NUR 235 EXAM 4 - Answers Latest Version - shorter airway (4 mm i...

NUR 235 EXAM 4

NUR 235 EXAM 4

NUR 235 Exam 4 Actual Questions and Answers Latest Version

• shorter airway (4 mm in diameter compared to 20 mm)
• flexible larynx is susceptible to spasms
• flexible trachea is susceptible to collapse
• decreased amount of alveoli
• underdeveloped lungs
• infants are obligatory nose breathers (until 4 weeks) -Correct Answer ✔Which

anatomical differences make caring for children with respiratory disorders different than caring for adults?

True. This creates a higher oxygen demand. -Correct Answer ✔T or F? An infant's metabolic rate is almost twice as high as an adult's metabolic rate.

If the infant is in respiratory distress. IV feedings & fluids should be initiated until oral intake is acceptable. -Correct Answer ✔When should oral feedings be discontinued for infants?

supine with HOB elevated 45 degrees -Correct Answer ✔What is the ideal position for optimal chest expansion?

• tachypnea & tachycardia
• intercostal retractions
• paradoxical breathing
• restlessness
• grunting
• nasal flaring
• diaphoresis (except in neonates)
• clubbing of fingertips
• acrocyanosis (normal in infants up to 48 hours) -Correct Answer ✔What are the S/S of

respiratory distress?

• pulse oximetry
• oxygen therapy
• nebulized aerosol
• MDI or dry powder inhaler
• chest physiotherapy
• suctioning (NT, OT, ET, tracheal)
• artificial airway insertion -Correct Answer ✔Methods used to increase oxygenation and

improve & monitor respiratory functioning include...

• determine which type of device should be used (i.e. mouthpiece, mask, or blow-by)
• assess VS and O2 saturation prior to & after administration

NUR 235 EXAM 4

NUR 235 EXAM 4

• monitor for bronchospasms
• *teach child to take slow, deep breaths by mouth* -Correct Answer ✔Nursing

management for nebulized aerosol therapy includes...

• shake the inhaler 5-6 times
• attach the spacer
• take a deep breath and exhale
• use the open-mouth or closed-mouth method
• press the inhaler and take a *slow, deep breath*
• hold breath for 5-10 seconds
• wait at least 1 minute between puffs if an additional puff is needed
• *rinse mouth out after use* -Correct Answer ✔Describe the proper way to use a

metered-dose inhaler.

• *DO NOT SHAKE the device*
• exhale completely
• place device between the lips and take a *fast, deep breath*
• hold breath for 5-10 seconds
• wait prescribed length of time if an additional puff is needed
• rinse the inhaler, cap, and spacer once daily -Correct Answer ✔Describe the proper

way to use a dry powder inhaler.

• at least 1 hour before eating
• at least 2 hours after eating -Correct Answer ✔When should chest physiotherapy be

performed in relation to mealtimes to prevent GI upset?

Venturi mask -Correct Answer ✔Which oxygen delivery device provides the most accurate control of oxygen administration?

- infants: less than 5 seconds

• children: less than 10 seconds -Correct Answer ✔How long should each suctioning

pass be performed on infants and children?

False. You should suction as you withdraw the catheter, rolling the catheter between the fingers. -Correct Answer ✔T or F? Suctioning is performed as you insert the catheter.

• *nasal corticosteroids (i.e. fluticasone)*
• 1st & 2nd generation antihistamines (based on age)
• beta adrenergic decongestants (i.e. pseudoephedrine)
• mast cell stabilizer (i.e. cromolyn)
• leukotriene modifiers (i.e. montelukast)
• anticholinergics (i.e. ipratropium) -Correct Answer ✔Treatment options for allergic

rhinitis include...

• *earache & tugging at the ears*

NUR 235 EXAM 4

NUR 235 EXAM 4

• *bulging, red, or opaque eardrum*
• *purulent, foul-smelling drainage*
• nonspecific S/S of infection (i.e. fever, N/V, crying, anorexia) -Correct Answer ✔What

are the S/S of otitis media?

• breastfeeding
• discontinue pacifier after 6 months
• feed children sitting straight up
• avoid smoking in the house
• immunizations (i.e. PCV 13 @ 2, 4, 6 months & flu vaccine beginning @ 6 months) -

Correct Answer ✔Methods used to prevent ear infections can include...

• *tenderness of the tragus and/or pinna*
• edematous auricle
• purulent drainage -Correct Answer ✔What are the S/S of otitis externa?

With pharyngitis, there is no sneezing or irritation of the nose. -Correct Answer ✔What is the main difference between the S/S of nasopharyngitis and pharyngitis?

• antihistamines
• antibiotics -Correct Answer ✔Which medications are not recommended for

nasopharyngitis?

• three or more episodes of tonsillitis per year
• chronic tonsillitis
• streptococcus carrier -Correct Answer ✔What are relative indications for a

tonsillectomy?

• recurrent peritonsillar abscesses
• airway obstruction -Correct Answer ✔What are absolute indications for a

tonsillectomy?

• hypertrophied adenoids
• obstruction of the nasal passages
• recurrent adenoiditis or sinusitis
• sleep apnea
• mouth breathing -Correct Answer ✔Indications for an adenoidectomy include...

• *check for evidence of bleeding* (i.e. frequent swallowing, restlessness, bright red

emesis, tachycardia, pallor)

• place in side-lying or prone position immediately post-op to facilitate drainage
• DO NOT give red or purple popsicles
• DO NOT use a tongue depressor for assessment
• provide an ice collar

NUR 235 EXAM 4

NUR 235 EXAM 4

• administer analgesics & antiemetics -Correct Answer ✔Nursing management post-

operative for a tonsillectomy includes...

• *no using a straw*
• *no coughing, sneezing, or blowing nose*
• no milk products
• no hot, spicy, or acidic foods for up to two weeks
• may progress to soft diet post-op day 2 -Correct Answer ✔Patient & family teaching for

a tonsillectomy includes...

• *stridor at rest*
• hypoxia
• increased work of breathing
• fever -Correct Answer ✔What are the S/S of bacterial tracheitis?

• weeks -Correct Answer ✔When is one considered protected from influenza after

receiving the vaccine?

• *oseltamivir (Tamiflu; given to children >1 year old & should begin within 48 hours from

symptom onset)*

• zanamivir
• rimantadine
• amantadine -Correct Answer ✔Types of antivirals given to reduce the effects of

influenza and shorten length of the illness include...

• *inspiratory stridor in the first 2 weeks of life that increases after feedings, emotional

distress, or laying down flat*

• *crowing noise with respirations*
• difficulty feeding
• mild tachypnea
• suprasternal retractions
• normal VS and O2 saturation -Correct Answer ✔What are the S/S of laryngomalacia?

• laryngitis (least serious)
• laryngotracheobronchitis (most common)
• laryngotracheitis (serious)
• epiglottitis (most serious) -Correct Answer ✔What are the four types of croup

syndrome?

- A: airway closed

- I: increased pulse

- R: restlessness

- R: retractions

- A: anxiety increased

- *I: inspiratory stridor*