9/26/23,n4:56nP Pediatric nNursing- nAnCase-
M Based nApproach n1stnEdition nTagher nKnapp nTestn…
PediatricnNurs ingn– nAn Cas e-B as edn Approachn 1stn Editi onn Taghern Knappn TestnB ank
Chaptern 1: n Bronchiolitis
1. Which nintervention nis n appropriatenforn theninfant nhospitalized n with nbronchiolitis?
a. Position non nthen sidenwith nneck n slightly nflexed.
b. Administern antibiotics n as n ordered.
c. Restrict n oral nand n parenteral nfluids n ifn tachypneic.
d. Given cool,n humidifiednoxygen
.n ANS: nD
Cool,nhumidified noxygen nis ngiven nto nrelievendyspnea,n hypoxemia,nand ninsensiblenfluid nloss n from
tachypnea.n Then infant nshould nben positioned nwithnthen head nand nchest n elevated n at n an 30-n to n 40-
degreen anglen and n then neck nslightly nextended nto nmaintain nan nopen n airway nand ndecreasen pressu
ren on n then diaphragm.n Then etiology n ofnbronchiolitisn is nviral.n Antibioticsn arengiven n only nifnthere
n is n a
secondary nbacterial ninfection.nTachypneanincreases ninsensiblenfluid nloss.n Ifntheninfantnis n tachy
pneic,n fluids n aren given n parenterally n to n prevent n dehydration.
2. An ninfant nwithnbronchiolitisnisnhospitalized.nThencausativenorganismnis nrespiratory nsyncyt
ial n virus n(RSV).n Then nursen knowsn that nanchild ninfectedn withn thisn virusn requires nwhat ntype
n ofn isolation?
a. Reversen isolation
b. Airbornenisolation
c. Contact n Precautions
d. Standard nPrecaution
s n ANS: nC
RSV n is n transmitted n through n droplets.n In n addition n to nStandard n Precautions n and n hand n washing,
Contact n Precautions naren required.n Caregivers n must nusen gloves n and ngowns nwhenn enteringn the
n room.n Caren is n taken nnotn to ntouch ntheirn own neyes nornmucousn membranes nwith nancontaminat
ed n gloved n hand.nChildren naren placed n in nan privatenroomnornin nanroomnwith nothern children nwit
h n RSV n infections.nReversenisolationnfocuses non nkeepingn bacterianaway nfromntheninfant.nWithn
RSV,n othern children n need n to nbenprotected nfromn exposuren ton thenvirus.n Thenvirusnis nnot nairbo
rne.
3. A n child nhas nanchronicncough nandndiffusenwheezingn duringn thenexpiratory nphasen ofnrespirati
on.n This n suggests n what n condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign nbody nin ntrache
an ANS: nA
Asthman may nhaven thesen chronicn signs n and n symptoms.n Pneumonian appears n with n an n acuten onset,
fever,nand ngeneral nmalaise.n Bronchiolitis n is n an nacuten condition ncaused n by nrespiratory nsyncytial
virus.n Foreign n body nin nthentracheanoccurs nwith nacutenrespiratory ndistress norn failurenand nmayben
stridor.
4. Which nnursingn diagnosis nisnmostnappropriatenforn anninfant nwithnacutenbronchiolitisndue
n to n respiratory n syncytial n virus n (RSV)?
a. Activity n Intolerance
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M Based
b. Decreased n Cardiac nApproach n1stnEdition nTagher nKnapp nTestn…
n Output
c. Pain,n Acute
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,9/26/23,n4:56nP Pediatric nNursing- nAnCase-
M Based nApproach n1stnEdition nTagher nKnapp nTestn…
virus.n Foreign n body nin nthentracheanoccurs nwith nacutenrespiratory ndistress norn failurenand nmayben
stridor.
4. Which nnursingn diagnosis nisnmostnappropriatenforn anninfant nwithnacutenbronchiolitisndue
n to n respiratory n syncytial n virus n (RSV)?
a. Activity n Intolerance
b. Decreased n Cardiacn Output
c. Pain,n Acute
d. TissuenPerfusion,nIneffectiven(peripheral
)n ANS.n A
Rationalen 1: nActivity n intolerancen is n an problemn becausen ofn then imbalancen between n oxygen n supply
and ndemand.n Cardiacnoutputn isnnotn compromisednduringn ann acuten phasenofn bronchiolitis.n Pai
n nisn notn usually nassociatedn withn acutenbronchiolitis.n Tissuen perfusionn (peripheral)n isn notn aff
ected n by n this n respiratory-diseasen process.
