBradycardiaoisonotoaosignoofohypoxia;ot
achycardiaois.oClubbingodevelopsooveroaoperiodoofomonthsoinoresponseotoohypoxia.oTheopresenceoofo
clubbingodoesonotoindicateotheochildsoconditionoisoworsening.
2. Whichofindingoisoexpectedowhenoassessingoaochildohospitalizedoforoasthma?
a. Inspiratoryostridor
b. Harsh,obarkyocough
c. Wheezing
d. Rhinorrhea
oANS:oC
Wheezingoisoaoclassicomanifestationoofoasthma.oInspiratoryostridoroisoaoclinicalomanifestationoof
croup.oAoharsh,obarkyocoughoisocharacteristicoofocroup.oRhinorrheaoisonotoassociatedowithoasthma.
3. Aochildohasohadocoldosymptomsoforomoreothano2oweeks,oaoheadache,onasalocongestionowithop
urulentonasalodrainage,ofacialotenderness,oandoaocoughothatoincreasesoduringosleep.oTheonurseore
cognizesotheseosymptomsoareocharacteristicoofowhichorespiratoryocondition?
a. Allergicorhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
oANS:oD
Sinusitisoisocharacterizedobyosignsoandosymptomsoofoaocoldothatodoonotoimproveoaftero14odays,oa
low-
gradeofever,onasalocongestionoandopurulentonasalodischarge,oheadache,otenderness,oaofeelingoofofull
nessooverotheoaffectedosinuses,ohalitosis,oandoaocoughothatoincreasesowhenotheochildoisolyingodown.oT
heoclassicosymptomsoofoallergicorhinitisoareowateryorhinorrhea,oitchyonose,oeyes,oears,oandopalate,oan
dosneezing.oSymptomsooccuroasolongoasotheochildoisoexposedotootheoallergen.oBronchitisoisocharacter
izedobyoaogradualoonsetooforhinitisoandoaocoughothatoisoinitiallyononproductiveobutomayochangeotooaol
ooseocough.oTheomanifestationsoofoasthmaomayovary,owithowheezingobeingoaoclassicosign.oTheosym
ptomsopresentedoinotheoquestionodoonotosuggestoasthma.
4. Whatoisoaocommonotriggeroforoasthmaoattacksoinochildren?
a. Febrileoepisodes
b. Dehydration
c. Exercise
d. Seizures
oANS:oC
, Exerciseoisooneoofotheomostocommonotriggersoforoasthmaoattacks,oparticularlyoinoschool-
ageochildren.oFebrileoepisodesoareoconsistentowithootheroproblems,oforoexample,oseizures.oDehydrati
onooccursoasoaoresultoofodiarrhea;oitodoesonototriggeroasthmaoattacks.oViraloinfectionsoareotriggersofor
oasthma.oSeizures ocanoresultofromoaotoo-
rapidointravenousoinfusionoofotheophyllineaotherapyoforoasthma.
5. Theopractitionerochangesotheomedicationsoforotheochildowithoasthmaotoosalmeterolo(Serevent).oT
heomotheroasksotheonurseowhatothisodrugowillodo.oTheonurseoexplainsothatosalmeterolo(Serevent)oiso
usedotootreatoasthmaobecauseotheodrugoproducesowhichocharacteristic?
1. Decreasesoinflammation
2. Decreasesomucousoproduction
3. Controlsoallergicorhinitis
4. Dilatesotheobronchioles
CorrectoAnswer:o4
Rationaleo1:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
Rationaleo2:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
Rationaleo3:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
Rationaleo4:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
GlobaloRationale:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
CognitiveoLevel:oAnalyzing
ClientoNeed:oPhysiologicaloIntegrity
ClientoNeedoSub:oPharmacologicaloandoParenteraloTherapies
Nursing/IntegratedoConcepts:oNursingoProcess:oImplementation
LearningoOutcome:oLOo20.6oCreateoaonursingocareoplanoforoaochildowithoaocommonoacuteorespirato
ryocondition.
6. Followingoparentaloteaching,otheonurseoisoevaluatingotheoparentsounderstandingoofoenviron
mentalocontroloforotheirochildsoasthmaomanagement.oWhichostatementobyotheoparentsoindicate
soappropriateounderstandingoofotheoteaching?
