Test Bank for Pediatric Nursing A Case-Based Approach 1st Edition Tagher Knapp

TestBankForPediatric
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NursingACase-Based
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Approach1stEditionTagher
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Knapp
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, PediatricNursing –ACase-BasedApproach1stEditionTagherKnappTestBank
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Chapter1: Bronchiolitis
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1. Whichinterventionisappropriatefortheinfanthospitalizedwithbronchiolitis? v v v




a. Positiononthesidewithneckslightlyflexed.v




b. Administerantibioticsasordered.
c. Restrictoralandparenteralfluidsiftachypneic.
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d. Givecool,humidifiedoxygen.
ANS:D
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Cool,humidifiedoxygenisgiventorelievedyspnea,hypoxemia,andinsensiblefluidlossfrom
tachypnea.Theinfantshouldbepositionedwiththeheadandchestelevated ata30-to40-degreeangle
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vandtheneckslightlyextendedtomaintainanopenairwayanddecreasepressureonthediaphragm.The
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vetiologyofbronchiolitisisviral.Antibioticsaregivenonlyifthereisasecondarybacterialinfection.
Tachypneaincreasesinsensiblefluidloss.Iftheinfantistachypneic,fluidsaregivenparenterallyto v v




vpreventdehydration.

2. Aninfantwithbronchiolitisishospitalized.Thecausativeorganismisrespiratorysyncytialvirus
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v(RSV).Thenurseknowsthatachildinfectedwiththisvirusrequireswhattypeofisolation? v




a. Reverseisolation v




b. Airborneisolation
c. ContactPrecautions v




d. StandardPrecautions v




ANS:C
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RSVistransmitted throughdroplets.InadditiontoStandardPrecautions andhandwashing,
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ContactPrecautionsarerequired.Caregiversmustuseglovesandgownswhenenteringtheroom.Care v




vistakennottotouchtheirowneyesormucousmembraneswithacontaminatedglovedhand.Children
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vareplacedinaprivateroom orinaroomwithotherchildrenwithRSVinfections.Reverseisolation
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vfocusesonkeepingbacteriaawayfromtheinfant.WithRSV,otherchildrenneedtobeprotectedfrom
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exposuretothevirus.Thevirusisnotairborne.
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3. Achildhasachroniccough anddiffusewheezingduringtheexpiratoryphaseofrespiration.This
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vsuggestswhatcondition?
a. Asthma
b. Pneumonia
c. Bronchiolitis
d. Foreignbodyintrachea v v




ANS:A
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Asthmamayhavethesechronicsignsandsymptoms.Pneumoniaappearswithanacuteonset,
fever,andgeneralmalaise.Bronchiolitisisanacuteconditioncausedbyrespiratorysyncytial

,virus.Foreignbodyinthetracheaoccurswith acuterespiratorydistressorfailureandmaybestridor.
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4. Whichnursingdiagnosisismostappropriateforaninfantwithacutebronchiolitisdueto
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respiratorysyncytialvirus(RSV)?
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a. ActivityIntolerance
b. DecreasedCardiacOutput
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c. Pain,Acute
d. TissuePerfusion,Ineffective(peripheral)
ANS.A
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Rationale1:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
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vdemand.Cardiacoutputis notcompromisedduringanacutephaseofbronchiolitis.Painisnotusually
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vassociatedwithacutebronchiolitis.Tissueperfusion (peripheral)isnotaffectedbythisrespiratory-
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vdiseaseprocess.
Rationale2:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
v v v v




vdemand.Cardiacoutputis notcompromisedduringanacutephaseofbronchiolitis.Painisnotusually
v v v v




vassociatedwithacutebronchiolitis.Tissueperfusion (peripheral)isnotaffectedbythisrespiratory-
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vdiseaseprocess.
Rationale3:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand v v




vdemand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusually
v v v v




vassociatedwithacutebronchiolitis.Tissueperfusion (peripheral)isnotaffectedbythisrespiratory-
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vdiseaseprocess.
Rationale4:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupplyand
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vdemand.Cardiacoutputisnotcompromisedduringanacutephaseofbronchiolitis.Painisnotusually v v




vassociatedwithacutebronchiolitis.Tissueperfusion (peripheral)isnotaffectedbythisrespiratory-
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vdiseaseprocess.
GlobalRationale:Activityintoleranceisaproblembecauseoftheimbalancebetweenoxygensupply
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vanddemand.Cardiacoutputisnotcompromised during anacutephaseofbronchiolitis.Painisnot
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vusuallyassociatedwithacutebronchiolitis.Tissueperfusion(peripheral)isnotaffectedbythis v v




respiratory-diseaseprocess.
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Chapter2:Asthma

1. Thenurseiscaringforachildhospitalizedforstatusasthmaticus.Whichassessmentfinding
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suggeststhatthechilds conditionisworsening?
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a. Hypoventilation
b. Thirst
c. Bradycardia
d. Clubbing
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, Thenursewouldassessthechildforsignsofhypoxia,includingrestlessness,fatigue,irritability,and
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vincreasedheartandrespiratoryrate.Asthechildtiresfromtheincreasedworkofbreathing
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vhypoventilationoccursleadingtoincreasedcarbondioxidelevels.Thenursewouldbealertforsignsof v v




vhypoxia.Thirst wouldreflectthechildshydrationstatus.Bradycardiais not asign ofhypoxia;
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tachycardiais.Clubbingdevelopsoveraperiodofmonthsinresponsetohypoxia.Thepresenceof
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vclubbingdoesnotindicatethechildsconditionisworsening.
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2. Whichfindingisexpectedwhenassessingachild hospitalizedforasthma?
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a. Inspiratorystridor
b. Harsh,barkycough
c. Wheezing
d. Rhinorrhea
ANS:C
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Wheezingisaclassicmanifestationofasthma.Inspiratorystridorisaclinicalmanifestation of
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croup.Aharsh,barkycoughischaracteristicofcroup.Rhinorrheaisnotassociatedwithasthma.
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3. Achildhashadcoldsymptomsformorethan2weeks,aheadache,nasalcongestion with
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v purulentnasaldrainage,facialtenderness,andacoughthatincreasesduringsleep.Thenurse
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vrecognizesthesesymptomsarecharacteristicofwhichrespiratorycondition? v




a. Allergicrhinitis
b. Bronchitis
c. Asthma
d. Sinusitis
ANS:D
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Sinusitisischaracterizedbysignsandsymptomsofacoldthatdonotimproveafter14days,a
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low-gradefever,nasalcongestionandpurulentnasaldischarge,headache,tenderness,afeelingof v




vfullnessovertheaffectedsinuses,halitosis,andacoughthatincreaseswhenthechildislyingdown.
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v Theclassicsymptomsofallergicrhinitisarewateryrhinorrhea,itchynose,eyes,ears,andpalate,and
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v sneezing.Symptomsoccuraslongasthechildisexposedtotheallergen.Bronchitisischaracterizedby
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v agradualonsetofrhinitisandacoughthatisinitiallynonproductivebutmaychangetoaloosecough. v




Themanifestationsofasthmamayvary,withwheezingbeingaclassicsign.Thesymptomspresented v v




v inthequestion donotsuggestasthma.
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4. Whatisacommontriggerforasthmaattacksinchildren?
a. Febrileepisodes
b. Dehydration
c. Exercise
d. Seizures
ANS:C
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