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Maternal Child Nursing 5th Edition London Ladewig Ball Bindler Test Bank

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Maternal Child Nursing 5th Edition London Ladewig Ball Bindler Test Bank

ISBN-13: 978-0134167220

ISBN-10: 0134167228

 

Description

Maternal Child Nursing 5th Edition London Ladewig Ball Bindler Test Bank

ISBN-13: 978-0134167220

ISBN-10: 0134167228

 

 

 

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Free Nursing Test Questions:

London, 5e

Chapter 46   The Child With Alterations in Respiratory Function

1)  The mother of a toddler-age client states, “My daughter seems to be at an increased risk for complications associated with respiratory infections.” Which response by the nurse is accurate?

  1. “You are incorrect in your assessment.”
  2. “The younger child’s airways are smaller and more easily occluded.”
  3. “Air passages are more likely to become blocked with mucus because younger children make more mucus than older children.”
  4. “Toddlers do not breathe as deeply as do older children.”

Answer:   2

Explanation:

  1. The mother is correct in her statement.
  2. Airways are smaller in the younger child and are more easily occluded when mucus is produced.
  3. Blockage of air passages with mucus is not related to the age of the child but more to the etiology of mucus production and the continuation of the causative agent.
  4. Depth of breathing is not age dependent.

Page Ref:   1147

Cognitive Level:   Applying

Client Need/Sub: Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.1 Describe unique characteristics of the pediatric respiratory system anatomy and physiology and apply that information to the care of children with respiratory conditions.

MNL Learning Outcome: 9.4.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

2)  Which nursing diagnosis should the nurse include in the plan of care for an infant diagnosed with acute bronchiolitis due to respiratory syncytial virus (RSV)?

  1. Activity Intolerance
  2. Ineffective Peripheral Tissue Perfusion
  3. Acute Pain
  4. Decreased Cardiac Output

Answer:   1

Explanation:

  1. Activity Intolerance is a problem because of the imbalance between oxygen supply and demand.
  2. Tissue perfusion (peripheral) is not affected by this respiratory disease process.
  3. Acute Pain is not usually associated with acute bronchiolitis.
  4. Cardiac Output is not compromised during an acute phase of bronchiolitis.

Page Ref:   1160

Cognitive Level:   Applying

Client Need/Sub: Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 46.5 Distinguish between conditions of the lower respiratory tract that cause illness in children.

MNL Learning Outcome: 9.3.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in child.

3)  A toddler-age client presents to the emergency department with a sore throat and difficulty swallowing. The nurse suspects acute epiglottitis. Which nursing action is avoided based on the current assessment data?

  1. Throat culture
  2. Medical history
  3. Vital signs
  4. Auscultation of breath sounds

Answer:   1

Explanation:

  1. Throat cultures should never be done when a diagnosis of epiglottis is suspected. Manipulation of the throat can stimulate the gag reflex in an already inflamed airway and can cause complete occlusion of the airway.
  2. Medical history should be obtained, which assists in diagnosis.
  3. Vital signs should always be taken when assessment is done.
  4. Assessment of breath sounds is essential for diagnosis.

Page Ref:   1156

Cognitive Level:   Applying

Client Need/Sub: Safe and Effective Care Environment/Management of Care

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy;| Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46.6 Create a nursing care plan for a child with a common acute respiratory condition.

MNL Learning Outcome: 9.4.3. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in child.

4)  Which nursing action is appropriate for the parents of a 4-month-old infant who died due to sudden infant death syndrome (SIDS)?

  1. Sheltering parents from the grief by not giving them any personal items of the infant, such as footprints
  2. Allowing parents to hold, touch, and rock the infant
  3. Advising parents that an autopsy is not necessary
  4. Interviewing parents to determine the cause of the incident

Answer:   2

Explanation:

  1. Parents will want any personal items available.
  2. The parents should be allowed to hold, touch, and rock the infant, giving them a chance to say good-bye to their baby.
  3. The death of an infant without a known medical condition is an indication for an autopsy.
  4. The parents need to know that SIDS is not their fault.

