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Respiratory System,,,

الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 3
أستاذ المادة عبد المهدي عبد الرضا حسن الشحماني       03/11/2017 05:33:04
Respiratory System,,,

1.
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:
Discuss
A.
Hold the child in an upright position and use a soft-tip bulb syringe
B.
Place the child in the supine position and turn the head to the right
C.
Prop the child in a semisitting position, chop up the food and place it in the child s mouth with plastic tableware
D.
Seat the child in the wheelchair, give small bites of food with metal tableware, and encourage the child s participation.
2.
A 10 year old student comes to the school nurse s office. He says he is unable to breathe. The first action is to:
Discuss
A.
Take vital signs
B.
Call the student s mother
C.
Give an aerosol treatment
D.
Listen to the student s lungs
3.
A 10 year old with a history of asthma is diagnosed with status asthmaticus. This child:
Discuss
A.
Has severe wheezing
B.
Hasn t responded to treatment
C.
Requires emergency intubation
D.
Has underlying pneumonia
4.
A 15-month old with croup is admitted to the pediatric unit. The nurse is most concerned that:
Discuss
A.
An inspiratory stridor is heard
B.
The mother cannot calm the child
C.
The toddler has a barking cough
D.
The toddler is restless while sleeping
5.
A 2 year old is admitted with croup and 1/4L oxygen vea nasal canula is administered because it:
Discuss
A.
Congeals the mucous secretions and relieves the dyspnea
B.
Decreases the effort required for breathing and also allows for rest. Decreases the effort required for breathing and also allows for rest
C.
Triggers the cough reflex and facilitates expectoration of mucus
D.
Liquifies the mucous secretions and makes them easier to expectorate
6.
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?
Discuss
A.
Bilateral breath sounds on auscultation are heard
B.
Oxygen saturation is 80%
C.
An audible cry is heard on inspiration
D.
The tip of the ET tube is in the right mainstem bronchus.
7.
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?
Discuss
A.
Gagging
B.
Coughing
C.
Inability to speak
D.
Rapid respirations
8.
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:
Discuss
A.
Take vital signs
B.
Secure the child s airway
C.
Visualize the child s throat with a tongue depressor
D.
Obtain throat cultures
9.
A 7 year old undergoes tonsillectomy for recurrent tonsillitis. Twenty-four hours after surgery, the child vomits material that resembles coffee grounds. What action by the nurse is most appropriate?
Discuss
A.
Notify the physician immediately.
B.
Maintain nothing-by-mouth status for the next 24 hours
C.
Maintain nothing-by-mouth status for the next 30 minutes and then resume clear liquids.
D.
Place the child in a supine position.
10.
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 childe as an intervention for an acute asthma attack?
Discuss
A.
Terbutaline (Brethine)
B.
Beclomethasone dipropionate (QVAR)
C.
Prednisone (Deltasone)
D.
Albuterol (Proventil)
11.
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:
Discuss
A.
Auscultate the child s breath sounds
B.
Monitor the child s respiratory pattern
C.
Assess the child s lips for a decrease in cyanosis
D.
Evaluate the child s current peak expiratory flow rate.
12.
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:
Discuss
A.
Have a tongue blade available
B.
Keep the child in a supine position
C.
Use nasotracheal suction as needed
D.
Place the child in a lateral Sims position
13.
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:
Discuss
A.
Infection
B.
Tracheobronchial edema
C.
Posttraumatic stress disorder
D.
Generalized adaptions to stress
14.
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:
Discuss
A.
Make sure the child eats a good diet
B.
Take the child s temperature twice a day
C.
Offer the child lots of orange juice to drink
D.
Increase chest physiotherapy to four times per day
15.
A clear mucus may indicates that the infection is most likely...
Discuss
A.
Bacterial
B.
Viral
C.
Fungal
16.
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?
Discuss
A.
Sunken abdomen
B.
Distended Jugular Veins
C.
Edema in the upper extremities
D.
Clubbing of the fingers and toes
17.
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?
Discuss
A.
Breast development is commonly delayed
B.
The adolescent is at risk for developing diabetes
C.
Pregnancy and child-bearing aren t affected
D.
Normal sexual relationships can be expected
E.
Only males carry the gene for the disease.
F.
By age 20, the frequency of respiratory treatment should be possible to decrease
18.
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?
Discuss
A.
Hoarseness
B.
Hypotension
C.
Burns over the chest and abdomen
D.
Decreased sputum
19.
A nurse is working a 0700 to 1500 shift of a pediatric floor, and her duties include giving the morning dose of pancreatic enzyme to a 12 year old with cystic fibrosis. This medication should be administered:
Discuss
A.
With breakfast
B.
After breakfast
C.
With antibiotics
D.
2 hours before breakfast
20.
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?
Discuss
A.
"I feel so guilty because my baby died"
B.
"If I d checked on my baby in the middle of the night he wouldn t have died"
C.
"Parents should take all pillows and stuffed animals out of a baby s crib"
D.
"it would probably be a good idea if I learned CPR"
21.
A result of repeated infections in children with cystic fibrosis is:
Discuss
A.
Increased irritability
B.
Bone marrow depression
C.
Enhanced academic ability
D.
Being prone to developing type 1 diabetes
22.
Absence of breath sounds accompanied by a sudden rise in respiratory rate is an ominous sign in Status Asthmaticus.