1. Weowilloreplaceotheocarpetoinoourochildsobedroomowithotile.
2. Wereogladotheodogocanocontinueotoosleepoinoourochildsoroom.
3. Wellobeosureotoouseotheofireplaceooftenotookeepotheohouseowarmoinotheowinter.
4. Wellokeepotheoplantsoinoourochildsoroomodusted.
CorrectoAnswer:o1
o o o o o o o o o o
on Tagher Knapp 2024
o o o
Chaptero1:o Bronchiolitis
1. Whichointerventionoisoappropriateoforotheoinfantohospitalizedowithobronchiolitis?
a. Positionoonotheosideowithoneckoslightlyoflexed.
b. Administeroantibioticsoasoordered.
c. Restrictooraloandoparenteralofluidsoifotachypneic.
d. Giveocool,ohumidifiedooxygen.o
ANS:oD
Cool,ohumidifiedooxygenoisogivenotoorelieveodyspnea,ohypoxemia,oandoinsensibleofluidolossofrom
tachypnea.oTheoinfantoshouldobeopositionedowithotheoheadoandochestoelevatedoatoao30-otoo40-
degreeoangleoandotheoneckoslightlyoextendedotoomaintainoanoopenoairwayoandodecreaseopressureoonot
heodiaphragm.oTheoetiologyoofobronchiolitisoisoviral.oAntibioticsoareogivenoonlyoifothereoisoaosecond
aryobacterialoinfection.oTachypneaoincreasesoinsensibleofluidoloss.oIfotheoinfantoisotachypneic,ofluids
oareogivenoparenterallyotooprevent odehydration.
2. Anoinfantowithobronchiolitisoisohospitalized.oTheocausativeoorganismoisorespiratoryosyncytialo
viruso(RSV).oTheonurseoknowsothatoaochildoinfectedowithothisovirusorequiresowhatotypeoofoisolati
on?
a. Reverseoisolation
b. Airborneoisolation
c. ContactoPrecautions
d. StandardoPrecautionso
ANS:oC
RSVoisotransmittedothroughodroplets.oInoadditionotooStandardoPrecautionsoandohandowashing,
ContactoPrecautionsoareorequired.oCaregiversomustouseoglovesoandogownsowhenoenteringotheoroom.
oCareoisotakenonototootouchotheiroownoeyes ooromucousomembranes owithoaocontaminatedoglovedohand
.oChildrenoareoplacedoinoaoprivateoroomooroinoaoroomowithootherochildrenowithoRSVoinfections.oReve
rseoisolationofocusesoonokeepingobacteriaoawayofromotheoinfant.oWithoRSV,ootherochildrenoneedotoob
eoprotectedofromoexposureotootheovirus.oTheovirusoisonotoairborne.
3. Aochildohasoaochronicocoughoandodiffuseowheezingoduringotheoexpiratoryophaseooforespiration.o
Thisosuggestsowhatocondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignobodyoinotracheao
ANS:oA
Asthmaomayohaveotheseochronicosignsoandosymptoms.oPneumoniaoappearsowithoanoacuteoonset,
fever,oandogeneralomalaise.oBronchiolitisoisoanoacuteoconditionocausedobyorespiratoryosyncytial
,virus.oForeignobodyoinotheotracheaooccursowithoacuteorespiratoryodistressoorofailureoandomaybeostrido
r.
4. Whichonursingodiagnosisoisomostoappropriateoforoanoinfantowithoacuteobronchiolitisodueotoor
espiratoryosyncytialoviruso(RSV)?
a. ActivityoIntolerance
b. DecreasedoCardiacoOutput
c. Pain,oAcute
d. TissueoPerfusion,oIneffectiveo(peripheral)o
ANS.oA
Rationaleo1:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoan
dodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonotou
suallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisoresp
iratory-diseaseoprocess.
Rationaleo2:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoan
dodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonotou
suallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisoresp
iratory-diseaseoprocess.
Rationaleo3:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoa
ndodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonoto
usuallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisores
piratory-diseaseoprocess.
Rationaleo4:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosupplyoan
dodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoisonotou
suallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyothisoresp
iratory-diseaseoprocess.
GlobaloRationale:oActivityointoleranceoisoaoproblemobecauseoofotheoimbalanceobetweenooxygenosu
pplyoandodemand.oCardiacooutputoisonotocompromisedoduringoanoacuteophaseoofobronchiolitis.oPainoi
sonotousuallyoassociatedowithoacuteobronchiolitis.oTissueoperfusiono(peripheral)oisonotoaffectedobyot
hisorespiratory-diseaseoprocess.
Chaptero2:oAsthma
1. Theonurseoisocaringoforoaochildohospitalizedoforostatusoasthmaticus.oWhichoassessmentofindingos
uggestsothatotheochildsoconditionoisoworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
oANS:oA
,Theonurseowouldoassessotheochildoforosignsoofohypoxia,oincludingorestlessness,ofatigue,oirritability,oa
ndoincreasedoheartoandorespiratoryorate.oAsotheochildotiresofromotheoincreasedoworkoofobreathingohyp
oventilationooccursoleadingotooincreasedocarbonodioxideolevels.oTheonurseowouldobeoalertoforosignso
ofohypoxia.oThirstowouldoreflectotheochildsohydrationostatus.oBradycardiaoisonotoaosignoofohypoxia;ot
achycardiaois.oClubbingodevelopsooveroaoperiodoofomonthsoinoresponseotoohypoxia.oTheopresenceoofo
clubbingodoesonotoindicateotheochildsoconditionoisoworsening.