Page Ref:   1155-1156

Cognitive Level:   Applying

Client Need/Sub: Psychosocial Integrity

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.6 Create a nursing care plan for a child with a common acute respiratory condition.

MNL Learning Outcome: 9.4.3. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in child.

5)  Which immunization should the nurse include in a teaching session for parents of a toddler-age client to decrease the risk for epiglottitis?

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

Answer:   4

Explanation:

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

Page Ref:   1156

Cognitive Level:   Applying

Client Need/Sub: Health Promotion and Maintenance

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46.2 Contrast the different respiratory medical conditions that can cause respiratory distress in infants and children.

MNL Learning Outcome: 9.4.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

6)  The nurse receives a phone call from the parent of a child who is prescribed rifampin (Rimactane) for treatment of tuberculosis because she saw that the child’s urine was orange. Which response by the nurse is accurate?

  1. “Encourage your child to drink cranberry juice.”
  2. “An orange discoloration of urine is expected while your child is on this medication.”
  3. “Bring your child to the clinic for a urinalysis.”
  4. “Bring your child to the clinic for a radiograph of the kidneys.”

Answer:   2

Explanation:

  1. Orange urine does not mean the child has a urinary tract infection, and a urinalysis, radiograph, and encouragement of cranberry juice would not be options.
  2. Rifampin can color the urine orangeRemember, the parents and child should be taught that this is an expected side effect.
  3. Orange urine does not mean the child has a urinary tract infection, and a urinalysis, radiograph, and encouragement of cranberry juice would not be options.
  4. Orange urine does not mean the child has a urinary tract infection, and a urinalysis, radiograph, and encouragement of cranberry juice would not be options.

Page Ref:   1164

Cognitive Level:   Applying

Client Need/Sub: Physiological Integrity/Pharmacological and Parenteral Therapies

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.6 Create a nursing care plan for a child with a common acute respiratory condition.

MNL Learning Outcome: 9.4.3. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in child.

7)  Which parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented?

  1. “We’re glad the dog can continue to sleep in our child’s room.”
  2. “We’ll keep the plants in our child’s room dusted.”
  3. “We’ll be sure to use the fireplace often to keep the house warm in the winter.”
  4. “We will replace the carpet in our child’s bedroom with tile.”

Answer:   4

Explanation:

  1. When possible, pets and plants should not be kept in the home.
  2. When possible, pets and plants should not be kept in the home.
  3. Smoke from fireplaces should be eliminated.
  4. Control of dust in the child’s bedroom is an important aspect of environmental control for asthma management.

Page Ref:   1176

Cognitive Level:   Analyzing

Client Need/Sub: Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 46.7 Develop a school-based nursing care plan for the child with asthma.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

8)  Which assessment data would cause the nurse to suspect that a newborn requires further testing for cystic fibrosis?

  1. Rectal prolapse
  2. Constipation
  3. Steatorrheic stools
  4. Meconium ileus

Answer:   4

Explanation:

  1. Rectal prolapse is a complication of the large, bulky fatty stools.
  2. Constipation is not a symptom of cystic fibrosis.
  3. Steatorrhea and rectal prolapse might be signs of cystic fibrosis seen in an older infant or child.
  4. Newborns with cystic fibrosis might present in the first 48 hours with meconium ileus.

Page Ref:   1178

Cognitive Level:   Understanding

Client Need/Sub: Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46.7 Develop a school-based nursing care plan for the child with asthma.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

9)  Which parental statement indicates correct understanding regarding pancreatic enzyme administration in the treatment of cystic fibrosis?

  1. “I will administer this medication 4 times each day.”
  2. “I will administer this medication twice each day.”
  3. “I will administer this medication with meals and snacks.”
  4. “I will administer this medication every 6 hours around the clock.”

Answer:   3

Explanation:

  1. A scheduled time would not be appropriate because the enzymes are used to assist in digestion of nutrients.
  2. A scheduled time would not be appropriate because the enzymes are used to assist in digestion of nutrients.
  3. Pancreatic enzymes are administered with meals and large snacks.
  4. A scheduled time would not be appropriate because the enzymes are used to assist in digestion of nutrients.