Rationalen 2: nActivity nintolerancenis nanproblemn becausenofnthen imbalancenbetween noxygen nsupp
ly n and n demand.nCardiacn output nis nnotn compromised nduringn ann acuten phasenofnbronchiolitis.nP
ain n is n not nusually nassociated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnotnaffe
cted n by n this n respiratory-diseasen process.
Rationalen 3: nActivity nintolerancen is nan problemn becausen ofnthenimbalancenbetween noxygen n supp
ly n and n demand.nCardiacn output nis nnotn compromised nduringn ann acuten phasenofnbronchiolitis.nP
ain n is n not nusually nassociated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnotnaffe
cted n by n this n respiratory-diseasen process.
Rationalen 4: nActivity nintolerancen is nan problemn becausen ofnthenimbalancenbetween noxygen n supp
ly n and n demand.nCardiacn output nis nnotn compromised nduringn ann acuten phasenofnbronchiolitis.nP
ain n is n not nusually nassociated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnotnaffe
cted n by n this n respiratory-diseasen process.
Global n Rationale: nActivity nintolerancen is nan problemnbecausenofnthenimbalancen between noxygen
n supply nandndemand.n Cardiacn output nis nnotncompromised nduringn an nacuten phasenofn bronchiolit
is.n Pain n is nnot nusuallyn associated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnot
n affected n by n this n respiratory-diseasen process.
Chaptern 2: n Asthma
1. Then nursen is ncaringnfornan childnhospitalized nfornstatus nasthmaticus.nWhich nassessment nfind
ingn suggests n that n then childs n condition n is n worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
n ANS: nA
Then nursen would nassess nthenchild nfornsigns nofnhypoxia,n includingn restlessness,n fatigue,n irritabilit
y,n and n increased nheart nand nrespiratory nrate.nAs nthen childn tires nfromnthenincreasedn work nofnbre
athingn hypoventilation noccurs nleadingn to nincreased ncarbonn dioxiden levels.nThen nursen wouldnbe
n alert n forn signs n ofn hypoxia.n Thirst nwould nreflect nthen childs nhydrationn status.nBradycardianis n n
ot n an sign n ofn hypoxia;n tachycardian is.nClubbingn developsn overn anperiod nofnmonths nin nresponsent
o n hypoxia.nThen presencen ofnclubbingn does n not n indicaten then childs n condition n is n worsening.
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M Based nApproach n1stnEdition nTagher nKnapp nTestn…
Then nursen would nassess nthenchild nfornsigns nofnhypoxia,n includingn restlessness,n fatigue,n irritabilit
y,n and n increased nheart nand nrespiratory nrate.nAs nthen childn tires nfromnthenincreasedn work nofnbre
athingn hypoventilation noccurs nleadingn to nincreased ncarbonn dioxiden levels.nThen nursen wouldnbe
n alert n forn signs n ofn hypoxia.n Thirst nwould nreflect nthen childs nhydrationn status.nBradycardianis n n
ot n an sign n ofn hypoxia;n tachycardian is.nClubbingn developsn overn anperiod nofnmonths nin nresponsent
o n hypoxia.nThen presencen ofnclubbingn does n not n indicaten then childs n condition n is n worsening.
2. Which nfindingn is n expected n when nassessingn an child n hospitalized n forn asthma?
a. Inspiratory n stridor
b. Harsh,n barky n cough
c. Wheezing
d. Rhinorrhea
n ANS: nC
Wheezingnis nanclassicnmanifestation nofnasthma.n Inspiratory nstridorn is n an clinical nmanifestation nof
croup.n A n harsh,nbarkyncough nis n characteristicn ofn croup.n Rhinorrhean is n not n associated n with n asthma.