2. Whichofindingoisoexpectedowhenoassessingoaochildohospitalizedoforoasthma?
a. Inspiratoryostridor
b. Harsh,obarkyocough
c. Wheezing
d. Rhinorrhea
oANS:oC
Wheezingoisoaoclassicomanifestationoofoasthma.oInspiratoryostridoroisoaoclinicalomanifestationoof
croup.oAoharsh,obarkyocoughoisocharacteristicoofocroup.oRhinorrheaoisonotoassociatedowithoasthma.
3. Aochildohasohadocoldosymptomsoforomoreothano2oweeks,oaoheadache,onasalocongestionowithop
urulentonasalodrainage,ofacialotenderness,oandoaocoughothatoincreasesoduringosleep.oTheonurseore
cognizesotheseosymptomsoareocharacteristicoofowhichorespiratoryocondition?
a. Allergicorhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
oANS:oD
Sinusitisoisocharacterizedobyosignsoandosymptomsoofoaocoldothatodoonotoimproveoaftero14odays,oa
low-
gradeofever,onasalocongestionoandopurulentonasalodischarge,oheadache,otenderness,oaofeelingoofofull
nessooverotheoaffectedosinuses,ohalitosis,oandoaocoughothatoincreasesowhenotheochildoisolyingodown.oT
heoclassicosymptomsoofoallergicorhinitisoareowateryorhinorrhea,oitchyonose,oeyes,oears,oandopalate,oan
dosneezing.oSymptomsooccuroasolongoasotheochildoisoexposedotootheoallergen.oBronchitisoisocharacter
izedobyoaogradualoonsetooforhinitisoandoaocoughothatoisoinitiallyononproductiveobutomayochangeotooaol
ooseocough.oTheomanifestationsoofoasthmaomayovary,owithowheezingobeingoaoclassicosign.oTheosym
ptomsopresentedoinotheoquestionodoonotosuggestoasthma.
4. Whatoisoaocommonotriggeroforoasthmaoattacksoinochildren?
a. Febrileoepisodes
b. Dehydration
c. Exercise
d. Seizures
oANS:oC
, Exerciseoisooneoofotheomostocommonotriggersoforoasthmaoattacks,oparticularlyoinoschool-
ageochildren.oFebrileoepisodesoareoconsistentowithootheroproblems,oforoexample,oseizures.oDehydrati
onooccursoasoaoresultoofodiarrhea;oitodoesonototriggeroasthmaoattacks.oViraloinfectionsoareotriggersofor
oasthma.oSeizures ocanoresultofromoaotoo-
rapidointravenousoinfusionoofotheophyllineaotherapyoforoasthma.
5. Theopractitionerochangesotheomedicationsoforotheochildowithoasthmaotoosalmeterolo(Serevent).oT
heomotheroasksotheonurseowhatothisodrugowillodo.oTheonurseoexplainsothatosalmeterolo(Serevent)oiso
usedotootreatoasthmaobecauseotheodrugoproducesowhichocharacteristic?
1. Decreasesoinflammation
2. Decreasesomucousoproduction
3. Controlsoallergicorhinitis
4. Dilatesotheobronchioles
CorrectoAnswer:o4
Rationaleo1:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
Rationaleo2:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
Rationaleo3:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
Rationaleo4:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
GlobaloRationale:oSalmeterolo(Serevent)oisoaolong-actingobeta2-
agonistothatoactsobyobronchodilating.oSteroidsoareoanti-
inflammatory,oanticholinergicsodecreaseomucousoproduction,oandoantihistaminesocontroloallergicorh
initis.
CognitiveoLevel:oAnalyzing
ClientoNeed:oPhysiologicaloIntegrity
ClientoNeedoSub:oPharmacologicaloandoParenteraloTherapies
Nursing/IntegratedoConcepts:oNursingoProcess:oImplementation
LearningoOutcome:oLOo20.6oCreateoaonursingocareoplanoforoaochildowithoaocommonoacuteorespirato
ryocondition.
6. Followingoparentaloteaching,otheonurseoisoevaluatingotheoparentsounderstandingoofoenviron
mentalocontroloforotheirochildsoasthmaomanagement.oWhichostatementobyotheoparentsoindicate
soappropriateounderstandingoofotheoteaching?
1. Weowilloreplaceotheocarpetoinoourochildsobedroomowithotile.
2. Wereogladotheodogocanocontinueotoosleepoinoourochildsoroom.
3. Wellobeosureotoouseotheofireplaceooftenotookeepotheohouseowarmoinotheowinter.
4. Wellokeepotheoplantsoinoourochildsoroomodusted.
CorrectoAnswer:o1
