Chapter 37

A group of nurses is reviewing the cardiovascular system and its function. Which of the following statements is the most accurate regarding the cardiovascular system in the child? A) At birth the right and left ventricle are about the same size. B) Between the ages of 5 and 6 the left ventricle grows to about two times the size of the right. C) The heart rate of the child decreases if the child has a fever. D) The heart matures and functions like an adult's between 12 and 15 years of age.

A

A nurse admits an infant with a possible diagnosis of congestive heart failure. Which of the following signs and symptoms would the infant most likely be exhibiting? A) Feeding problems C) Bradycardia B) Rapid weight gain D) Yellowish color

A

A symptom often seen in the child diagnosed with hemophilia is that the child has bleeding into the joints. This symptom is referred to as which of the following? A) Hemarthrosis B) Nuchal rigidity C) Encephalopathy D) Purpuric rash

A

In a child diagnosed with sickle cell disease, which of the following clinical manifestations would the nurse most likely see? A) Decreased hemoglobin level C) Strawberry colored tongue B) Increased appetite D) Hyperactive bowel sounds

A

In caring for the child with rheumatic fever which of the following medications would the nurse likely administer? A) Aspirin B) Tylenol C) Insulin D) Dilantin

A

When administering corticosteroids to the child with rheumatic fever, which of the following should the nurse recognize as an important aspect of giving this classification of medications for this diagnosis? A) The drug should be stopped gradually by giving decreasing dosages. B) The drug will be given for the rest of the child's life. C) The drug should be taken for a full course, usually 10 days. D) The drug should be taken using a metered-dose inhaler

A

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which of the following blood factors? A) Factor V B) Factor VIII C) Factor X D) Factor XIII

B

In discussing the causes of iron deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron deficiency anemia? A) "A family's economic problems are often a cause of malnutrition." B) "Milk is a perfect food, and babies should be able to have all the milk they want." C) "Caregivers sometimes don't understand the importance of iron and proper nutrition." D) "Children have a hard time getting enough iron from food during their first few years."

B

Which of the following sites is most frequently used to perform a bone marrow aspiration? A) Humerus B) Iliac crest C) Rib cage D) Femur

B

The nurse is collecting data from a caregiver, and the caregiver states that the child has had a "strawberry colored tongue." The nurse recognizes this as a manifestation of which of the following disorders? A) Congestive heart failure C) Kawasaki disease B) Rheumatic fever D) Hemophilia

C

The nurse is collecting data on a 5 year old child admitted with the diagnosis of congestive heart failure. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A) Jerking movements of the arms and legs B) Scissoring of the legs with toes pointed down C) Failure to gain weight D) Clubbing of the fingers

C

The nurse is preparing a child for discharge following a sickle cell crisis. The mother makes the following statements to the nurse. Which statement by the mother indicates a need for further teaching? A) "She loves popsicles, so I'll let her have them as a snack or for dessert." B) "I bought the medication to give to her when she complains of pain." C) "She has been down, but playing in soccer camp will cheer her up." D) "I put her legs up on pillows when her knees start to hurt."

C

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which of the following statements made by the caregivers is correct regarding giving ferrous sulfate? A) "When I give my son ferrous sulfate I know he also needs potassium supplements." B) "I always give the ferrous sulfate with meals." C) "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C." D) "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate."

C

A nurse admits a child with a diagnosis of acute lymphatic leukemia. During the phase of treatment known as the sanctuary phase, which of the following would most likely be seen? The child would A) Suffer a relapse B) Have a complete remission C) Be given a bone marrow transplant D) Have methotrexate injected into cerebrospinal fluid

D

For the child with Kawasaki disease who is treated with immunoglobulin it is most important to delay the administration of which of the following immunizations for 3 to 6 months following the treatment? A) DTaP (diphtheria, tetanus, acellular pertussis) B) Hepatitis B C) Inactivated poliovirus D) MMR (measles, mumps, rubella)

D

In caring for a child with sickle cell disease, the highest priority goal is which of the following? A) The family caregivers' anxiety will be reduced. B) The child's skin integrity will be maintained. C) The family will verbalize understanding of of the disease crisis. D) The child's fluid intake will improve.

