ch 40 respiratory

Question 1

the nurse is examining an 8 year old boy with tachycardia and tachypnea. the nurse anticipates which test as most helpful in determining the extent of the child’s hypoxia?

Answer 1

pulse oximetry

Question 2

the nurse is discussing discharge instructions with the parents of a 6 year old who had a tonsilectomy. what is the most important thing to stress?

Answer 2

inspect the throat for bleeding

Question 3

a nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason?

Answer 3

hasten air reabsorption

Question 4

bacterial pneumonia is suspected in a 4 year old boy with fever, headache, and chest pain. which assessment finding would most likely indicate the need for this child to be hospitalized?

Answer 4

tachypnea with retractions

Question 5

the nurse is assessing a 5 year old who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. based on these findings, what would be least appropriate for the nurse to perform?

Answer 5

visualizing the throat

Question 6

the nurse is educating the parents of a 7 year old boy with asthma about the medications that have been prescribed. which drug would the nurse identify as an adjunct to a b2-adrenergic agonist for bronchospasm treatment

Answer 6

ipratropium

Question 7

the nurse is caring for a 3 year old with respiratory disorder. the nurse anticipates the need for providing supplemental oxygen to the child when performing which action?

Answer 7

suctioning a tracheostomy tube

Question 8

the nurse is examining a 5 year old. which sign or symptom is a reliable first indication of respiratory illness in children?

Answer 8

rapid, shallow breathing

Question 9

a child requires supplemental oxygen therapy at 8 L per minute. which delivery device would the nurse most likely expect to be used?

Answer 9

simple mask

Question 10

a group of nursing students are reviewing information about the variations in respiratory at atoms and physiology in children in comparison to adults. the students demonstrate understanding of the information when they identify which finding?

Answer 10

children develop hypoxemia more rapidly than adults do.

Question 11

the nurse providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. the nurse most likely suspects sinusitis in which child?

Answer 11

a 7 year old with halitosis and thick, yellow nasal discharge

Question 12

a parent asks she nurse about immunizing her 7 month old daughter against the flu. which response by the nurse would most likely be appropriate?

Answer 12

since your daughter is older than 6 months, she should be the vaccine every year

Question 13

a child with a pneumothorax has a chest tube attached to a water seal system. when assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. what would the nurse do first?

Answer 13

clamp the chest tube

Question 14

a nurse is preparing a teaching plan for the family of a child with allergic rhinitis. when describing the immune reaction that occurs, the nurse would identify the role of which immunoglobulin?

Answer 14

IgE

Question 15

a group of nursing students are reviewing the medications to treat asthma. the students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?

Answer 15

albuterol

Question 16

the nurse is preparing to perform a physical examination of a child with asthma. which technique would he nurse be least likely to perform ?

Answer 16

palpation

Question 17

a nursing instructor is preparing a class on chronic lung disease. what information would the instructor include when describing this disorder?

Answer 17

it is seen most commonly in premature infants

Question 18

a nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. which would the nurse instruct the parents to administer orally?

Answer 18

anti inflammatory agents

Question 19

when performing the physical examination of a child with cystic fibrosis, what would the nurse expect to assess?

Answer 19

decreased tactile fremitus

Question 20

the nurse is preparing to provide tracheostomy care to an infant.a father gathering the necessary equipment, what would the nurse do next?

Answer 20

position the infant supine with a towel roll under the neck

Question 21

a child is brought to the emergency dept. by his parent because he suddenly developed a barking cough. further assessment leads the nurse to suspect the child is experiencing croup. what would the nurse have most likely assessed?

Answer 21

inspiratory stridor

Question 22

a child has been prescribed a nasal cannula for oxygen delivery. what should the nurse do before applying the cannula?

Answer 22

assess patency of the nares

Question 23

the nurse is obtaining a health history of a child suspected of tuberculosis. what question would the nurse ask first about the child’s cough?

Answer 23

how long has your child had a cough

Question 24

the nurse is teaching the parent of a child with cystic fibrosis about nutrition requirements for the child. what should be included in the teaching. select all that apply

Answer 24

-give your child high calorie foods and snacks
-feed your child foods high in protein
-give pancreatic enzymes with meals

Question 25

the nurse is preparing a room for a child being transferred out of the icu. the child has a tracheostomy. what items are essential for the nurse to have available at the bedside in case of emergency? select all that apply.

Answer 25

-a new tracheostomy tube of the same size -a new tracheostomy tube of a smaller size -a bag valve mask

Question 26

a parent with a child who has cystic fibrosis asks the nurse how to determine if the child is receiving adequate amount of pancreatic enzymes. how should the nurse respond? select all that apply.

Answer 26

-the dose is adequate when your child is only having 1-2 stools per day -the dose is adequate if your child’s weight is improving -when your child starts to eat more quantity of food you will need to adjust the amount of enzyme pills

Question 27

a child is in the ear wit an asthma exacerbation. upon auscultation the nurse is unable to hear air movement in the lungs. what action should the nurse take first?

Answer 27

administer beta-2 adrenergic agonist (albuterol)

Question 28

a hospitalized child suddenly begins reporting my chest hurts, is tachypneic, and has tachycardia. the nurse auscultates the lung sounds and finds absent breath sounds on one side. after notifying the health care provider what action should the nurse take first?

Answer 28

prepare from chest tube insertion

Question 29

a child is hospitalized with pneumonia. the nurse assesses an increase in the work of breathing and the respiratory rate. what intervention should the nurse do first to help this child?

Answer 29

elevate head of the bed

Question 30

an infant with a high respiratory rate is npo and receiving iv fluids. what assessments will the nurse make to assure this infant is hydrated? select all that apply.

Answer 30

-measure skin tugor -palpate anterior fontanel -determine urine output