Pediatric Respiratory Quiz Questions And Answers

CF patients excrete excessive electrolytes (specifically sodium and chloride) from their sweat and salivary glands.

• True

• False

Croup symptoms may include: Ronchi, Rales and a "barky" or "bark like" __________

A 5-year-old child is brought into the emergency department with drooling, strident cough, and lethargy. Epiglottitis is suspected.  The priority intervention for this child is to:

• Take vital signs

• Secure the child's airway

• Visualize the child's throat with a tongue depressor

• Obtain throat cultures

Some structural differences in the airway in children compared to adults are: Larynx and glottis are located higher in the neck, tonsils are larger, and some cartilage is less developed.

• True

• False

Postural drainage is typically performed 1 hour before meals or 2 hours after meals.

• True

• False

In patients with CF, abnormally thick mucous leads to obstruction of the secretory ducts of the ____________ that can contribute to malnutrition and diabetes.

A child experiencing an acute asthma attack presents to the emergency department.  Which of the following medications should a nurse prepare to administer to the child as an intervention for an acute asthma attack?

• Terbutaline (Brethine)

• Beclomethasone dipropionate (QVAR)

• Prednisone (Deltasone)

• Albuterol (Proventil)

Cystic fibrosis is inherited as an Autosomal recessive trait.  So in order for a child to present with a diagnosis of Cystic Fibrosis who had the Gene???

• Only the mom

• Only the dad

• Both the mom and dad

• Neither, it's caused by nurses not washing their hands.

Goal for a child with respiratory infection:  "The child will exhibit adequate oxygenation and ___________ airway.  Keep O₂ sats >92-93%

A child who was rescued from a burning building is brought to the hospital via emergency medical services.  Smoke inhalation has caused the child's condition to deteriorate within 24 hours.  The nurse should be particularly alert for signs of:

• Infection

• Tracheobronchial edema

• Posttraumatic stress disorder

• Generalized adaptions to stress

Respiratory treatment that involves percussion, vibration, and postural drainage to mobilize secretions.  A cupped hand or special device over the chest wall/rib cage is used to break up secretions.

• Postural Drainage

• Chest Pysiotherapy CPT)

• Flutter Therapy

• MDI

Absence of breath sounds accompanied by a sudden rise in respiratory rate is an ominous sign for Status Asthmaticus.

• True

• False

A 2-year-old is admitted with croup, and 1/4L oxygen via nasal canula is administered because it:

• Congeals the mucous secretions and relieves the dyspnea

• Decreases the effort required for breathing and also allows for rest. Decreases the effort required for breathing and also allows for rest

• Triggers the cough reflex and facilitates expectoration of mucus

• Liquifies the mucous secretions and makes them easier to expectorate

A 2-year-old is suffering from poor oxygenation due to streptococcal pneumonia and requires an endotracheal (ET) tube.  Which outcome indicates that ET  intubation is successful?

• Bilateral breath sounds on auscultation are heard

• Oxygen saturation is 80%

• An audible cry is heard on inspiration

• The tip of the ET tube is in the right mainstem bronchus.

A clear mucus may indicate that the infection is most likely.

• Bacterial

• Viral

• Fungal

A 4-year-old is brought to the emergency department by his parents, who report that he swallowed a small toy.  What symptom suggests complete airway obstruction by a foreign body?

• Gagging

• Coughing

• Inability to speak

• Rapid respirations

The nurse giving oxygen to an infant with respiratory distress syndrome should give high priority to administering oxygen that is warmed and humidified.

• True

• False

CF often shows up as "Patchy" atelectasis on chest x-ray

• True

• False

An 8-month-old is admitted to the pediatric unit with a history of multiple respiratory infections and suspected cystic fibrosis.  Which symptom suggests cystic fibrosis?

• Fatty Stools

• Decreased Appetite

• Decreased Respiratory Rate

• Early passage of meconium in the neonatal period

If a patient with Status Asthmaticus is not responding to standard meds (Beta-2, Albuterol, Corticosteroids (IV),  Aminophylline drips (IV), the MD may consider subcutaneous epinephrine 1:1000 at a dose of 0.01mL/kg max dose of 0.3 mL.  That is just a fact.  The true or false question is: is it true or false that the use of Bicarb may be  indicated for the correction of acidosis secondary to status asthmaticus????

• True

• False

A nurse is caring for a child with a burn injury sustained in a house fire.  Which assessment finding suggests that the child has suffered smoke inhalation?

• Hoarseness

• Hypotension

• Burns over the chest and abdomen

• Decreased sputum

A nurse is working a 0700 to 1500 shift  a pediatric floor, and her duties include giving the morning dose of the pancreatic enzyme to a 12-year-old with cystic fibrosis.  This medication should be administered:

• With breakfast

• After breakfast

• With antibiotics

• 2 hours before breakfast

Eppiglottitis is almost always caused by Haemophilus influenza

• True

• False

A 10-year-old student comes to the school nurse's office. He says he is unable to breathe. The first action is to:

• Take vital signs

• Call the student's mother

• Give an aerosol treatment

• Listen to the student's lungs

A child with cystic fibrosis has early signs of an upper respiratory tract infection, including a cough and runny nose.  The nurse should teach the child's mother to:

• Make sure the child eats a good diet

• Take the child's temperature twice a day

• Offer the child lots of orange juice to drink

• Increase chest physiotherapy to four times per day

Factors that increase the risk/frequency of respiratory infections in children include: (choose all that apply)

• Consumption of canned food

• Smaller airway diameter

• Shorter distances between structures of the airway

• Short eustachian tubes

• Repeated exposure to "Baby Mozart"

An 8-year-old child with asthma is being assessed by the nurse.  An assessment that requires immediate intervention would be:

• A round face

• Audible wheezing

• Regular use of inhalers

• A respiratory rate of 30 per minute.

