. A 2-year-old boy is seen for acute laryngotracheobronchitis. Which of the following observations would lead you to suspect that airway occlusion is
... [Show More] occurring?
A) He states he is tired and wants to sleep.
B) His respiratory rate is gradually increasing.
C) His cough is becoming harsher.
D) His nasal discharge is increasing.
2. Which of the following measures would be most effective in aiding bronchodilation in a child with laryngotracheobronchitis?
A) Urging the child to continue to take oral fluids.
B) Administering an oral analgesic.
C) Teaching the child to take long, slow breaths.
D) Assisting with racemic epinephrine nebulizer therapy.
3. A 4-year-old girl has acute nasopharyngitis (a common cold). Which of the following measures would you want to teach her parents?
A) Healthy children rarely have more than one cold per year.
B) Typically the child will pull her ear when a cold is present.
C) A cough that accompanies a cold should rarely be suppressed.
D) An antibiotic is prescribed for children younger than 5 years of age.
4. What measure at home could help a child with an upper respiratory infection breathe more easily?
A) Increasing room humidity.
B) Limiting fluid intake.
C) Enforcing strict bed rest.
D) Playing “rapid breathing” games.
5. A school-age child develops a nosebleed (epistaxis). Which of the following would you do?
A) Elevate the head of the bed slightly and apply pressure to the forehead.
B) Sit the child upright and apply pressure to the sides of the nose.
C) Turn the child's head to the side and press on the nasal ridge.
D) Keep the child flat and apply pressure to the bridge of the nose.
6. A 6-year-old is diagnosed as having streptococcal pharyngitis. When planning care you should be aware that the chief danger of such an infection is that
A) lymph nodes will swell and obstruct the airway.
B) the infection may spread and cause a tooth abscess.
C) a small proportion of children develop rheumatic fever.
D) four of five children develop nephrosis afterward.
7. A 7-year-old has been scheduled for a tonsillectomy. Which of the following would be most important to assess before surgery?
A) Specific gravity of urine.
B) Pulse and respiratory rate.
C) Bleeding and clotting time.
D) Blood pressure both lying down and sitting up.
8. After tonsillectomy surgery, the preferred position of a child until fully awake is
A) on the side with the head elevated.
B) on the abdomen with a pillow under the chest.
C) on the back with warm compresses applied to the throat.
D) on the side with continuous oxygen by cannula at 30%.
9. You notice that a child is spitting up small amounts of blood in the immediate postoperative period after a tonsillectomy. Which of the following would be the best intervention?
A) Suction the back of the throat.
B) Encourage the child to cough.
C) Continue to assess for bleeding.
D) Notify the physician immediately.
10. To relieve a child's feeling of thirst immediately after tonsillectomy, the best thing to offer would be
A) milk.
B) juice.
C) ice chips.
D) ginger ale.
11. You see a 3-year-old boy in an ambulatory setting for localized wheezing on auscultation. Which statement by his mother would be most important to report?
A) She gives the child hard candy as an afternoon treat.
B) The child has two cousins who have many allergies.
C) She likes the child to play by himself for 15 minutes every afternoon.
D) The child was eating peanuts yesterday.
12. Wheezing in children is best heard
A) with the child supine.
B) as the child exhales.
C) as the child cries.
D) without a stethoscope.
13. A 4-year-old girl has been admitted to the hospital with a diagnosis of pneumococcal pneumonia. Her parents are extremely distraught over her condition and the fact she has not wanted to eat anything for the past 2 days. Which nursing approach would be most important to take to help alleviate the high anxiety level of these parents?
A) Allow the parents to remain with the child as much as possible.
B) Encourage the parents to return home and get some rest.
C) Tell the parents that their child is receiving the best care possible.
D) Avoid telling the parents unnecessary facts regarding her prognosis.
14. To help meet the nutritional needs of a child with pneumonia, you would
A) encourage reducing fluid intake.
B) offer small, frequent feedings.
C) encourage intake of three large meals daily.
D) suggest feeding by enteral tube feedings.
15. Which of the following nursing diagnoses would be most appropriate for a child with pneumonia during the acute phase of illness?
A) Excess fluid volume related to excessive mucus production.
B) Activity intolerance related to poor oxygen–carbon dioxide exchange.
C) Altered urinary elimination related to hypervolemic state.
D) Pain related to swelling of abdominal lymph nodes.
16. You would plan activity periods for a child with pneumonia to include
A) frequent position changes to prevent pooling of secretions.
B) continuous activity to keep the lungs aerated.
C) complete bed rest to prevent exhaustion.
D) periodic use of the supine position.
17. To prevent drying and thickening of respiratory secretions when oxygen is administered, you would
A) ensure that fluid intake is limited.
B) provide frequent postural drainage.
C) ensure that the oxygen is warmed and humidified.
D) remove the oxygen periodically to allow normal mucus accumulation.
18. You notice that a child who has pneumonia has blood gas values of PaO2, 80; PaCO2, 60; pH, 7.31. Based on this, the child is experiencing
A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory acidosis.
D) respiratory alkalosis.
19. A child is to use an incentive spirometer four times daily. Which statement suggests that the child understands the purpose and correct technique of the procedure?
A) “To do this right, I take in a very deep breath.”
B) “Using this will help me cough less.”
C) “The harder I blow out, the better I am doing.”
D) “This will make more room for my heart in my chest.”
20. You are caring for a child with a tracheostomy tube. Suddenly, the child coughs, and the tube is expelled. Which of the following initial interventions is most appropriate?
A) Assess the child for respiratory distress.
B) Notify the emergency response team.
C) Place the child on the stomach.
D) Reinsert the tube without the obturator.
21. When a 4-year-old child with a tracheostomy tube eats, a primary nursing responsibility would be to
A) prevent aspiration of food or fluids into the tube.
B) limit ingestion of too much fluid.
C) foster smooth passage of foods through the tube opening.
D) prevent dyspnea from eating too rapidly.
22. When you momentarily turn your back while caring for an infant, she aspirates a small toy. She begins coughing, turns cyanotic, and is unable to make a sound. Which of the following nursing actions would be most important?
A) Perform a chest thrust the same as with an adult.
B) Turn the infant prone and administer back blows.
C) Stimulate further coughing with a tongue blade.
D) Verbally encourage the infant to continue coughing.
23. A 2-year-old with a new tracheostomy needs suctioning for the presence of increased secretions. A nursing measure that should be instituted during each suctioning period would be:
A) Use of clean technique.
B) Instilling 1 to 2 drops of normal saline before suctioning.
C) Having oxygen on and ready at bedside.
D) Preoxygenating before suctioning.
24. When assessing a child for cyanosis, the nurse should keep in mind that:
A) Cyanosis is an early indicatory of respiratory distress.
B) The degree of cyanosis is not an accurate indicator of the degree of hypoxia.
C) Cyanosis is caused by a decrease in the depth of respirations.
D) Cyanosis will be present if the child has had a large loss of blood volume. [Show Less]