3. A n child n hasn had n cold nsymptoms n forn morenthann 2n weeks,n anheadache,nnasal ncongestion n
with n purulent nnasal ndrainage,n facial ntenderness,n andn ancough n that nincreases nduringn sleep.n
Then nursen recognizes n thesen symptoms naren characteristicnofnwhich nrespiratory n condition?
a. Allergicn rhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
n ANS: nD
Sinusitis nis n characterized n by nsigns n and n symptoms n ofn an cold n that n do n not n improven aftern 14 n days,n a
low-
graden fever,n nasal n congestion nand npurulent nnasaln discharge,n headache,n tenderness,n anfeelingn o
fn fullness novernthen affected nsinuses,nhalitosis,n andnan cough n that nincreases nwhen nthenchild nis nlyi
ngn down.n Then classicn symptoms nofnallergicn rhinitis naren watery nrhinorrhea,n itchy nnose,n eyes,n ea
rs,n and n palate,nand nsneezing.n Symptoms n occurnas nlongn as nthen child nis nexposed ntonthenallergen.
n Bronchitis n isn characterized nby nangradual nonset nofnrhinitis nand nancough nthat nisn initially nnonpro
ductiven but nmay n changen to nanloosencough.n Thenmanifestations nofnasthman may nvary,n with nwhe
ezingn beingn an classicn sign.n Then symptomsn presented nin nthenquestion ndo n not n suggest n asthma.
4. What n is n an common n triggern forn asthman attacks n in n children?
a. Febrilen episodes
b. Dehydration
c. Exercise
d. Seizures
n ANS: nC
Exercisen is n onen ofn then most n common n triggers n forn asthman attacks,n particularly n in n school-
agen children.n Febrilen episodes narenconsistentnwith nothernproblems,nfornexample,n seizures.nDehy
dration n occurs nas nan resultn ofndiarrhea; nit ndoes nnotn triggern asthman attacks.nViraln infections naren
triggers n forn asthma.n Seizures n can n result n fromn an too-
rapid n intravenous n infusion n ofn theophyllinean therapy n forn asthma.
5. Then practitionern changes n thenmedicationsn fornthen childn withn asthman to nsalmeterol n(Sereven
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M Based nApproach n1stnEdition nTagher nKnapp nTestn…
PediatricnNurs ingn– nAn Cas e-B as edn Approachn 1stn Editi onn Taghern Knappn TestnB ank
Chaptern 1: n Bronchiolitis
1. Which nintervention nis n appropriatenforn theninfant nhospitalized n with nbronchiolitis?
a. Position non nthen sidenwith nneck n slightly nflexed.
b. Administern antibiotics n as n ordered.
c. Restrict n oral nand n parenteral nfluids n ifn tachypneic.
d. Given cool,n humidifiednoxygen
.n ANS: nD
Cool,nhumidified noxygen nis ngiven nto nrelievendyspnea,n hypoxemia,nand ninsensiblenfluid nloss n from
tachypnea.n Then infant nshould nben positioned nwithnthen head nand nchest n elevated n at n an 30-n to n 40-
degreen anglen and n then neck nslightly nextended nto nmaintain nan nopen n airway nand ndecreasen pressu
ren on n then diaphragm.n Then etiology n ofnbronchiolitisn is nviral.n Antibioticsn arengiven n only nifnthere
n is n a
secondary nbacterial ninfection.nTachypneanincreases ninsensiblenfluid nloss.n Ifntheninfantnis n tachy
pneic,n fluids n aren given n parenterally n to n prevent n dehydration.
2. An ninfant nwithnbronchiolitisnisnhospitalized.nThencausativenorganismnis nrespiratory nsyncyt
ial n virus n(RSV).n Then nursen knowsn that nanchild ninfectedn withn thisn virusn requires nwhat ntype
n ofn isolation?
a. Reversen isolation
b. Airbornenisolation
c. Contact n Precautions
d. Standard nPrecaution
s n ANS: nC
RSV n is n transmitted n through n droplets.n In n addition n to nStandard n Precautions n and n hand n washing,
Contact n Precautions naren required.n Caregivers n must nusen gloves n and ngowns nwhenn enteringn the
n room.n Caren is n taken nnotn to ntouch ntheirn own neyes nornmucousn membranes nwith nancontaminat
ed n gloved n hand.nChildren naren placed n in nan privatenroomnornin nanroomnwith nothern children nwit
h n RSV n infections.nReversenisolationnfocuses non nkeepingn bacterianaway nfromntheninfant.nWithn
RSV,n othern children n need n to nbenprotected nfromn exposuren ton thenvirus.n Thenvirusnis nnot nairbo
rne.