Page Ref:   1180

Cognitive Level:   Analyzing

Client Need/Sub: Physiological Integrity/Pharmacological and Parenteral Therapies

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 46.7 Develop a school-based nursing care plan for the child with asthma.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

10)  Which should the nurse include in a teaching session for the mother of a 3-year-old client who is concerned about her child choking?

  1. Show the mother how to do cardiac compressions and rescue breathing.
  2. Recommend the mother perform back blows and chest thrusts.
  3. Teach the mother how to perform abdominal thrusts.
  4. Tell the mother to do nothing until the child loses consciousness.

Answer:   3

Explanation:

  1. The method of cardiac compressions and rescue breathing is not the first thing that the mother needs to know.
  2. This is the treatment for a choking infant, not a child.
  3. Giving abdominal thrusts is the correct intervention for a choking child.
  4. The mother should respond to the choking child before the child loses consciousness.

Page Ref:   1153

Cognitive Level:   Applying

Client Need/Sub: Safe and Effective Care Environment/Safety and Infection Control

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46.2 Contrast the different respiratory medical conditions that can cause respiratory distress in infants and children.

MNL Learning Outcome: 9.4.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

11)  Which positions are appropriate for the nurse to include in a plan of care for the infant who is diagnosed with acute respiratory distress? Select all that apply.

  1. Upright
  2. Semi-Fowler position
  3. Prone position
  4. With the infant’s head hyperextended
  5. With the infant’s head in a sniffing position

Answer:   2, 5

Explanation:

  1. An infant cannot be placed in an upright position.
  2. The semi-Fowler position elevates the head of bed. This allows better movement of the diaphragm.
  3. Prone positioning will not promote respirations.
  4. The head should not be hyperextended as that position does not open the airway in an infant.
  5. A sniffing position straightens and shortens the airway and is the position that is best.

Page Ref:   1173

Cognitive Level:   Applying

Client Need/Sub: Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 46.6 Create a nursing care plan for a child with a common acute respiratory condition.

MNL Learning Outcome: 9.4.3. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in child.

12)  Which nursing action is appropriate when providing care to a newborn with a respiratory rate of 102 breaths per minute with lungs that are clear to auscultation?

  1. Administering the bath to the neonate in the nursery
  2. Transferring to the neonatal intensive care unit for further observation
  3. Allowing the neonate to room-in to promote bonding
  4. Providing the first feeding in the nursery

Answer:   2

Explanation:

  1. The newborn is tachypneic. Bathing will only add to the respiratory distress and should be avoided.
  2. This newborn needs to remain under constant observation due to the respiratory rate.
  3. The newborn needs to be monitored.
  4. With a respiratory rate this high, aspiration is likely so feeding should be avoided.

Page Ref:   1159-1160

Cognitive Level:   Applying

Client Need/Sub: Safe and Effective Care Environment/Management of Care

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritualRemember,cioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches| NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.4 Assess the child’s respiratory status and analyze the need for oxygen supplementation.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

13)  Which independent nursing action is appropriate for a 2-month-old infant who is a direct admission to the pediatric unit with a diagnosis of ALTE (apparent life-threatening event)?

  1. Place the child on an apnea monitor.
  2. Place the child on nasal cannula oxygen.
  3. Draw blood for arterial blood gases.
  4. Place the child on contact isolation.

Answer:   1

Explanation:

  1. This is appropriate monitoring of the infant.
  2. Oxygen is a dependent order except under emergency situations. There is no evidence the child needs oxygen.
  3. Laboratory tests are not an independent action.
  4. There is no indication of a respiratory infection. At this time, contact isolation is not indicated.

Page Ref:   1153

Cognitive Level:   Applying

Client Need/Sub: Safe and Effective Care Environment/Management of Care

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritualRemember,cioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches| NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implemenation

Learning Outcome: 46.4 Assess the child’s respiratory status and analyze the need for oxygen supplementation.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

14)  Which is the priority nursing action for a premature neonate who is experiencing apnea?