The nurse organizes care for an infant with bronchiolitis to allow for uninterrupted periods of rest.  This plan would be:

• Inappropriate because constant care is necessary in the acute stage

• Appropriate because the cool mist helps to maintain hydration status

• Inappropriate because frequent assessment by auscultation is required

• Appropriate because this action promotes decreased oxygen demands

A nurse is caring for a 10 year old with CF.  The child reports that he feels like he isn't getting enough air.  Which finding indicates that the child is compensating for decreased serum oxygen levels?

• Sunken abdomen

• Distended Jugular Veins

• Edema in the upper extremities

• Clubbing of the fingers and toes

A nurse is working with a group of parents whose infants have died from sudden infant death syndrome (SIDS).  Which statement by a parent indicates the need for further teaching?

• "I feel so guilty because my baby died"

• "If I'd checked on my baby in the middle of the night he wouldn't have died"

• "Parents should take all pillows and stuffed animals out of a baby's crib"

• "it would probably be a good idea if I learned CPR"

An important nursing measure for a 6-month-old infant with bronchiolitis is:

• Promoting stimulating activities that meet the infant's developmental needs

• Making regular assessments of the infant's skin color, anterior fontanel, and vital signs

• Discouraging visits from the parents during the acute phase to conserve the infant's energy

• Maintaining airborne precautions including wearing a gown, cap, mask, and gloves when giving care to the infant.

A child who has just returned to the unit after surgery is drowsy and not alert to commands.  To maintain an airway, the nurse should:

• Have a tongue blade available

• Keep the child in a supine position

• Use nasotracheal suction as needed

• Place the child in a lateral Sims' position

Which of the following statements is true according to Mrs. Reklau's Notes?

• Higher Fever with Bacterial , No Fever with Viral

• Higher Fever with Bacterial, Lower with Viral

• Higher Fever with Viral, Lower with Bacterial

A 10-year-old child who is developmentally delayed and blind must be fed all meals.  The child has problems swallowing and frequently chokes and coughs during the feeding.  When feeding this child, the nurse should:

• Hold the child in an upright position and use a soft-tip bulb syringe

• Place the child in the supine position and turn the head to the right

• Prop the child in a semisitting position, chop up the food and place it in the child's mouth with plastic tableware

• Seat the child in the wheelchair, give small bites of food with metal tableware, and encourage the child's participation.

A 10-year-old with a history of asthma is diagnosed with status asthmaticus.  This child:

• Has severe wheezing

• Hasn't responded to treatment

• Requires emergency intubation

• Has underlying pneumonia

The 4 "D's" of Eppiglottitis are:  Dysphonia (muffled voice), Drooling,and  ___________ (impairment of speech)

CF is primarily a Mechanical obstruction.

• True

• False

If epiglottitis is suspected, the nurse should attempt to visualize the epiglottis without the use of a tongue depressor.

• True

• False

A child who had been admitted for status asthmaticus appears to be improving.  The most objective way for the nurse to evaluate the child's response to therapy is to:

• Auscultate the child's breath sounds

• Monitor the child's respiratory pattern

• Assess the child's lips for a decrease in cyanosis

• Evaluate the child's current peak expiratory flow rate.

A result of repeated infections in children with cystic fibrosis is:

• Increased irritability

• Bone marrow depression

• Enhanced academic ability

• Being prone to developing type 1 diabetes

Which of the following are signs of airway obstruction/respiratory distress?  Hypoxia is a gimme.  Check all boxes that apply:

• Diaphoresis

• Tachypnea

• Tachycardia

• Restlessness

• Increased PTT

• Bradycardia

The mother of a 3-year-old calls the nurse into the room because she says that her son is choking.  What intervention should be the nurse's highest priority?

• Opening the child's mouth and sweeping for foreign materials

• Giving five back blows with the child face down over the nurse's arm

• Assessing whether the child can make vocal sounds

• Performing up to five subdiaphragmatic abdominal thrusts with the child in a supine position

An infant with a history of respiratory tract infection is brought to the emergency department and diagnosed with bronchiolitis and respiratory syncytial virus (RSV) infection.  The nurse places the infant in a private room and institutes what type of precautions?

• Droplet precautions

• Standard precautions

• Contact precautions

• Airborne precautions

Meningismus is nuchal rigidity and photophobia without the presence of a headache.

• True

• False

A 15-month-old with croup is admitted to the pediatric unit. The nurse is most concerned that:

• An inspiratory stridor is heard

• The mother cannot calm the child

• The toddler has a barking cough

• The toddler is restless while sleeping

A 7-year-old undergo tonsillectomy for recurrent tonsillitis.  Twenty-four hours after surgery, the child vomits material that resembles coffee grounds.  What is action by the nurse most appropriate?

• Notify the physician immediately.

• Maintain nothing-by-mouth status for the next 24 hours

• Maintain nothing-by-mouth status for the next 30 minutes and then resume clear liquids.

• Place the child in a supine position.

Which of the following Medicines is commonly not used in treating children's respiratory symptoms?  (choose all that apply)

• Antitussives

• Antibiotics

• Decongestants

A nurse is caring for a 17-year-old female with cystic fibrosis who has been admitted to the hospital to receive I.V. antibiotic and respiratory treatment for exacerbation of a lung infection.  The adolescent has a number of questions about her future and the consequences of the disease.  Which statements about the course of cystic fibrosis are true?

• Breast development is commonly delayed

• The adolescent is at risk for developing diabetes

• Pregnancy and child-bearing aren't affected

• Normal sexual relationships can be expected

• Only males carry the gene for the disease.

• By age 20, the frequency of respiratory treatment should be possible to decrease