A 10-year-old child with recently diagnosed asthma is receiving information about the use of a peak expiratory flow meter (PEFM). The nurse knows that the child understands how to use the PEFM when she makes which statement?
1
"I have to blow out as fast and hard into the machine as I can."
2
"...
EVOLVE EAQ respiratory 178 questions
Correctly Solved|2024
A 10-year-old child with recently diagnosed asthma is receiving information about the use of a peak
expiratory flow meter (PEFM). The nurse knows that the child understands how to use the PEFM when
she makes which statement?
1
"I have to blow out as fast and hard into the machine as I can."
2
"I can stand or sit to use the flow meter. I just can't lie down."
3
"I have to take three readings and record the average on the flow sheet."
4
"I'll use the meter whenever I can throughout the day—it doesn't really matter when." - ✔ ✔ "I have
to blow out as fast and hard into the machine as I can."
-A PEFM is used to measure the amount of air being exhaled. To adequately measure this, the client
must blow out fast and hard. The client should use the PEFM while in a standing position to permit
better expansion of the lungs. The highest of three readings, not the average, is recorded. The readings
should be obtained close to the same time each day to ensure consistency.
A 16-year-old client has a steady boyfriend with whom she is having sexual relations. She asks the nurse
how she can protect herself from contracting human immunodeficiency virus (HIV). Which guidance is
most appropriate for the nurse to provide?
1
Ask her partner to withdraw before ejaculating.
2
Make certain their relationship is monogamous.
3
,Insist that her partner use a condom when having sex.
4
Seek counseling about various contraceptive methods. - ✔ ✔ Insist that her partner use a condom
when having sex.
A 3-year-old child is admitted to the pediatric unit with a diagnosis of acute asthma. The child is short of
breath, the respiratory rate is 56 breaths/min, the pulse is 102 beats/min, and there is a nonproductive
cough. What does the nurse expect regarding the child's blood gas values?
1
pH of 7.32
2
Po2 of 95 mm Hg
3
Pco2 of 40 mm Hg
4
HCO3- of 26 mEq/L (26 mmol/L) - ✔ ✔ pH of 7.32
A 5-year-old child is admitted to the pediatric intensive care unit with a diagnosis of acute asthma. A
blood sample is obtained to measure the child's arterial blood gases. What finding does the nurse
expect?
,-Gas exchange is limited because of narrowing and swelling of the bronchi; the carbon dioxide level
increases. The oxygen level will be decreased, not increased. The pH will decrease; the child is in
respiratory acidosis, not alkalosis. The bicarbonate level will be increased to compensate for acidosis
A 5-year-old child who is HIV positive is taken to the health department for immunizations before the
start of school. The CD4 count shows severe immunosuppression. What immunizations can the child be
given safely at this time? Select all that apply.
1
Varicella
2
Hepatitis A
3
Polio vaccine (IPV)
4
Measles, mumps, rubella (MMR)
5
Diphtheria, tetanus, pertussis (DTaP) - ✔ ✔ Hepatitis A
Polio vaccine (IPV)
Diphtheria, tetanus, pertussis (DTaP)
A 6-year-old child with status asthmaticus is admitted to the pediatric intensive care unit. What should
the nurse include in the plan of care as the child starts to recover from the episode?
1
Maintain the high-Fowler position.
2
Restrict fluids to two-thirds of the usual intake.
3
, Keep droplet precautions in place for 24 hours.
4
Administer the prescribed prophylactic antibiotic. - ✔ ✔ Maintain the high-Fowler position.
A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base
imbalance should the nurse expect the child to develop?
1
Metabolic alkalosis caused by excessive production of acid metabolites
2
Respiratory alkalosis caused by accelerated respirations and loss of carbon dioxide
3
Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid
4
Metabolic acidosis caused by the kidneys' inability to compensate for increased carbonic acid formation
- ✔ ✔ Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid
-The restricted ventilation accompanying an asthma attack limits the body's ability to blow off carbon
dioxide. As carbon dioxide accumulates in the body fluids, it reacts with water to produce carbonic acid;
the result is respiratory acidosis.
A child with a history of asthma is brought to the emergency department experiencing an acute
exacerbation of asthma. Which nursing assessment findings support this conclusion? Select all that
apply.
1
Fever
2
Stridor
3
Wheezing
4
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