ATI LPN
Questions of Respiratory System Questions
Question 1 of 5
A young toddler is being discharged after an emergency admission for foreign body aspiration. The parents ask what they can do to prevent another accident. What advice is appropriate for the nurse to give the parents?
Correct Answer: C
Rationale: Keeping small objects out of reach (C) prevents aspiration, per document (3). Toddlers (1-3 years) explore orally 90% of cases <5 cm objects (e.g., coins). Watching (A) or teaching (B) fail developmentally. Continuous observation (D) is impractical. C's environmental control 50% risk drop fits AAP safety, unlike A's vagueness.
Question 2 of 5
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?
Correct Answer: B
Rationale: Decreased wheezing in a child with asthma during an acute exacerbation can signal worsening, not improvement. Asthma, a chronic inflammatory airway disease, causes bronchoconstriction, typically producing wheezing as air squeezes through narrowed passages. If wheezing diminishes without treatment resolving the attack, it may indicate a 'silent chest' severe airflow obstruction where air movement is too restricted to produce sound, risking respiratory failure. Warm, dry skin suggests improvement, as exacerbations often cause diaphoresis. A pulse of 90 beats/minute (normal: 70-110 for a 10-year-old) and respirations of 18 breaths/minute (normal: 16-20) are within expected ranges and not alarming. Monitoring for decreased wheezing is critical, as it prompts urgent intervention like bronchodilators to restore airflow, a key nursing priority in asthma management to prevent hypoxia and escalation.
Question 3 of 5
A client is receiving isoetharine hydrochloride (Bronkosol) via a nebulizer. The nurse monitors the client for which side effect of this medication?
Correct Answer: D
Rationale: Isoetharine (Bronkosol), a beta-2 agonist bronchodilator, commonly causes tachycardia (D) as a side effect. It stimulates beta-2 receptors in bronchial smooth muscle to relieve bronchospasm, but beta-1 crossover in the heart increases heart rate palpitations or tremors may follow. Constipation (A) and diarrhea (B) aren't linked; gastrointestinal effects are rare. Bradycardia (C) opposes beta-adrenergic stimulation, which accelerates pulse. Other effects like nervousness or dry mouth occur, but tachycardia is a primary concern, requiring monitoring, especially in COPD or asthma patients with cardiac comorbidities, a key nursing task to ensure safety during nebulizer therapy.
Question 4 of 5
The nurse is preparing to administer respiratory medications to a child hospitalized with asthma. By which most frequently used route will the medication be administered?
Correct Answer: A
Rationale: Aerosol (A), via nebulizer or inhaler, is the most frequent route for asthma medications in hospitalized children (e.g., albuterol). It delivers drugs like bronchodilators directly to airways, rapidly relieving bronchospasm with minimal systemic effects ideal for acute settings. Intravenous (B) suits emergencies (e.g., status asthmaticus) with steroids or theophylline, but it's less common. Subcutaneous (C) is rare epinephrine is historical, not routine. Oral (D) steroids or leukotriene modifiers are slower, for maintenance. Aerosol's targeted, fast action dominates inpatient asthma care, a nursing standard to optimize respiratory relief and monitor response.
Question 5 of 5
A 33-year-old man suddenly develops severe dyspnea with wheezing. On physical examination, his vital signs are temperature, 37C; pulse, 95/min; respirations, 35/min; and blood pressure, 130/80 mm Hg. A chest radiograph shows increased lucency in all lung fields. Arterial blood gas analysis shows Po2, 65 mm Hg; Pco2, 30 mm Hg; and pH, 7.48. A sputum cytologic specimen shows Curschmann spirals, Charcot-Leyden crystals, branching septate hyphae, and eosinophils in a background of abundant mucus. What is the most likely risk factor predisposing him to illness?
Correct Answer: A
Rationale: Cytokine gene polymorphisms (A) predispose to allergic bronchopulmonary aspergillosis (ABPA) in this asthma case (Page 28, Ans: A). TH2 cytokine excess (IL-5, IL-13) drives eosinophilia and IgE (Page 6), reacting to Aspergillus hyphae . Spirals and crystals confirm atopic asthma. Aspiration (B) lacks eosinophils. Dusts (C) cause restriction. CFTR (D) yields bronchiectasis. A's genetic link 5q locus explains hypersensitivity, unlike B's mechanical cause, per document.