Medical Tests Medical Tests Certifications CEN Questions & Answers

• Question 71:

  You are caring for a child with acute exacerbation of asthma. What would indicate a worsening of the condition?

  A. Increased wheezing

  B. Decreased wheezing

  C. Warm, dry skin

  D. A pulse rate of 90 beats per minute

  Correct Answer: B

  Decreased wheezing would indicate a worsening of the condition. This could indicate an inability of the child to move air. With treatment, increased wheezing would indicate an improvement in the child's condition.

• Question 72:

  You are caring for a child with epiglottitis. On assessment of the child what would indicate to you that the child is experiencing airway obstruction?

  A. The child is leaning backwards and supporting himself with his hands and arms.

  B. The child has a low-grade fever and complains of a sore throat.

  C. The child is leaning forward with the chin thrust out.

  D. The child exhibits nasal flaring and bradycardia.

  Correct Answer: C

  If a child is leaning forward with the chin thrust out, this is an indication that the airway may be obstructed. Other indications might include nasal flaring, tachycardia, high fever and sore throat. To prevent spasm of the epiglottitis and airway obstruction, no attempt should be made to visualize the pharynx.

• Question 73:

  You are caring for a child with respiratory syncytial virus (RSV). You are preparing to give the child ribavirin (Virazole). Which route is most appropriate for administering this medication?

  A. Subcutaneous

  B. Intramuscular

  C. Oxygen tent

  D. Oral

  Correct Answer: C

  An oxygen tent is the most appropriate route of administration for ribavirin (Virazole). This is an antiviral medication used mainly in children with severe RSV. It can also be administered through a hood or face mask.

• Question 74:

  You are caring for child with bronchiolitis. Which of the following would be the most appropriate method of assessing this patient for dehydration?

  A. Intake and output

  B. Fontanels

  C. Mucous membranes

  D. Weight

  Correct Answer: D

  Weight is a good indication of this patient's fluid loss or gain. One kilogram of weight represents one liter of fluid loss or gain, which makes this a very reliable source for dehydration.

• Question 75:

  You need to read a Mantoux test on the child you are caring for. An area of induration measuring 10 mm would indicate what result?

  A. Negative

  B. Positive

  C. Inconclusive

  D. Definitive and requiring a repeat test

  Correct Answer: B

  An area of induration measuring 10 mm would indicate a positive result in children less than 4 years old. An area of induration 5 mm or greater would be considered positive in any high risk patients, such as those with HIV. An area of induration 15 mm or larger would be considered positive for patient four years old or older with no high risks for tuberculosis.

• Question 76:

  You are caring for a patient with suspected cystic fibrosis. A sweat test has been performed on the child. Which of the following test results would be considered a positive result?

  A. Chloride of 20 mEq/L

  B. Chloride of 30 mEq/L

  C. Chloride of 40 mEq/L

  D. Chloride of 70 mEq/L

  Correct Answer: D

  A chloride of 70 mEq/L would indicate a positive sweat test. In a sweat test, sweating is stimulated on the forearm with pilocarpine, and the amounts of sodium and chloride are measured. At least 50 mg of sweat is required to get an accurate test. A chloride level of 60 mEq/L or greater is considered a positive test.

• Question 77:

  If you were caring for a child who had croup that had to be in a cool mist tent, what action would you need to take if the child became frightened and began crying consistently?

  A. Notify the physician and get an order for sedation.

  B. Have the mother make the child stay in the tent.

  C. Give the child a toy to play with in the tent.

  D. Place the child in mom's lap and direct cool mist over the child's face.

  Correct Answer: D

  The nurse would want to place the child in the mom's lap and direct cool mist over the child's face. Crying will aggravate laryngospasm and increase hypoxia. This will lead to airway obstruction so it is important to decrease crying quickly.

• Question 78:

  You are caring for a toddler with croup. Which of the following clinical manifestations would you not see with croup?

  A. Worsening symptoms at night, that improve during the day

  B. Worsening symptoms during the day that improve with sleep

  C. Harsh, brassy cough

  D. Inspiratory stridor and low grade fever

  Correct Answer: B

  All of the above are correct except worsening symptoms during the day that improve with sleep. Usually, a child develops croup after several days of respiratory infection. Croup begins with a harsh, brassy cough, sore throat and inspiratory stridor. The patient may develop a low grade fever, but in some cases the fever will get as high as 104 degrees.

• Question 79:

  You are caring for an older patient who is on complete bedrest. What interventions would you take to prevent respiratory complications?

  A. Monitoring vital signs routinely

  B. Decreasing oral fluid intake

  C. Turning the patient every two hours

  D. Instructing the patient to bear down every hour and hold their breath

  Correct Answer: C

  The patient should be turned every two hours to prevent respiratory complications. This helps to mobilize lung secretions and prevent pooling. The patient would be encouraged to drink more fluids to thin secretions. Cough and deep breathing exercise would be encouraged to promote mobilization of secretions. Vital signs would be taken every four hours to insure that no temperature had developed, which would indicate pneumonia.

• Question 80:

  You are caring for a patient who had a radical neck dissection. The endotracheal tube has just been removed. Which of the following signs would you want to report to the physician immediately?

  A. Stridor

  B. Occasional pink-tinged sputum

  C. Respiratory rate of 24 breaths a minute

  D. Basilar crackles on the right side

  Correct Answer: A

  The physician will need to be notified if the patient develops stridor. Stridor is a high-pitched, coarse sound heard over the trachea. This is an indication of airway edema, which puts the patient at risk for airway blockage.