The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child's first chest physiotherapy (CPT) each day. Which is the nurse's best response?
1. "Thirty minutes before feeding the child breakfast."
2. "After deep-suctioning the child each morning."
3. "Thirty minutes after feeding the child breakfast."
4. "Only when the child has congestion or coughing."

What would the nurse advise the parent of a child with a barky cough that gets worse at night?
1. Take the child outside into the more humid night air for 15 minutes.
2. Take the child to the ER immediately.
3. Give the child an over-the-counter cough suppressant.
4. Give the child warm liquids to soothe the throat.

A nurse in a newborn nursery is caring for a neonate. On assessment, the infant is exhibiting signs of cyanosis, tachypnea, nasal flaring, and grunting. Respiratory distress syndrome is diagnosed, and the physician prescribes surfactant replacement therapy. The nurse prepares to administer this therapy by:
1. Intravenous injection
2. Subcutaneous injection
3. Intramuscular injection
4. Instillation of the preparation into the lung through an endotracheal tube

Which breathing exercises should the nurse have an asthmatic 3-year-old child do to increase her expiratory phase?
1. Use an incentive spirometer.
2. Breathe into a paper bag.
3. Blow a pinwheel.
4. Take several deep breaths.

How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)?
The values indicate the child is
1. Not compliant with taking her vitamins.
2. Not compliant with taking her enzymes.
3. Eating too many foods high in fat.
4. Eating too many foods high in fiber.

The parent of a child with croup tells the nurse that her other child just had croup and it cleared up in a couple of days without intervention. She asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. Which is the
nurse's best response?
1. "Some children just react differently to viruses. It is best to treat each child as an individual."
2. "Younger children have wider airways that make it easier for bacteria to enter and colonize."
3. "Younger children have short and wide eustachian tubes, making them more
susceptible to respiratory infections."
4. "Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed."

Which child is in the greatest need of emergency medical treatment?
1. 3-year-old who has a barky cough, is afebrile, and has mild intercostal retractions.
2. 6-year-old who has high fever, no spontaneous cough, and frog-like croaking.
3. 7-year-old who has abrupt onset of moderate respiratory distress, a mild fever, and a barky cough.
4. 13-year-old who has a high fever, stridor, and purulent secretions.

The parent of a 9-month-old calls the ER because his child is choking on a marble. The parent asks how to help his child while awaiting Emergency Medical Services. Which is the nurse's best response?
1. "You should administer five abdominal thrusts followed by five back blows."
2. "You should try to retrieve the object by inserting your finger in your child's mouth."
3. "You should perform the Heimlich maneuver."
4. "You should administer five back blows followed by five chest thrusts."

A 2-year-old has just been diagnosed with cystic fibrosis (CF). The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best response?
1. "You can expect your child to develop a barrel-shaped chest."
2. "You can expect your child to develop a chronic productive cough."
3. "You can expect your child to develop bronchiectasis."
4. "You can expect your child to develop wheezing respirations."

A parent asks the nurse how it will be determined if their child has respiratory syncytial virus (RSV). Which is the nurse's best response?
1. "We will do a simple blood test to determine whether your child has RSV."
2. "There is no specific test for RSV. The diagnosis is made based on the child's symptoms."
3. "We will swab your child's nose and send that specimen for testing."
4. "We will have to send a viral culture to an outside lab for testing."

Which physical findings would be of most concern in an infant with respiratory distress?
1. Tachypnea.
2. Mild retractions.
3. Wheezing.
4. Grunting.

Which child with asthma should the nurse see first?
1. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%.
2. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezing bilaterally, and has an oxygen saturation of 93%.
3. A 9-year-old who is quiet, is pale in color, and is wheezing bilaterally with an oxygen saturation of 92%.
4. A 16-year-old who is speaking in short sentences, is wheezing, is sitting upright, and has an oxygen saturation of 93%.

The parents of a 5-week-old have just been told that their child has cystic fibrosis (CF). The mother had a sister who died of CF when she was 19 years of age. The parents are sad and ask the nurse about the current projected life expectancy. What is the nurse's best response?
1. "The life expectancy for CF patients has improved significantly in recent years."
2. "Your child might not follow the same course that the mother's sister did."
3. "The physician will come to speak to you about treatment options."
4. The nurse answers their questions briefly, listens to their concerns, and is available later after they've processed the information.

How will a child with respiratory distress and stridor and who is diagnosed with RSV be treated?
1. Intravenous antibiotics.
2. Intravenous steroids.
3. Nebulized racemic epinephrine.
4. Alternating doses of Tylenol and Motrin.

Which would be an early sign of respiratory distress in a 2-month-old?
1. Breathing shallowly.
2. Tachypnea.
3. Tachycardia.
4. Bradycardia

Which information will be most helpful in teaching parents about the primary
prevention of foreign body aspiration?
1. Signs and symptoms of foreign body aspiration.
2. Therapeutic management of foreign body aspiration.
3. Most common objects that toddlers aspirate.
4. Risks associated with foreign body aspiration.

What does the therapeutic management of cystic fibrosis (CF) patients include?
Select all that apply.
1. Providing a high-protein, high-calorie diet.
2. Providing a high-fat, high-carbohydrate diet.
3. Encouraging exercise.
4. Minimizing pulmonary complication.
5. Encouraging medication compliance.

Which child is at highest risk for requiring hospitalization to treat respiratory syncytial virus (RSV)?
1. A 2-month-old who was born at 32 weeks.
2. A 16-month-old with a tracheostomy.
3. A 3-year-old with a congenital heart defect.
4. A 4-year-old who was born at 30 weeks.

Which assessment is of greatest concern in a 15-month-old?
1. The child is lying down, has moderate retractions, low-grade fever, and nasal congestion.
2. The child is in the tripod position, has diminished breath sounds, and a muffled cough.
3. The child is sitting up and has coarse breath sounds, coughing, and fussiness.
4. The child is restless and crying, has bilateral wheezes, and is feeding poorly.

What is the most important piece of information that the nurse must ask the parent of a child in status asthmaticus?
1. "What time did your child eat last?"
2. "Has your child been exposed to any of the usual asthma triggers?"
3. "When was your child last admitted to the hospital for asthma?"
4. "When was your child's last dose of medication?"