3. A n child nhas nanchronicncough nandndiffusenwheezingn duringn thenexpiratory nphasen ofnrespirati
on.n This n suggests n what n condition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreign nbody nin ntrache
an ANS: nA
Asthman may nhaven thesen chronicn signs n and n symptoms.n Pneumonian appears n with n an n acuten onset,
fever,nand ngeneral nmalaise.n Bronchiolitis n is n an nacuten condition ncaused n by nrespiratory nsyncytial
virus.n Foreign n body nin nthentracheanoccurs nwith nacutenrespiratory ndistress norn failurenand nmayben
stridor.
4. Which nnursingn diagnosis nisnmostnappropriatenforn anninfant nwithnacutenbronchiolitisndue
n to n respiratory n syncytial n virus n (RSV)?
a. Activity n Intolerance
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,9/26/23,n4:56nP Pediatric nNursing- nAnCase-
M Based
b. Decreased n Cardiac nApproach n1stnEdition nTagher nKnapp nTestn…
n Output
c. Pain,n Acute
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M Based nApproach n1stnEdition nTagher nKnapp nTestn…
virus.n Foreign n body nin nthentracheanoccurs nwith nacutenrespiratory ndistress norn failurenand nmayben
stridor.
4. Which nnursingn diagnosis nisnmostnappropriatenforn anninfant nwithnacutenbronchiolitisndue
n to n respiratory n syncytial n virus n (RSV)?
a. Activity n Intolerance
b. Decreased n Cardiacn Output
c. Pain,n Acute
d. TissuenPerfusion,nIneffectiven(peripheral
)n ANS.n A
Rationalen 1: nActivity n intolerancen is n an problemn becausen ofn then imbalancen between n oxygen n supply
and ndemand.n Cardiacnoutputn isnnotn compromisednduringn ann acuten phasenofn bronchiolitis.n Pai
n nisn notn usually nassociatedn withn acutenbronchiolitis.n Tissuen perfusionn (peripheral)n isn notn aff
ected n by n this n respiratory-diseasen process.
Rationalen 2: nActivity nintolerancenis nanproblemn becausenofnthen imbalancenbetween noxygen nsupp
ly n and n demand.nCardiacn output nis nnotn compromised nduringn ann acuten phasenofnbronchiolitis.nP
ain n is n not nusually nassociated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnotnaffe
cted n by n this n respiratory-diseasen process.
Rationalen 3: nActivity nintolerancen is nan problemn becausen ofnthenimbalancenbetween noxygen n supp
ly n and n demand.nCardiacn output nis nnotn compromised nduringn ann acuten phasenofnbronchiolitis.nP
ain n is n not nusually nassociated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnotnaffe
cted n by n this n respiratory-diseasen process.
Rationalen 4: nActivity nintolerancen is nan problemn becausen ofnthenimbalancenbetween noxygen n supp
ly n and n demand.nCardiacn output nis nnotn compromised nduringn ann acuten phasenofnbronchiolitis.nP
ain n is n not nusually nassociated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnotnaffe
cted n by n this n respiratory-diseasen process.
Global n Rationale: nActivity nintolerancen is nan problemnbecausenofnthenimbalancen between noxygen
n supply nandndemand.n Cardiacn output nis nnotncompromised nduringn an nacuten phasenofn bronchiolit
is.n Pain n is nnot nusuallyn associated nwith nacutenbronchiolitis.n Tissuen perfusion n(peripheral)n is nnot
n affected n by n this n respiratory-diseasen process.