Discuss
A.
True
B.
False
23.
An 8-month old is admitted is admitted to the pediatric unit with a history of multiple respiratory infections and suspected cystic fibrosis. Which symptom suggests cystic fibrosis?
Discuss
A.
Fatty Stools
B.
Decreased Appetite
C.
Decreased Respiratory Rate
D.
Early passage of meconium in the neonatal period
24.
An 8-year old child with asthma is being assessed by the nurse. An assessment that requires immediate intervention would be:
Discuss
A.
A round face
B.
Audible wheezing
C.
Regular use of inhalers
D.
A respiratory rate of 30 per minute.
25.
An important nursing measure for a 6-month old infant with bronchiolitis is:
Discuss
A.
Promoting stimulating activities that meet the infant s developmental needs
B.
Making regular assessments of the infant s skin color, anterior fontanel, and vital signs
C.
Discouraging visits from the parents during the acute phase to conserve the infant s energy
D.
Maintaining airborne precautions including wearing a gown, cap, mask, and gloves when giving care to the infant.
26.
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?
Discuss
A.
Droplet precautions
B.
Standard precautions
C.
Contact precautions
D.
Airborne precautions
27.
CF is primarily a Mechanical obstruction.
Discuss
A.
True
B.
False
28.
CF often shows up as "Patchy" atelectasis on chest x-ray
Discuss
A.
True
B.
False
29.
CF patients excrete excessive electrolytes (specifically sodium and chloride) from their sweat and salivary glands.
Discuss
A.
True
B.
False
30.
Children with CF should not get flu shots.
A.
True
B.
False
31.
Clinical manifestations of Cystic Fibrosis may include: (check all that apply)
Discuss
A.
Bile stained Vomiting
B.
Meconium Ileus
C.
Large bulky, loose, frothy stools that float
D.
Wheezy respirations
E.
Barrel chest
F.
Clubbing of fingers and toes
32.
Croup symptoms may include: Ronchi, Rales and a "barky" or "bark like" __________
33.
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???
A.
Only the mom
B.
Only the dad
C.
Both the mom and dad
D.
Neither, it s caused by nurses not washing their hands.
34.
Eppiglottitis is almost always caused by Haemophilus influenza
Discuss
A.
True
B.
False
35.
Factors that increase the risk/frequency of respiratory infections in children include: (choose all that apply)
A.
Consumption of canned food
B.
Smaller airway diameter
C.
Shorter distances between structures of the airway
D.
Short eustachian tubes
E.
Repeated exposure to "Baby Mozart"
36.
Goal for child with respiratory infection: "The child will exhibit adequate oxygenation and __________ airway. Keep O2 sats >92-93%
37.
If epiglottitis is suspected, the nurse should attempt to visualize the epiglottis without the use of tongue depressor.
Discuss
A.
True
B.
False
38.
If patient with Status Asthmaticus is not responding to standard meds (Beta-2, Albuterol, Coricosteroids (IV), Amminophylline 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 correction of acidosis secondary to status asthmaticus????
Discuss
A.
True
B.
False
39.
If you suspect respiratory distress in a child never leave them alone.
A.
True
B.
False
40.
In patients with CF, abnormally thick mucous leads to obstruction of the secretory ducts of the ___________ which can contribute to malnutrition and diabetes.
41.
Meningismus is nuchal rigidity and photophobia without the presence of a headache.
A.
True
B.
False
42.
Postural drainage is typically performed 1 hour before meals or 2 hours after meals.
A.
True
B.
False
43.
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.
A.
Postural Drainage
B.
Chest Pysiotherapy CPT)
C.
Flutter Therapy
D.
MDI
44.
Some structural differences of 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.
A.
True
B.
False
45.
The 4 "D s" of Eppiglottitis are: Dysphonia (muffled voice), Drooling,and ___________ (impairment of speech)
46.
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?
A.
Opening the child s mouth and sweeping for foreign materials
B.
Giving five back blows with the child face down over the nurse s arm
C.
Assessing whether the child can make vocal sounds
D.
Performing up to five subdiaphragmatic abdominal thrusts with the child in a supine position
47.
The nurse giving oxygen to an infant with respiratory distress syndrome should give high priority to administer oxygen which is warmed and humidified.
A.
True
B.
False
48.
The nurse organizes care for an infant with bronchiolitis to allow for uniterrupted periods of rest. This plan would be:
A.
Inappropriate because constant care is necessary in the acute stage
B.
Appropriate because the cool mist helps to maintain hydration status
C.
Inappropriate because frequent assessment by auscultation is required
D.
Appropriate because this action promotes decreased oxygen demands
49.
Which of the following are signs of of airway obstruction/respiratory distress? Hypoxia is a gimme. Check all boxes that apply:
A.
Diaphoresis
B.
Tachypnea
C.
Tachycardia
D.
Restlessness
E.
Increased PTT
F.
Bradycardia
50.
Which of the following Medicines are commonly not used in treating children s respiratory symptoms? (choose all that apply)
A.
Antitussives
B.
Antibiotics
C.
Decongestants
51.
Which of the following statements is true according to Mrs. Reklau s Notes?
Discuss
A.
Higher Fever with Bacterial , No Fever with Viral
B.
Higher Fever with Bacterial, Lower with Viral
C.
Higher Fever with Viral, Lower with Bacterial
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المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .