Pediatric Nursing | Respiratory Disorders NCLEX Quiz 7

1. Beta-adrenergic agonists such as albuterol are given to Reggie. a child with asthma. Such drugs are administered primarily to do which of the following?

Dilate the bronchioles

Reduce secondary infections

Decrease postnasal drip

Reduce airway inflammation

Beta-adrenergic agonists. such as albuterol. are highly effective bronchodilators and are used to dilate the narrow airways associated with asthma.Option B: Antibiotics are used to prevent secondary infection.Option C: Decongestants may be given to decrease postnasal drip.Option D: Corticosteroids may be used for their anti-inflammatory effect.

Explanation

Beta-adrenergic agonists. such as albuterol. are highly effective bronchodilators and are used to dilate the narrow airways associated with asthma.Option B: Antibiotics are used to prevent secondary infection.Option C: Decongestants may be given to decrease postnasal drip.Option D: Corticosteroids may be used for their anti-inflammatory effect.

2. Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of the following must Nurse Archie keep in mind when developing a care plan for the child?

Pulmonary secretions are abnormally thick.

Elevated levels of potassium are found in the sweat.

CF is an autosomal dominant hereditary disorder.

Obstruction of the endocrine glands occurs.

CF is identified by abnormally thick pulmonary secretions.Option B: Diagnosis of CF is based on elevated chloride levels detected in sweat.Option C: It is a chronic. inherited disorder. particularly an autosomal recessive hereditary disorder concerning the exocrine. not endocrine glands.Option D: The thick mucus blocks the exocrine glands.

Explanation

CF is identified by abnormally thick pulmonary secretions.Option B: Diagnosis of CF is based on elevated chloride levels detected in sweat.Option C: It is a chronic. inherited disorder. particularly an autosomal recessive hereditary disorder concerning the exocrine. not endocrine glands.Option D: The thick mucus blocks the exocrine glands.

3. Alice is rushed to the emergency department during an acute. severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following?

Status asthmaticus

Reactive airway disease

Intrinsic asthma

Extrinsic asthma

Status asthmaticus is an acute. prolonged. severe asthma attack that is unresponsive to usual treatment. Typically. the child requires hospitalization.Option B: Reactive airway disease is another general term for asthma.Option C: Intrinsic is a term used to denote internal precipitating factors. such as viruses.Option D: Extrinsic is a term used to denote external precipitating factors. such as allergens.

Explanation

Status asthmaticus is an acute. prolonged. severe asthma attack that is unresponsive to usual treatment. Typically. the child requires hospitalization.Option B: Reactive airway disease is another general term for asthma.Option C: Intrinsic is a term used to denote internal precipitating factors. such as viruses.Option D: Extrinsic is a term used to denote external precipitating factors. such as allergens.

4. Veronica's parents were told that their daughter needs ribavirin (Virazole). This drug is used to treat which of the following?

Cystic fibrosis

Otitis media

Respiratory syncytial virus (RSV)

Bronchitis

Ribavirin is an antiviral medication used for treating RSV infection and for children with RSV who are compromised (such as children with bronchopulmonary dysplasia or heart disease).Option A,B,D: The drug is not used to treat bronchiolitis, otitis media, or CF.

Explanation

Ribavirin is an antiviral medication used for treating RSV infection and for children with RSV who are compromised (such as children with bronchopulmonary dysplasia or heart disease).Option A,B,D: The drug is not used to treat bronchiolitis, otitis media, or CF.

5. Which of the following infants is least probable to develop sudden infant death syndrome (SIDS)?

Baby Angela who was premature

A sibling of Baby Angie who died of SIDS

Baby Gabriel with prenatal drug exposure

Baby Gabby who sleeps on his back

Infants who sleep on their back are least likely to develop SIDS. However. SIDS has been associated with infants who sleep on their abdomens.Option A.B.C: Being premature. having a sibling who died of SIDS. and being prenatally exposed to drugs all place the infant at high risk for developing SIDS.

Explanation

Infants who sleep on their back are least likely to develop SIDS. However. SIDS has been associated with infants who sleep on their abdomens.Option A.B.C: Being premature. having a sibling who died of SIDS. and being prenatally exposed to drugs all place the infant at high risk for developing SIDS.

6. The Andrews family has been taking good care of their youngest. Archie. who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?

“He should increase his fluid intake regularly to thin secretions.”

“We’ll make sure that he avoids exercise to prevent attacks.”

“He is to use his bronchodilator inhaler before the steroid inhaler.”

“We need to identify what things trigger his attacks.”

Additional teaching is needed if the family states that the child with asthma should avoid exercise to prevent attacks. Children with asthma should be encouraged to exercise as tolerated.Option A.C.D: Identifying triggers. using a bronchodilator inhaler before a steroid inhaler. and increasing fluid intake are appropriate measures to be included in a home care teaching program for the child with asthma and his family.

