Chapter 23 Caring for the Child With a Respiratory Condition

Chapter 23  Caring for the Child With a Respiratory Condition

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which statement by the nursing student indicates a correct understanding of the anatomy and physiology of the respiratory system?
A.
Air passes through the trachea into the bronchus.
B.
Oxygen exchange with the bloodstream occurs in the veins.
C.
Oxygen passes from the larynx to the pharynx.
D.
The bronchus divides into smaller branches or acini.

ANS: A
The oxygen passes from the pharynx to the larynx. From the larynx, air passes through the trachea, which branches into the left and right bronchi. Each bronchus divides into smaller branches called bronchioles. The bronchioles end in a cluster of air sacs called acini. Oxygen exchange with the bloodstream occurs in the capillaries.

Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

2. The pediatric nurse explains to the parents of a 1-year-old patient with pneumonia that the differences between the adult’s and child’s respiratory system affect function and subsequent respiratory conditions. Which difference does the nurse include in the discussion with the patient’s parents?
A.
Infants are obligate nose breathers until 6 months of age.
B.
The epiglottis in the child under 8 is shorter and more rigid.
C.
The larynx and the glottis are higher in the younger child’s neck.
D.
In the child, there are more functional muscles in the neck and less soft tissue.

ANS: C
Until about age 4 weeks, infants are obligate nose breathers and do not open their mouths to breathe. The epiglottis in the younger (usually age 8 years and younger) child is longer and flaccid (floppy), which makes it more susceptible to swelling. The larynx and the glottis are higher in the younger child’s neck, which makes the child more prone to aspiration. There are fewer functional muscles in the neck, and the increased amount of soft tissue makes the younger child more susceptible to infection and edema.

Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

3. The pediatric nurse examines a neonate and documents that the baby is pink in color when crying but turns bluish when quiet. Which question would be most appropriate to ask the parent?
A.
“Does the baby have trouble when eating?”
B.
“Have your other children had this problem?”
C.
“How many respiratory infections has she had?”
D.
“You don’t ever prop her bottle, do you?”

ANS: A
Choanal atresia is a congenital malformation of the nose in which there is blockage of the posterior side of the nose. It often is associated with bony abnormalities and may affect one side or both sides of the nose. A child with bilateral choanal atresia usually displays respiratory problems during development. A newborn who is pink in color when crying, yet turns bluish when quiet should be suspected of having bilateral choanal atresia or another defect impeding the nasal airway. Another sign of this disorder is feeding difficulties and resultant lack of weight gain. Because this is not genetic, asking about other children with the condition is irrelevant. The number of respiratory infections will not give information as to the possible diagnosis. Because of the potential for aspiration, the baby should be fed in a semi-upright to upright position; however, the wording of the question might make the parent feel defensive.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1

4. A school-age child has asthma and lives in a home where both parents smoke. The nurse has provided extensive education to the parents on the dangers of second-hand smoke. Which assessment by the nurse indicates that goals for a family nursing diagnosis have been met?
A.
Child’s clothing no longer smells of cigarette smoke
B.
Father states he has quit smoking; mother has cut down
C.
Parents state they smoke only in the basement now
D.
Significant decrease in asthma “attacks” over a year

ANS: D
An important goal for this family is understanding how to avoid exposing their child to second-hand smoke. The only objective assessment data to show that the child is not exposed to smoke is the decrease in asthma “attacks” the child has had in the last year. New clothing will not smell like smoke; if the mother continues to smoke even in lesser amounts, the child will still be exposed; and smoking anywhere in the house pollutes all the air in the house.

Cognitive Level: Evaluating/Evaluation
Content Area: Pediatrics/Maternity
Client Needs Category: Health Promotion and Maintenance
Integrated Process: Nursing Process: Evaluation
Difficulty: Easy

PTS: 1

5. A 4-year-old girl is brought to the emergency department. She has a “frog-like” croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. Which nursing action is the priority for this patient?
A.
Maintain the airway.
B.
Obtain a throat culture.
C.
Start an intravenous line.
D.
Transport for a chest x-ray.

ANS: A
Airway, breathing, and circulation are the primary concerns for all patients. When a patient has acute respiratory distress, the most important nursing intervention is maintaining an airway. Starting an IV is important, but it is not the primary concern. Obtaining a throat culture would be contraindicated at this time, as it could cause vomiting or occlusion of the airway. The child should not be transported for x-ray; it should be done with portable equipment.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment: Management of Care
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate

PTS: 1