PEDIATRIC NURSING A CARE B
v
Pediatric Nursing- A Case-Based Approach 1st Edition
v v v v
v v
v v
v
ASED APPROCH
v Tagher Knapp1ST EDITION T
Test Bank
v v v v v v
AGHER KNAPP TEST BANK
v
Test Preparation (University of Mississippi)
v v
v
v v
v
, lOMoARcPSD| 14969581
1. Whichvinterventionvisvappropriatevforvthevinfantvhospitalizedvwithvbronchiolitis?
a. Positionvonvthevsidevwithvneckvslightlyvflexed.
b. Administervantibioticsvasvordered.
c. Restrictvoralvandvparenteralvfluidsvifvtachypneic.
d. Givevcool,vhumidifiedv
oxygen.vANS:vD
Cool,vhumidifiedvoxygenvisvgivenvtovrelievevdyspnea,vhypoxemia,vandvinsensiblevfluidvlossvfrom
tachypnea.vThevinfantvshouldvbevpositionedvwithvthevheadvandvchestvelevatedvatvav30-vtov40-
degreevanglevandvthevneckvslightlyvextendedvtovmaintainvanvopenvairwayvandvdecreasevpressurevonvt
hevdiaphragm.vThevetiologyvofvbronchiolitisvisvviral.vAntibioticsvarevgivenvonlyvifvtherevisvavseconda
ryvbacterialvinfection.vTachypneavincreasesvinsensiblevfluidvloss.vIfvthevinfantvisvtachypneic,vfluidsv
arevgivenvparenterallyvtovpreventvdehydration.
2. Anvinfantvwithvbronchiolitisvisvhospitalized.vThevcausativevorganismvisvrespiratoryvsyncytialv
virusv(RSV).vThevnursevknowsvthatvavchildvinfectedvwithvthisvvirusvrequiresvwhatvtypevofvisolati
on?
a. Reversevisolation
b. Airbornevisolation
c. ContactvPrecautions
d. StandardvPrecautionsv
ANS:vC
RSVvisvtransmittedvthroughvdroplets.vInvadditionvtovStandardvPrecautionsvandvhandvwashing,
ContactvPrecautionsvarevrequired.vCaregiversvmustvusevglovesvandvgownsvwhenventeringvthevroom.
vCarevisvtakenvnotvtovtouchvtheirvownveyes vorvmucousvmembranes vwithvavcontaminatedvglovedvhand
.vChildrenvarevplacedvinvavprivatevroomvorvinvavroomvwithvothervchildrenvwithvRSVvinfections.vReve
rsevisolationvfocusesvonvkeepingvbacteriavawayvfromvthevinfant.vWithvRSV,vothervchildrenvneedvtovb
evprotectedvfromvexposurevtovthevvirus.vThevvirusvisvnotvairborne.
3. Avchildvhasvavchronicvcoughvandvdiffusevwheezingvduringvthevexpiratoryvphasevofvrespiration.v
Thisvsuggestsvwhatvcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignvbodyvinv
tracheavANS:vA
Asthmavmayvhavevthesevchronicvsignsvandvsymptoms.vPneumoniavappearsvwithvanvacutevonset,
fever,vandvgeneralvmalaise.vBronchiolitisvisvanvacutevconditionvcausedvbyvrespiratoryvsyncytial
,virus.vForeignvbodyvinvthevtracheavoccursvwithvacutevrespiratoryvdistressvorvfailurevandvmaybevstrido
r.
4. Whichvnursingvdiagnosisvisvmostvappropriatevforvanvinfantvwithvacutevbronchiolitisvduevt
ovrespiratoryvsyncytialvvirusv(RSV)?
a. ActivityvIntolerance
b. DecreasedvCardiacvOutput
c. Pain,vAcute
d. TissuevPerfusion,vIneffectivev(peripheral)v
ANS.vA
Rationalev1:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
Rationalev2:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
Rationalev3:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
Rationalev4:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
GlobalvRationale:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsu
pplyvandvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainv
isvnotvusuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvt
hisvrespiratory-diseasevprocess.
Chapterv2:vAsthma
1. Thevnursevisvcaringvforvavchildvhospitalizedvforvstatusvasthmaticus.vWhichvassessmentvf
indingvsuggestsvthatvthevchildsvconditionvisvworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
vANS: vA
, Thevnursevwouldvassessvthevchildvforvsignsvofvhypoxia,vincludingvrestlessness,vfatigue,virritability,va
ndvincreasedvheartvandvrespiratoryvrate.vAsvthevchildvtiresvfromvthevincreasedvworkvofvbreathingvhyp
oventilationvoccursvleadingvtovincreasedvcarbonvdioxidevlevels.vThevnursevwouldvbevalertvforvsignsv
ofvhypoxia.vThirstvwouldvreflectvthevchildsvhydrationvstatus.vBradycardiavisvnotvavsignvofvhypoxia;vt
achycardiavis.vClubbingvdevelopsvovervavperiodvofvmonthsvinvresponsevtovhypoxia.vThevpresencevofv
clubbingvdoesvnotvindicatevthevchildsvconditionvisvworsening.
2. Whichvfindingvisvexpectedvwhenvassessingvavchildvhospitalizedvforvasthma?
a. Inspiratoryvstridor
b. Harsh,vbarkyvcough
c. Wheezing
d. Rhinorrhea
vANS: vC
Wheezingvisvavclassicvmanifestationvofvasthma.vInspiratoryvstridorvisvavclinicalvmanifestationvof
croup.vAvharsh,vbarkyvcoughvisvcharacteristicvofvcroup.vRhinorrheavisvnotvassociatedvwithvasthma.
3. Avchildvhasvhadvcoldvsymptomsvforvmorevthanv2vweeks,vavheadache,vnasalvcongestionvwithvp
urulentvnasalvdrainage,vfacialvtenderness,vandvavcoughvthatvincreasesvduringvsleep.vThevnursevr
ecognizesvthesevsymptomsvarevcharacteristicvofvwhichvrespiratoryvcondition?
a. Allergicvrhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
vANS: vD
Sinusitisvisvcharacterizedvbyvsignsvandvsymptomsvofvavcoldvthatvdovnotvimprovevafterv14vdays,va
low-
gradevfever,vnasalvcongestionvandvpurulentvnasalvdischarge,vheadache,vtenderness,vavfeelingvofvfull
nessvovervthevaffectedvsinuses,vhalitosis,vandvavcoughvthatvincreasesvwhenvthevchildvisvlyingvdown.v
Thevclassicvsymptomsvofvallergicvrhinitisvarevwateryvrhinorrhea,vitchyvnose,veyes,vears,vandvpalate,v
andvsneezing.vSymptomsvoccurvasvlongvasvthevchildvisvexposedvtovthevallergen.vBronchitisvisvcharac
terizedvbyvavgradualvonsetvofvrhinitisvandvavcoughvthatvisvinitiallyvnonproductivevbutvmayvchangevtov
avloosevcough.vThevmanifestationsvofvasthmavmayvvary,vwithvwheezingvbeingvavclassicvsign.vThevsy
mptomsvpresentedvinvthevquestionvdovnotvsuggestvasthma.
4. Whatvisvavcommonvtriggervforvasthmavattacksvinvchildren?
a. Febrilevepisodes
b. Dehydration
c. Exercise
d. Seizures
vANS:vC
v
Pediatric Nursing- A Case-Based Approach 1st Edition
v v v v
v v
v v
v
ASED APPROCH
v Tagher Knapp1ST EDITION T
Test Bank
v v v v v v
AGHER KNAPP TEST BANK
v
Test Preparation (University of Mississippi)
v v
v
v v
v
, lOMoARcPSD| 14969581
1. Whichvinterventionvisvappropriatevforvthevinfantvhospitalizedvwithvbronchiolitis?
a. Positionvonvthevsidevwithvneckvslightlyvflexed.
b. Administervantibioticsvasvordered.
c. Restrictvoralvandvparenteralvfluidsvifvtachypneic.
d. Givevcool,vhumidifiedv
oxygen.vANS:vD
Cool,vhumidifiedvoxygenvisvgivenvtovrelievevdyspnea,vhypoxemia,vandvinsensiblevfluidvlossvfrom
tachypnea.vThevinfantvshouldvbevpositionedvwithvthevheadvandvchestvelevatedvatvav30-vtov40-
degreevanglevandvthevneckvslightlyvextendedvtovmaintainvanvopenvairwayvandvdecreasevpressurevonvt
hevdiaphragm.vThevetiologyvofvbronchiolitisvisvviral.vAntibioticsvarevgivenvonlyvifvtherevisvavseconda
ryvbacterialvinfection.vTachypneavincreasesvinsensiblevfluidvloss.vIfvthevinfantvisvtachypneic,vfluidsv
arevgivenvparenterallyvtovpreventvdehydration.
2. Anvinfantvwithvbronchiolitisvisvhospitalized.vThevcausativevorganismvisvrespiratoryvsyncytialv
virusv(RSV).vThevnursevknowsvthatvavchildvinfectedvwithvthisvvirusvrequiresvwhatvtypevofvisolati
on?
a. Reversevisolation
b. Airbornevisolation
c. ContactvPrecautions
d. StandardvPrecautionsv
ANS:vC
RSVvisvtransmittedvthroughvdroplets.vInvadditionvtovStandardvPrecautionsvandvhandvwashing,
ContactvPrecautionsvarevrequired.vCaregiversvmustvusevglovesvandvgownsvwhenventeringvthevroom.
vCarevisvtakenvnotvtovtouchvtheirvownveyes vorvmucousvmembranes vwithvavcontaminatedvglovedvhand
.vChildrenvarevplacedvinvavprivatevroomvorvinvavroomvwithvothervchildrenvwithvRSVvinfections.vReve
rsevisolationvfocusesvonvkeepingvbacteriavawayvfromvthevinfant.vWithvRSV,vothervchildrenvneedvtovb
evprotectedvfromvexposurevtovthevvirus.vThevvirusvisvnotvairborne.
3. Avchildvhasvavchronicvcoughvandvdiffusevwheezingvduringvthevexpiratoryvphasevofvrespiration.v
Thisvsuggestsvwhatvcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignvbodyvinv
tracheavANS:vA
Asthmavmayvhavevthesevchronicvsignsvandvsymptoms.vPneumoniavappearsvwithvanvacutevonset,
fever,vandvgeneralvmalaise.vBronchiolitisvisvanvacutevconditionvcausedvbyvrespiratoryvsyncytial
,virus.vForeignvbodyvinvthevtracheavoccursvwithvacutevrespiratoryvdistressvorvfailurevandvmaybevstrido
r.
4. Whichvnursingvdiagnosisvisvmostvappropriatevforvanvinfantvwithvacutevbronchiolitisvduevt
ovrespiratoryvsyncytialvvirusv(RSV)?
a. ActivityvIntolerance
b. DecreasedvCardiacvOutput
c. Pain,vAcute
d. TissuevPerfusion,vIneffectivev(peripheral)v
ANS.vA
Rationalev1:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
Rationalev2:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
Rationalev3:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
Rationalev4:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsupplyva
ndvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainvisvnotv
usuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvthisvres
piratory-diseasevprocess.
GlobalvRationale:vActivityvintolerancevisvavproblemvbecausevofvthevimbalancevbetweenvoxygenvsu
pplyvandvdemand.vCardiacvoutputvisvnotvcompromisedvduringvanvacutevphasevofvbronchiolitis.vPainv
isvnotvusuallyvassociatedvwithvacutevbronchiolitis.vTissuevperfusionv(peripheral)visvnotvaffectedvbyvt
hisvrespiratory-diseasevprocess.
Chapterv2:vAsthma
1. Thevnursevisvcaringvforvavchildvhospitalizedvforvstatusvasthmaticus.vWhichvassessmentvf
indingvsuggestsvthatvthevchildsvconditionvisvworsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
vANS: vA
, Thevnursevwouldvassessvthevchildvforvsignsvofvhypoxia,vincludingvrestlessness,vfatigue,virritability,va
ndvincreasedvheartvandvrespiratoryvrate.vAsvthevchildvtiresvfromvthevincreasedvworkvofvbreathingvhyp
oventilationvoccursvleadingvtovincreasedvcarbonvdioxidevlevels.vThevnursevwouldvbevalertvforvsignsv
ofvhypoxia.vThirstvwouldvreflectvthevchildsvhydrationvstatus.vBradycardiavisvnotvavsignvofvhypoxia;vt
achycardiavis.vClubbingvdevelopsvovervavperiodvofvmonthsvinvresponsevtovhypoxia.vThevpresencevofv
clubbingvdoesvnotvindicatevthevchildsvconditionvisvworsening.
2. Whichvfindingvisvexpectedvwhenvassessingvavchildvhospitalizedvforvasthma?
a. Inspiratoryvstridor
b. Harsh,vbarkyvcough
c. Wheezing
d. Rhinorrhea
vANS: vC
Wheezingvisvavclassicvmanifestationvofvasthma.vInspiratoryvstridorvisvavclinicalvmanifestationvof
croup.vAvharsh,vbarkyvcoughvisvcharacteristicvofvcroup.vRhinorrheavisvnotvassociatedvwithvasthma.
3. Avchildvhasvhadvcoldvsymptomsvforvmorevthanv2vweeks,vavheadache,vnasalvcongestionvwithvp
urulentvnasalvdrainage,vfacialvtenderness,vandvavcoughvthatvincreasesvduringvsleep.vThevnursevr
ecognizesvthesevsymptomsvarevcharacteristicvofvwhichvrespiratoryvcondition?
a. Allergicvrhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
vANS: vD
Sinusitisvisvcharacterizedvbyvsignsvandvsymptomsvofvavcoldvthatvdovnotvimprovevafterv14vdays,va
low-
gradevfever,vnasalvcongestionvandvpurulentvnasalvdischarge,vheadache,vtenderness,vavfeelingvofvfull
nessvovervthevaffectedvsinuses,vhalitosis,vandvavcoughvthatvincreasesvwhenvthevchildvisvlyingvdown.v
Thevclassicvsymptomsvofvallergicvrhinitisvarevwateryvrhinorrhea,vitchyvnose,veyes,vears,vandvpalate,v
andvsneezing.vSymptomsvoccurvasvlongvasvthevchildvisvexposedvtovthevallergen.vBronchitisvisvcharac
terizedvbyvavgradualvonsetvofvrhinitisvandvavcoughvthatvisvinitiallyvnonproductivevbutvmayvchangevtov
avloosevcough.vThevmanifestationsvofvasthmavmayvvary,vwithvwheezingvbeingvavclassicvsign.vThevsy
mptomsvpresentedvinvthevquestionvdovnotvsuggestvasthma.
4. Whatvisvavcommonvtriggervforvasthmavattacksvinvchildren?
a. Febrilevepisodes
b. Dehydration
c. Exercise
d. Seizures
vANS:vC