  1. Administering oxygen
  2. Performing back blows and chest thrusts
  3. Calling a code blue
  4. Providing stimulation by stroking the back

Answer:   4

Explanation:

  1. If the infant is not breathing, oxygen will not help.
  2. This is intervention for choking, not apnea.
  3. A code is not the initial response. If the nurse is unable to restart breathing, then a code should be initiated.
  4. Tactile stimulation is often sufficient to restart the infant’s respirations. Apnea of prematurity is due to immaturity of the respiratory center.

Page Ref:   1153

Cognitive Level:   Analyzing

Client Need/Sub: Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.2 Contrast the different respiratory medical conditions that can cause respiratory distress in infants and children.

MNL Learning Outcome: 9.4.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

15)  Which statements should the nurse include in the discharge medication teaching for a child diagnosed with asthma who is prescribed cromolyn sodium (a mast cell stabilizer)? Select all that apply.

  1. “The medication works to prevent exacerbations.”
  2. “The medication should be administered at the first symptom of an asthmatic attack.”
  3. “The medication should be taken on a daily basis.”
  4. “The medication should not be administered if the child has a cold.”
  5. “The medication desensitizes the child against specific allergens.”

Answer:   1, 3

Explanation:

  1. This statement is true. Cromolyn sodium is used to inhibit an asthmatic response to allergens.
  2. This is incorrect. This medication does not improve the child’s condition during an asthmatic attack.
  3. This is a preventative medication so doses should not be missed.
  4. The medication should be taken daily.
  5. This medication does not desensitize the child against allergens.

Page Ref:   1171

Cognitive Level:   Applying

Client Need/Sub: Physiological Integrity/Pharmacological and Parenteral Therapies

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.7 Develop a school-based nursing care plan for the child with asthma.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

16)  Which is the priority nursing action for a child who presents in the emergency department after a motor vehicle accident with a sucking wound of the chest?

  1. Placing the child in a Trendelenburg position
  2. Beginning rescue breathing for the child
  3. Beginning cardiac resuscitation for the child
  4. Covering the child’s wound with an air occlusive dressing

Answer:   4

Explanation:

  1. This would not be the appropriate response to a sucking chest wound.
  2. The child is conscious. Rescue breathing is not appropriate at this time.
  3. There is no need for cardiac resuscitation at this time.
  4. This prevents more air from entering the chest and is appropriate.

Page Ref:   1185

Cognitive Level:   Analyzing

Client Need/Sub: Safe and Effective Care Environment/Management of Care

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy;| Nursing/Integrated Concepts: Nursing Process:

Learning Outcome: 46.9 Contrast the signs of different injuries to the respiratory system.

MNL Learning Outcome: 9.5.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

 

17) Which data collected during the respiratory assessment would indicate the pediatric client is compromised? Select all that apply.

  1. Lung sounds clear to auscultation
  2. Stridor
  3. Substernal retractions
  4. Nasal flaring
  5. Strong cry

Answer:   2, 3, 4

Explanation:

  1. Lung sounds that are clear to auscultation do not indicate respiratory compromise.
  2. Stridor is an adventitious breath sound that may indicate respiratory compromise.
  3. Substernal retractions may indicate respiratory compromise.
  4. Nasal flaring may indicate respiratory compromise.
  5. A weak, not strong, cry may indicate respiratory compromise.

Page Ref:   1150

Cognitive Level:   Understanding

Client Need/Sub:   Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritualRemember,cioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46.3 Explain the visual and auditory observations made to assess a child’s respiratory effort or work of breathing.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

 

 

18) Which should the nurse assess to determine oxygenation during the respiratory assessment for a pediatric client? Select all that apply.

  1. Mucous membranes
  2. Nail beds
  3. Skin
  4. Sclerae
  5. Corneas

Answer:   1, 2, 3

Explanation:

  1. The nurse assesses the mucous membranes to determine oxygenation during the respiratory assessment for a pediatric client.
  2. The nurse assesses the nail beds to determine oxygenation during the respiratory assessment for a pediatric client.
  3. The nurse assesses the skin to determine oxygenation during the respiratory assessment for a pediatric client.
  4. The sclerae are not assessed to determine oxygenation during the respiratory assessment for a pediatric client.
  5. The corneas are not assessed to determine oxygenation during the respiratory assessment for a pediatric client.

