Question 1

A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which?

Accepted Answer

A)  Racemic epinephrine and corticosteroids 
B)  Nebulizer treatments and oxygen 
C)  Antibiotics and albuterol 
D)  Chest physiotherapy and humidity 
A)  Racemic epinephrine and corticosteroids 
B)  Nebulizer treatments and oxygen 
C)  Antibiotics and albuterol 
D)  Chest physiotherapy and humidity

Question 2

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition?

Accepted Answer

A)  Otitis media 
B)  Diabetes insipidus (DI) 
C)  Nephrotic syndrome 
D)  Acute rheumatic fever 
A)  Otitis media 
B)  Diabetes insipidus (DI) 
C)  Nephrotic syndrome 
D)  Acute rheumatic fever

Question 3

Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39° C (102.2° F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication?

Accepted Answer

A)  Decongestants to ease stuffy nose 
B)  Antihistamines to help the child sleep 
C)  Aspirin for pain and fever management 
D)  Benzocaine ear drops for topical pain relief 
A)  Decongestants to ease stuffy nose 
B)  Antihistamines to help the child sleep 
C)  Aspirin for pain and fever management 
D)  Benzocaine ear drops for topical pain relief

Question 4

A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal?

Accepted Answer

A)  Encourage increased fluid intake. 
B)  Recommend increased use of a budesonide (Pulmicort) inhaler. 
C)  Administer an antitussive to suppress coughing. 
D)  Encourage the child to blow a pinwheel every 6 hours while awake. 
A)  Encourage increased fluid intake. 
B)  Recommend increased use of a budesonide (Pulmicort) inhaler. 
C)  Administer an antitussive to suppress coughing. 
D)  Encourage the child to blow a pinwheel every 6 hours while awake.

Question 5

The nurse is calculating the amount of expected urinary output for a 24-hour period on a child with laryngotracheobronchitis who weighs 33 lb. The nurse recognizes the formula to be used is 1 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number.
_____________

Accepted Answer

360
Perform the calc

Question 6

What condition is the leading cause of chronic illness in children?

Accepted Answer

A)  Asthma 
B)  Pertussis 
C)  Tuberculosis 
D)  Cystic fibrosis 
A)  Asthma 
B)  Pertussis 
C)  Tuberculosis 
D)  Cystic fibrosis

Question 7

A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action?

Accepted Answer

A)  Notify the health care provider. 
B)  Continue to assess for bleeding. 
C)  Give the child a red flavored ice pop. 
D)  Position the child in a Trendelenburg position. 
A)  Notify the health care provider. 
B)  Continue to assess for bleeding. 
C)  Give the child a red flavored ice pop. 
D)  Position the child in a Trendelenburg position.

Question 8

The nurse is caring for a newborn with suspected congenital diaphragmatic hernia. What of the following findings would the nurse expect to observe? (Select all that apply.)

Accepted Answer

A)  Loud, harsh murmur 
B)  Scaphoid abdomen 
C)  Poor peripheral pulses 
D)  Mediastinal shift 
E)  Inguinal swelling
F) Moderate respiratory distress 
A)  Loud, harsh murmur 
B)  Scaphoid abdomen 
C)  Poor peripheral pulses 
D)  Mediastinal shift 
E)  Inguinal swelling
F) Moderate respiratory distress

Question 9

A 5-year-old child is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process?

Accepted Answer

A)  Fever, cough, and chest pain 
B)  Stridor, wheezing, and ear infection 
C)  Nasal discharge, headache, and cough 
D)  Pharyngitis, intermittent fever, and eye infection 
A)  Fever, cough, and chest pain 
B)  Stridor, wheezing, and ear infection 
C)  Nasal discharge, headache, and cough 
D)  Pharyngitis, intermittent fever, and eye infection

Question 10

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true?

Accepted Answer

A)  Given subcutaneously 
B)  May cause voice alterations 
C)  May cause mucus to thicken 
D)  Not indicated for children younger than age 12 years 
A)  Given subcutaneously 
B)  May cause voice alterations 
C)  May cause mucus to thicken 
D)  Not indicated for children younger than age 12 years

Question 11

The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The child's SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take?

Accepted Answer

A)  Withhold feedings. 
B)  Notify the health care provider. 
C)  Put the infant in an infant seat. 
D)  Keep the infant in the plastic hood. 
A)  Withhold feedings. 
B)  Notify the health care provider. 
C)  Put the infant in an infant seat. 
D)  Keep the infant in the plastic hood.

Question 12

What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

Accepted Answer

A)  Ephedrine 
B)  Theophylline 
C)  Aminophylline 
D)  Short-acting $\beta_{2}$-agonists 
A)  Ephedrine 
B)  Theophylline 
C)  Aminophylline 
D)  Short-acting $\beta_{2}$-agonists

Question 13

The health care provider prescribes vancomycin 200 mg per intravenous piggy back (IVPB) every 6 hours for a child with cystic fibrosis. The pharmacy sends the medication to the unit in a 150-ml bag with directions to run the medication over 120 minutes. What milliliters per hour will the nurse set the intravenous pump to run the medication over 120 minutes? Fill in the blank and record your answer in a whole number.
_____________

Accepted Answer

75
Perform the calculation.
Co

Question 14

In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind?