Explanation

Additional teaching is needed if the family states that the child with asthma should avoid exercise to prevent attacks. Children with asthma should be encouraged to exercise as tolerated.Option A.C.D: Identifying triggers. using a bronchodilator inhaler before a steroid inhaler. and increasing fluid intake are appropriate measures to be included in a home care teaching program for the child with asthma and his family.

7. Which of the following instructions should Nurse Cheryl include in her teaching plan for the parents of Reggie with otitis media?

Placing the child in the supine position to bottle-feed

Giving prescribed amoxicillin (Amoxil) on an empty stomach

Cleaning the inside of the ear canals with cotton swabs

Avoiding contact with people who have upper respiratory tract infections

Otitis media is commonly precipitated by an upper respiratory tract infection. Therefore. children prone to otitis should avoid people known to have an upper respiratory tract infection.Option A: A bottle-fed child should be fed in an upright position because feeding the child in the supine position may actually precipitate otitis by allowing the formula to pool in the pharyngeal cavity.Option B: Amoxicillin. when prescribed. should be given with food to prevent stomach upset.Option C: Cotton swabs can cause injuries such as tympanic perforation. They may be used to clean the outer ear. but they should never be inserted into the ear canal.

Explanation

Otitis media is commonly precipitated by an upper respiratory tract infection. Therefore. children prone to otitis should avoid people known to have an upper respiratory tract infection.Option A: A bottle-fed child should be fed in an upright position because feeding the child in the supine position may actually precipitate otitis by allowing the formula to pool in the pharyngeal cavity.Option B: Amoxicillin. when prescribed. should be given with food to prevent stomach upset.Option C: Cotton swabs can cause injuries such as tympanic perforation. They may be used to clean the outer ear. but they should never be inserted into the ear canal.

8. Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess?

Mild cough

Slight fever

Chest pain

Bulging fontanel

Older children with pneumococcal pneumonia may complain of chest pain.Option A.B: A mild cough and slight fever are commonly assessed with viral pneumonia.Option D: A bulging fontanel may be seen in infants with meningitis or increased intracranial pressure.

Explanation

Older children with pneumococcal pneumonia may complain of chest pain.Option A.B: A mild cough and slight fever are commonly assessed with viral pneumonia.Option D: A bulging fontanel may be seen in infants with meningitis or increased intracranial pressure.

9. Archie who weighs 44 lb has been given an order for amoxicillin 500 mg b.i.d. The drug text notes that the daily dose of amoxicillin is 50 mg/kg/day in two divided doses. What dose in milligrams is safest for this child?

1000 mg

750 mg

500 mg

250 mg

First. calculate the child’s weight in kg: 44/2.2 = 20 kg. Then calculate the appropriate daily dose according to the drug text: 50 mg/kg/day = 50 mg x 20 kg = 1.000 mg/day. the abbreviation b.i.d. means twice daily; therefore 1.000 divided by 2 equals 500 mg.

Explanation

First. calculate the child’s weight in kg: 44/2.2 = 20 kg. Then calculate the appropriate daily dose according to the drug text: 50 mg/kg/day = 50 mg x 20 kg = 1.000 mg/day. the abbreviation b.i.d. means twice daily; therefore 1.000 divided by 2 equals 500 mg.

10. Baby Melody is a neonate who has a very low-birth-weight. Nurse Josie carefully monitors inspiratory pressure and oxygen (O2) concentration to prevent which of the following?

Meconium aspiration syndrome

Bronchopulmonary dysplasia (BPD)

Respiratory syncytial virus (RSV)

Respiratory distress syndrome (RDS)

Close monitoring of inspiratory pressure and O2 concentration is necessary to prevent BPD. which is related to the use of high inspiratory pressures and O2 concentrations especially in very low-birth-weight and extremely low-birth-weight neonates with lung disorders.Option A: Meconium aspiration syndrome is a respiratory disorder created by the aspiration of meconium in perinatal period.Option C: RSV is a group of viruses that cause respiratory tract infections. such as bronchiolitis and pneumonia.Option D: RDS. a disorder caused by lack of surfactant. usually is found in premature neonates.

Explanation

Close monitoring of inspiratory pressure and O2 concentration is necessary to prevent BPD. which is related to the use of high inspiratory pressures and O2 concentrations especially in very low-birth-weight and extremely low-birth-weight neonates with lung disorders.Option A: Meconium aspiration syndrome is a respiratory disorder created by the aspiration of meconium in perinatal period.Option C: RSV is a group of viruses that cause respiratory tract infections. such as bronchiolitis and pneumonia.Option D: RDS. a disorder caused by lack of surfactant. usually is found in premature neonates.