Chapter 20 Principles of Pediatric Nursing 6th Ed By Ball

Chapter 20 Principles of Pediatric Nursing 6th Ed By Ball

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A child is showing signs of acute respiratory distress. Which position will the nurse place this child?

1. Upright
2. Side-lying
3. Flat
4. In semi-Fowler’s

Correct Answer: 1

Rationale 1: Upright is correct because it allows for optimal chest expansion. Side-lying, flat, and semi-Fowler’s (head up slightly) do not allow for as optimal chest expansion as the upright position.

Rationale 2: Upright is correct because it allows for optimal chest expansion. Side-lying, flat, and semi-Fowler’s (head up slightly) do not allow for as optimal chest expansion as the upright position.

Rationale 3: Upright is correct because it allows for optimal chest expansion. Side-lying, flat, and semi-Fowler’s (head up slightly) do not allow for as optimal chest expansion as the upright position.

Rationale 4: Upright is correct because it allows for optimal chest expansion. Side-lying, flat, and semi-Fowler’s (head up slightly) do not allow for as optimal chest expansion as the upright position.

Global Rationale: Upright is correct because it allows for optimal chest expansion. Side-lying, flat, and semi-Fowler’s (head up slightly) do not allow for as optimal chest expansion as the upright position.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 20.6 Create a nursing care plan for a child with a common acute respiratory condition.

 

Question 2

Type: MCSA

A nurse delegates the task of neonatal vital-sign assessment to a nurse technician. Which instruction will the nurse give to the technician prior to assign care?

1. Report any neonate using abdominal muscles to breathe.
2. Report any neonate with apnea for 10 seconds.
3. Count respirations for 15 seconds and multiply by 4 to get the rate for 1 minute.
4. Report any neonate with a breathing pause that lasts 20 seconds or longer.

Correct Answer: 4

Rationale 1: The abnormal assessment finding for vital signs that the nurse should instruct a nurse technician to report is any breathing pause by a neonate lasting longer than 20 seconds. This can indicate apnea and could lead to an apparent life-threatening event (ALTE). A breathing pause of 10 seconds or less is called periodic breathing and is a normal pattern for a neonate. Respirations should be counted for 1 minute, not 15 seconds. It is normal for neonates to use abdominal muscles for breathing.

Rationale 2: The abnormal assessment finding for vital signs that the nurse should instruct a nurse technician to report is any breathing pause by a neonate lasting longer than 20 seconds. This can indicate apnea and could lead to an apparent life-threatening event (ALTE). A breathing pause of 10 seconds or less is called periodic breathing and is a normal pattern for a neonate. Respirations should be counted for 1 minute, not 15 seconds. It is normal for neonates to use abdominal muscles for breathing.

Rationale 3: The abnormal assessment finding for vital signs that the nurse should instruct a nurse technician to report is any breathing pause by a neonate lasting longer than 20 seconds. This can indicate apnea and could lead to an apparent life-threatening event (ALTE). A breathing pause of 10 seconds or less is called periodic breathing and is a normal pattern for a neonate. Respirations should be counted for 1 minute, not 15 seconds. It is normal for neonates to use abdominal muscles for breathing.

Rationale 4: The abnormal assessment finding for vital signs that the nurse should instruct a nurse technician to report is any breathing pause by a neonate lasting longer than 20 seconds. This can indicate apnea and could lead to an apparent life-threatening event (ALTE). A breathing pause of 10 seconds or less is called periodic breathing and is a normal pattern for a neonate. Respirations should be counted for 1 minute, not 15 seconds. It is normal for neonates to use abdominal muscles for breathing.

Global Rationale: The abnormal assessment finding for vital signs that the nurse should instruct a nurse technician to report is any breathing pause by a neonate lasting longer than 20 seconds. This can indicate apnea and could lead to an apparent life-threatening event (ALTE). A breathing pause of 10 seconds or less is called periodic breathing and is a normal pattern for a neonate. Respirations should be counted for 1 minute, not 15 seconds. It is normal for neonates to use abdominal muscles for breathing.

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 20.2 Contrast the different respiratory conditions and injuries that can cause respiratory distress in infants and children.

 

Question 3

Type: MCSA

A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). Which nursing intervention is the priority for this child?

1. Administer nebulized epinephrine and oral or IM dexamethasone.
2. Administer antibiotics and assist with possible intubation.
3. Swab the throat for a throat culture.
4. Obtain a sputum specimen.

Correct Answer: 1

Rationale 1: Nebulized epinephrine and dexamethasone are given for LTB. Antibiotic administration and possible intubation are associated with epiglottitis. Throat cultures are not obtained for LTB because it is viral and swabbing the throat could cause complete obstruction to occur. Sputum specimens will not assist in the diagnosis of LTB.

