Review Practice Exercise 1

Lower Respiratory Tract Infections > Child Health

Exam Review

Practice Exercise 1

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Total Questions : 4

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Question 1:

A nurse is caring for a 2-year-old client with acute bronchitis. Which of the following interventions is contraindicated for this client?

A. Encouraging oral fluids B. Using a cool-mist humidifier C. Administering a cough suppressant D. Providing acetaminophen for fever

Answer and Explanation

Choice A:

Encouraging oral fluids is a correct intervention. Fluids help thin secretions, prevent dehydration, and improve mucus clearance.

Choice B:

Using a cool-mist humidifier soothes inflamed airways, reduces irritation, and eases coughing.

Choice C:

Administering a cough suppressant is contraindicated in young children with bronchitis. Suppressing the cough reflex prevents clearance of secretions, leading to mucus plugging and worsening airway obstruction. Additionally, many over-the-counter cough suppressants have been shown to be unsafe and ineffective in children under 6 years old.

Choice D:

Providing acetaminophen for fever is an appropriate intervention since it safely reduces fever and discomfort in children.

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Question 2:

A parent asks the nurse why the doctor did not prescribe an antibiotic for their 6-year-old child who was diagnosed with acute bronchitis. What is the nurse's best response?

A. "Antibiotics are only used if the fever is very high." B. "Most cases of bronchitis are caused by viruses, and antibiotics don't kill viruses." C. "The doctor is saving the antibiotics in case your child develops pneumonia." D. "Antibiotics are contraindicated because they can make a viral infection worse."

Answer and Explanation

Choice A:

"Antibiotics are only used if the fever is very high." Fever severity is not the deciding factor for antibiotic use. The etiology (viral vs. bacterial) is what matters.

Choice B:

"Most cases of bronchitis are caused by viruses, and antibiotics don't kill viruses." This is the best response because it provides accurate education to the parent, explaining that antibiotics are ineffective against viruses and therefore not prescribed for viral bronchitis.

Choice C:

"The doctor is saving the antibiotics in case your child develops pneumonia." Antibiotics are not “saved” for later; they are prescribed when there is a confirmed or highly suspected bacterial infection.

Choice D:

"Antibiotics are contraindicated because they can make a viral infection worse." Antibiotics don’t worsen viral infections; they are simply ineffective and unnecessary.

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Question 3:

Which physical assessment finding is most characteristic of acute bronchitis in an older child?

A. Inspiratory stridor B. Absence of cough C. Wheezing or coarse rhonchi on auscultation D. Hyperresonance to percussion

Answer and Explanation

Choice A:

Inspiratory stridor indicates upper airway obstruction such as croup, epiglottitis, or foreign body, not bronchitis, which affects the lower airways.

Choice B:

A persistent cough is the hallmark symptom of acute bronchitis, not the absence of a cough.

Choice C:

Wheezing or coarse rhonchi on auscultation are the most characteristic findings of acute bronchitis. They result from airway inflammation, mucus, and narrowing of the bronchi, which cause turbulent airflow.

Choice D:

Hyperresonance to percussion suggests air trapping or hyperinflation, more characteristic of asthma or emphysema, not acute bronchitis.

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Question 4:

The primary goal of nursing management for a child with acute viral bronchitis is:

A. Preventing bacterial superinfection. B. Promoting rest and adequate fluid intake. C. Administering a leukotriene modifier. D. Eradicating the causative organism.

Answer and Explanation

Choice A:

While important, preventing bacterial superinfection is a secondary concern. The main goal is supportive care, not prophylaxis.

Choice B:

Promoting rest and adequate fluid intake is the primary goal in nursing management. Rest helps recovery, while fluids prevent dehydration and thin mucus, making secretions easier to clear. Supportive measures are the cornerstone of care for viral bronchitis.

Choice C:

Administering a leukotriene modifier are used in chronic asthma, not in acute viral bronchitis.

Choice D:

Eradicating the causative organism is not possible with antibiotics since bronchitis is viral. The infection resolves on its own with supportive measures.

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Total Questions : 4

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Practice Exercise 1

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