Chapter 21: The Child with a Respiratory Alteration

Chapter 21: The Child with a Respiratory Alteration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which of the following changes in the respiratory system occurs postnatally?

a.	Respirations are stimulated by hypoxemia.
b.	It takes up to 48 hours for most of the alveoli to expand.
c.	Surfactant in the lungs interferes with lung expansion.
d.	Pulmonary blood flow decreases after birth.

 

 

ANS:   A

 

	Feedback
A	A postnatal change in the respiratory system is the stimulation of respiration by hypoxemia, hypercarbia, cold, tactile stimulation, and a possible decrease in the concentration of prostaglandin E2.
B	Inflation of the normal lung is complete within a few breaths, and most alveoli have expanded within the first hour of life.
C	Surfactant in the lungs lowers surface tension and facilitates lung expansion.
D	Pulmonary blood flow increases after birth.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 601

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

2. What information would the nurse teach families about reducing exposure to pollens and dust?

a.	Replace wood and tile floors with wall-to-wall carpeting.
b.	Do not use an air conditioner.
c.	Put dust-proof covers on pillows and mattresses.
d.	Keep humidity in the house above 60%.

 

 

ANS:   C

 

	Feedback
A	Carpets retain dust. To reduce exposure to dust, carpeting should be replaced with wood, tile, slate, or vinyl. These floors can be cleaned easily.
B	For anyone with pollen allergies, it is best to keep windows closed and to run the air conditioner.
C	Covering mattresses and pillows with dust-proof covers will reduce exposure to dust.
D	A humidity level above 60% promotes dust mites. It is recommended that household humidity be kept between 40% and 50% to reduce dust mites inside the house.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 606

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

3. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes these symptoms are characteristic of which respiratory condition?

a.	Allergic rhinitis
b.	Bronchitis
c.	Asthma
d.	Sinusitis

 

 

ANS:   D

 

	Feedback
A	The classic symptoms of allergic rhinitis are watery rhinorrhea, itchy nose, eyes, ears, and palate, and sneezing. Symptoms occur as long as the child is exposed to the allergen.
B	Bronchitis is characterized by a gradual onset of rhinitis and a cough that is initially nonproductive but may change to a loose cough.
C	The manifestations of asthma may vary, with wheezing being a classic sign. The symptoms presented in the question do not suggest asthma.
D	Sinusitis is characterized by signs and symptoms of a cold that do not improve after 14 days, a low-grade fever, nasal congestion and purulent nasal discharge, headache, tenderness, a feeling of fullness over the affected sinuses, halitosis, and a cough that increases when the child is lying down.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 607

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

4. The child with chronic otitis media with effusion should be evaluated for which of the following problems?

a.	Brain abscess
b.	Meningitis
c.	Hearing loss
d.	Perforation of the tympanic membrane

 

 

ANS:   C

 

	Feedback
A	The infection of acute otitis media can spread to surrounding tissues, causing a brain abscess.
B	The infection of acute otitis media can spread to surrounding tissues, causing meningitis.
C	Chronic otitis media with effusion is the most common cause of hearing loss in children.
D	Inflammation and pressure from acute otitis media may result in perforation of the tympanic membrane.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pgs 608-609

OBJ:    Nursing Process Step: Evaluation      MSC:   NCLEX: Physiological Integrity