Rationale 2: Nebulized epinephrine and dexamethasone are given for LTB. Antibiotic administration and possible intubation are associated with epiglottitis. Throat cultures are not obtained for LTB because it is viral and swabbing the throat could cause complete obstruction to occur. Sputum specimens will not assist in the diagnosis of LTB.

Rationale 3: Nebulized epinephrine and dexamethasone are given for LTB. Antibiotic administration and possible intubation are associated with epiglottitis. Throat cultures are not obtained for LTB because it is viral and swabbing the throat could cause complete obstruction to occur. Sputum specimens will not assist in the diagnosis of LTB.

Rationale 4: Nebulized epinephrine and dexamethasone are given for LTB. Antibiotic administration and possible intubation are associated with epiglottitis. Throat cultures are not obtained for LTB because it is viral and swabbing the throat could cause complete obstruction to occur. Sputum specimens will not assist in the diagnosis of LTB.

Global Rationale: Nebulized epinephrine and dexamethasone are given for LTB. Antibiotic administration and possible intubation are associated with epiglottitis. Throat cultures are not obtained for LTB because it is viral and swabbing the throat could cause complete obstruction to occur. Sputum specimens will not assist in the diagnosis of LTB.

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 20.6 Create a nursing care plan for a child with a common acute respiratory condition.

 

Question 4

Type: MCSA

The nurse is teaching a group of mothers of infants about the benefits of immunization. Which immunization will the nurse teach to the mothers that can assist in preventing the life-threatening disease epiglottitis?

1. Measles, mumps, and rubella (MMR)
2. Haemophilus influenzae type B (HIB)
3. Hepatitis B
4. Polio

Correct Answer: 2

Rationale 1: The Haemophilus influenzae type B (HIB) immunization can assist in prevention of epiglottitis. Hepatitis B, measles, mumps, rubella, and the polio virus are not causative agents for epiglottitis.

Rationale 2: The Haemophilus influenzae type B (HIB) immunization can assist in prevention of epiglottitis. Hepatitis B, measles, mumps, rubella, and the polio virus are not causative agents for epiglottitis.

Rationale 3: The Haemophilus influenzae type B (HIB) immunization can assist in prevention of epiglottitis. Hepatitis B, measles, mumps, rubella, and the polio virus are not causative agents for epiglottitis.

Rationale 4: The Haemophilus influenzae type B (HIB) immunization can assist in prevention of epiglottitis. Hepatitis B, measles, mumps, rubella, and the polio virus are not causative agents for epiglottitis.

Global Rationale: The Haemophilus influenzae type B (HIB) immunization can assist in prevention of epiglottitis. Hepatitis B, measles, mumps, rubella, and the polio virus are not causative agents for epiglottitis.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 20.2 Contrast the different respiratory conditions and injuries that can cause respiratory distress in infants and children.

 

Question 5

Type: MCSA

A nurse is assessing a neonate. Which assessment finding indicates that the neonate’s respiratory status is worsening?

1. Acrocyanosis
2. Arterial CO₂ of 40
3. Periorbital edema
4. Grunting respirations with nasal flaring

Correct Answer: 4

Rationale 1: Grunting respirations with nasal flaring indicates respiratory status is becoming worse. Acrocyanosis (cyanosis of the extremities) is a normal finding in a neonate. CO₂ of 40 is within a normal range. Periorbital edema does not necessarily mean deterioration in respiratory status.

Rationale 2: Grunting respirations with nasal flaring indicates respiratory status is becoming worse. Acrocyanosis (cyanosis of the extremities) is a normal finding in a neonate. CO₂ of 40 is within a normal range. Periorbital edema does not necessarily mean deterioration in respiratory status.

Rationale 3: Grunting respirations with nasal flaring indicates respiratory status is becoming worse. Acrocyanosis (cyanosis of the extremities) is a normal finding in a neonate. CO₂ of 40 is within a normal range. Periorbital edema does not necessarily mean deterioration in respiratory status.

Rationale 4: Grunting respirations with nasal flaring indicates respiratory status is becoming worse. Acrocyanosis (cyanosis of the extremities) is a normal finding in a neonate. CO₂ of 40 is within a normal range. Periorbital edema does not necessarily mean deterioration in respiratory status.

Global Rationale: Grunting respirations with nasal flaring indicates respiratory status is becoming worse. Acrocyanosis (cyanosis of the extremities) is a normal finding in a neonate. CO₂ of 40 is within a normal range. Periorbital edema does not necessarily mean deterioration in respiratory status.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 20.8 Perform a nursing assessment of the child with an acute lung injury.