Chaptern 2: n Asthma
1. Then nursen is ncaringnfornan childnhospitalized nfornstatus nasthmaticus.nWhich nassessment nfind
ingn suggests n that n then childs n condition n is n worsening?
a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
n ANS: nA
Then nursen would nassess nthenchild nfornsigns nofnhypoxia,n includingn restlessness,n fatigue,n irritabilit
y,n and n increased nheart nand nrespiratory nrate.nAs nthen childn tires nfromnthenincreasedn work nofnbre
athingn hypoventilation noccurs nleadingn to nincreased ncarbonn dioxiden levels.nThen nursen wouldnbe
n alert n forn signs n ofn hypoxia.n Thirst nwould nreflect nthen childs nhydrationn status.nBradycardianis n n
ot n an sign n ofn hypoxia;n tachycardian is.nClubbingn developsn overn anperiod nofnmonths nin nresponsent
o n hypoxia.nThen presencen ofnclubbingn does n not n indicaten then childs n condition n is n worsening.
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M Based nApproach n1stnEdition nTagher nKnapp nTestn…
Then nursen would nassess nthenchild nfornsigns nofnhypoxia,n includingn restlessness,n fatigue,n irritabilit
y,n and n increased nheart nand nrespiratory nrate.nAs nthen childn tires nfromnthenincreasedn work nofnbre
athingn hypoventilation noccurs nleadingn to nincreased ncarbonn dioxiden levels.nThen nursen wouldnbe
n alert n forn signs n ofn hypoxia.n Thirst nwould nreflect nthen childs nhydrationn status.nBradycardianis n n
ot n an sign n ofn hypoxia;n tachycardian is.nClubbingn developsn overn anperiod nofnmonths nin nresponsent
o n hypoxia.nThen presencen ofnclubbingn does n not n indicaten then childs n condition n is n worsening.
2. Which nfindingn is n expected n when nassessingn an child n hospitalized n forn asthma?
a. Inspiratory n stridor
b. Harsh,n barky n cough
c. Wheezing
d. Rhinorrhea
n ANS: nC
Wheezingnis nanclassicnmanifestation nofnasthma.n Inspiratory nstridorn is n an clinical nmanifestation nof
croup.n A n harsh,nbarkyncough nis n characteristicn ofn croup.n Rhinorrhean is n not n associated n with n asthma.
3. A n child n hasn had n cold nsymptoms n forn morenthann 2n weeks,n anheadache,nnasal ncongestion n
with n purulent nnasal ndrainage,n facial ntenderness,n andn ancough n that nincreases nduringn sleep.n
Then nursen recognizes n thesen symptoms naren characteristicnofnwhich nrespiratory n condition?
a. Allergicn rhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
n ANS: nD
Sinusitis nis n characterized n by nsigns n and n symptoms n ofn an cold n that n do n not n improven aftern 14 n days,n a
low-
graden fever,n nasal n congestion nand npurulent nnasaln discharge,n headache,n tenderness,n anfeelingn o
fn fullness novernthen affected nsinuses,nhalitosis,n andnan cough n that nincreases nwhen nthenchild nis nlyi
ngn down.n Then classicn symptoms nofnallergicn rhinitis naren watery nrhinorrhea,n itchy nnose,n eyes,n ea
rs,n and n palate,nand nsneezing.n Symptoms n occurnas nlongn as nthen child nis nexposed ntonthenallergen.
n Bronchitis n isn characterized nby nangradual nonset nofnrhinitis nand nancough nthat nisn initially nnonpro
ductiven but nmay n changen to nanloosencough.n Thenmanifestations nofnasthman may nvary,n with nwhe
ezingn beingn an classicn sign.n Then symptomsn presented nin nthenquestion ndo n not n suggest n asthma.
4. What n is n an common n triggern forn asthman attacks n in n children?
a. Febrilen episodes
b. Dehydration
c. Exercise
d. Seizures
n ANS: nC
Exercisen is n onen ofn then most n common n triggers n forn asthman attacks,n particularly n in n school-
agen children.n Febrilen episodes narenconsistentnwith nothernproblems,nfornexample,n seizures.nDehy
dration n occurs nas nan resultn ofndiarrhea; nit ndoes nnotn triggern asthman attacks.nViraln infections naren
triggers n forn asthma.n Seizures n can n result n fromn an too-
rapid n intravenous n infusion n ofn theophyllinean therapy n forn asthma.
5. Then practitionern changes n thenmedicationsn fornthen childn withn asthman to nsalmeterol n(Sereven
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