Accepted Answer

A)  Fats and proteins must be greatly curtailed. 
B)  Most fruits and vegetables are not well tolerated. 
C)  Diet should be high in calories, proteins, and unrestricted fats. 
D)  Diet should be low fat but high in calories and proteins. 
A)  Fats and proteins must be greatly curtailed. 
B)  Most fruits and vegetables are not well tolerated. 
C)  Diet should be high in calories, proteins, and unrestricted fats. 
D)  Diet should be low fat but high in calories and proteins.

Question 15

The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system? (Select all that apply.)

Accepted Answer

A)  Children with mild persistent asthma have nighttime signs or symptoms less than two times a month. 
B)  Children with moderate persistent asthma use a short-acting b-agonist more than two times per week. 
C)  Children with severe persistent asthma have a peak expiratory flow (PEF) of 60% to 80% of predicted value. 
D)  Children with mild persistent asthma have signs or symptoms more than two times per week. 
E)  Children with moderate persistent asthma have some limitations with normal activity.
F) Children with severe persistent asthma have frequent nighttime signs or symptoms. 
A)  Children with mild persistent asthma have nighttime signs or symptoms less than two times a month. 
B)  Children with moderate persistent asthma use a short-acting b-agonist more than two times per week. 
C)  Children with severe persistent asthma have a peak expiratory flow (PEF) of 60% to 80% of predicted value. 
D)  Children with mild persistent asthma have signs or symptoms more than two times per week. 
E)  Children with moderate persistent asthma have some limitations with normal activity.
F) Children with severe persistent asthma have frequent nighttime signs or symptoms.

Question 16

A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, "My tummy hurts." The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the child's pain?

Accepted Answer

A)  Ice chips 
B)  Tylenol PO 
C)  Tylenol PR 
D)  Popsicle 
A)  Ice chips 
B)  Tylenol PO 
C)  Tylenol PR 
D)  Popsicle

Question 17

A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.)

Accepted Answer

A)  Cleft palate 
B)  Seizure disorders 
C)  Blood dyscrasias 
D)  Sickle cell disease 
E)  Acute infection at the time of surgery 
A)  Cleft palate 
B)  Seizure disorders 
C)  Blood dyscrasias 
D)  Sickle cell disease 
E)  Acute infection at the time of surgery

Question 18

A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition?

Accepted Answer

A)  Asthma 
B)  Pneumonia 
C)  Bronchiolitis 
D)  Foreign body in trachea 
A)  Asthma 
B)  Pneumonia 
C)  Bronchiolitis 
D)  Foreign body in trachea

Question 19

A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)?

Accepted Answer

A)  Less than 18 mEq/L 
B)  18 to 40 mEq/L 
C)  40 to 60 mEq/L 
D)  Greater than 60 mEq/L 
A)  Less than 18 mEq/L 
B)  18 to 40 mEq/L 
C)  40 to 60 mEq/L 
D)  Greater than 60 mEq/L

Question 20

A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup?

Accepted Answer

A)  A bath in tepid water can help resolve this type of croup. 
B)  Tylenol can help to relieve the cough and stridor. 
C)  A cool mist vaporizer at the bedside can help prevent this type of croup. 
D)  Antibiotics need to be given to reduce the inflammation. 
A)  A bath in tepid water can help resolve this type of croup. 
B)  Tylenol can help to relieve the cough and stridor. 
C)  A cool mist vaporizer at the bedside can help prevent this type of croup. 
D)  Antibiotics need to be given to reduce the inflammation.

Exam 28: The Child with Respiratory Dysfunction

A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which?

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition?

A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal?

What condition is the leading cause of chronic illness in children?

A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action?

The nurse is caring for a newborn with suspected congenital diaphragmatic hernia. What of the following findings would the nurse expect to observe? (Select all that apply.)

A 5-year-old child is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process?

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true?

The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The child's SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take?

What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind?

The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system? (Select all that apply.)

A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.)

A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition?

A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)?

Perspectives of Pediatric Nursing

Social, Cultural, Religious, and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, Physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

The High-Risk Newborn and Family

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child with Chronic Illness or Disability

Family-Centered Palliative Care

The Child with Cognitive, Sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child with Fluid and Electrolyte Imbalance

The Child with Renal Dysfunction

The Child with Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child with Cardiovascular Dysfunction

The Child with Hematologic or Immunologic Dysfunction

The Child with Cancer

The Child with Cerebral Dysfunction

The Child with Endocrine Dysfunction

The Child with Musculoskeletal or Articular Dysfunction

The Child with Neuromuscular or Muscular Dysfunction

Filters

The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The child's SaO₂ saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take?