Page Ref:   1150

Cognitive Level:   Applying

Client Need/Sub:   Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritualRemember,cioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46.3 Explain the visual and auditory observations made to assess a child’s respiratory effort or work of breathing.

MNL Learning Outcome: 9.4.3. Apply the nursing process in providing care for the child and family.

 

 

19) Which nursing actions are appropriate when providing care to a pediatric client who has sustained a smoke-inhalation injury? Select all that apply.

  1. Assessing for respiratory distress
  2. Auscultating the lungs for wheezing
  3. Prescribing oxygen for low saturations
  4. Administering prescribed prophylactic antibiotic therapy
  5. Providing support to the family

Answer:   1, 2, 5

Explanation:

  1. A pediatric client who sustained a smoke-inhalation injury is at risk for respiratory distress; therefore, it is appropriate for the nurse to assess this patient for clinical manifestations associated with the phenomenon.
  2. Crackles and wheezing are both complications associated with a smoke-inhalation injury. This nursing action is appropriate.
  3. It is outside the scope of nursing practice to prescribe oxygen therapy for a pediatric client. The nurse would, however, administer prescribed oxygen for this client.
  4. Prophylactic antibiotic therapy is not included in the treatment plan for a pediatric client who sustained a smoke-inhalation injury.
  5. The nurse should provide support to the family of a pediatric client who sustained a smoke-inhalation injury.

Page Ref:   1184

Cognitive Level:   Applying

Client Need/Sub:   Safe and Effective Care Environment/Management of Care

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 46.9 Contrast the signs of different injuries to the respiratory system.

MNL Learning Outcome: 9.5.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

 

 

20) Which pediatric clients would require a nursing assessment for blunt chest trauma? Select all that apply.

  1. A preschool-age client who is admitted after a house fire.
  2. A toddler-age client who is admitted for injuries sustained in a motor vehicle accident.
  3. A school-age client who is admitted for observation after a skateboarding accident.
  4. An adolescent client admitted for an asthma exacerbation.
  5. An infant admitted to rule out cystic fibrosis.

Answer:   2, 3

Explanation:

  1. A preschool-age client admitted after a house fire would require assessment for smoke-inhalation injury not blunt chest trauma.
  2. A toddler-age client admitted for injuries sustained in a motor vehicle accident would require assessment to determine blunt chest trauma.
  3. A school-age client admitted for observation after a skateboarding accident would require assessment to determine blunt chest trauma.
  4. An asthma exacerbation would not necessitate a nursing assessment for blunt chest trauma.
  5. An infant admitted to rule out cystic fibrosis would not necessitate a nursing assessment for blunt chest trauma.

Page Ref:   1184

Cognitive Level:   Analyzing

Client Need/Sub:   Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46.9 Contrast the signs of different injuries to the respiratory system.

MNL Learning Outcome: 9.5.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

 

 

21) Which nursing assessment data would indicate that a pediatric client sustained a large pulmonary contusion in a motor vehicle crash? Select all that apply.

  1. Eupnea
  2. Dyspnea
  3. Hemoptysis
  4. Fever
  5. Crackles

Answer:   2, 3, 4, 5

Explanation:

  1. Eupnea, or a normal respiratory rate, is not assessment data the nurse expects for a pediatric client who sustained a large pulmonary contusion in a motor vehicle crash.
  2. Dyspnea is a clinical manifestation associated with respiratory distress, which can occur for the pediatric client who sustained a large pulmonary contusion in a motor vehicle crash.
  3. Hemoptysis is a clinical manifestation associated with a large pulmonary contusion.
  4. Fever is a clinical manifestation associated with a large pulmonary contusion.
  5. Crackles are a clinical manifestation associated with a large pulmonary contusion.

Page Ref:   1184

Cognitive Level:   Understanding

Client Need/Sub:   Physiological Integrity/Physiological Adaptation

Standards:   QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Context and Environment: apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 46.9 Contrast the signs of different injuries to the respiratory system.

MNL Learning Outcome: 9.5.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

 

 

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