D

Following the administration of liquid ferrous sulfate, the most important action for the child to be encouraged to do is which of the following? A) Drink a glass of milk C) Rinse his or her mouth with water B) Brush his or her teeth D) Not eat or drink for one hour

B

In understanding the cardiovascular and hematologic systems of the body it is important to know that the blood is made up of plasma, red blood cells, white blood cells, and platelets. These blood cells are formed in which of the following? A) Arteries B) Bone marrow C) Capillaries D) Lymph nodes

B

The care provider has ordered the drug furosemide (Lasix) to treat a child diagnosed with congestive heart failure. The nurse knows that this drug will be used to: A) Increase vasodilation C) Slow the heart rate B) Eliminate excess fluids D) Strengthen the heart's contractility

B

The child with Thalassemia may be given which of the following classifications of medications to prevent one of the complications frequently seen with the treatment of this disorder. A) Vitamin supplements C) Factor VIII preparations B) Iron-chelating drugs D) Potassium supplements

B

The nurse is caring for a child diagnosed with hemophilia. The child is crying and complaining of pain. Of the following nursing actions, which action would be appropriate for the nurse to do to relieve the child's pain? The nurse should A) Give aspirin as ordered B) Immobilize the affected extremity C) Distract the child with an age-appropriate activity D) Have the child do range-of-motion exercises

B

The nurse is discussing the stages of Kawasaki disease with a group of peers. The nurse states that the child is at the greatest risk for having an aneurysm during which of the following? A) The acute stage C) The convalescent stage B) The subacute stage D) The chronic stage

B

The nurse is explaining possible side effects of corticosteroids to the caregiver of a child diagnosed with rheumatic fever. The caregiver comments, "I don't understand what hirsutism means." The nurse would be correct in explaining that hirsutism is which of the following? A) Facial grimaces C) A "moon face" appearance B) Abnormal hair growth D) Repetitive movements

B

The nurse is teaching an inservice program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? A) "This disorder is caused by genetic factors." B) "Children who have this diagnosis may have had strep throat." C) "Being up to date on immunizations is the best way to prevent this disorder." D) "The onset and progression of this disorder is rapid."

B

The nurse is teaching an inservice program to a group of nurses on the topic of children diagnosed with sickle cell anemia. The nurses in the group make the following statements. Which statement is most accurate regarding sickle cell anemia? A) "The trait or the disease is seen in one generation and skips the next generation." B) "If the trait is inherited from both parents the child will have the disease." C) "The disease is most often seen in individuals of Asian decent." D) "Males are much more likely to have the disease than females."

B

In addition to the child's history, symptoms, and blood studies, which of the following helps to confirm the diagnosis of leukemia? A) Genetic studies C) Bone marrow aspiration B) Modified Jones criteria D) Chest x-rays

C

In caring for the child with rheumatic fever, the nurse recognizes that which of the following nursing diagnoses would be the most important to include in this child's plan of care? A) Delayed growth and development C) Risk for acute pain B) Risk for aspiration D) Disturbed body image

C

The caregiver of a child with sickle cell disease asks the nurse how much fluid her child should have each day after the child goes home. In response to the caregiver's question, the nurse would explain that for the child with sickle cell disease, it is best that the child have: A) 300 to 800 mL of fluid per day C) 1,500 to 2,000 mL of fluid per day B) 1,000 to 1,200 mL of fluid per day D) 2,500 to 3,200 mL of fluid per day

C

The most serious concern for the child diagnosed with Kawasaki disease is the effect on which of the following body organs? A) Brain B) Lungs C) Heart D) Kidneys

C

The nurse is administering iron-dextran (Imferon) to a child diagnosed with iron deficiency anemia. The most appropriate method of administration of this drug would be which of the following? A) Intravenous B) Rectal C) Intramuscular D) Subcutaneous

C

The nurse is caring for a child with leukemia. Which of the following nursing interventions would be the highest priority for this child? A) Encouraging the child to share feelings B) Grouping nursing care C) Following guidelines for protective isolation D) Providing age appropriate activities

C

The nurse is caring for a child with rheumatic fever who has polyarthritis. Which of the following lab results would the nurse most anticipate with this child's diagnosis and symptoms? A) Increased clotting time B) Decreased white blood cell count (WBC) C) Increased erythrocyte sedimentation rate (ESR) D) Decreased leukocyte count

C

The nurse is reinforcing teaching with the caregivers of a child with rheumatic fever. Which of the following statements made by the caregivers best indicates an understanding of the treatment for this disorder? A) "She will be on a high sodium diet until the symptoms go away." B) "Keeping her involved in her regular sports activities will be important." C) "We don't let her watch TV, but while she is in bed we will let her watch some." D) "If she cuts herself, we know to keep that part of her body elevated above the heart."

C

The nurse is talking with a 9-year-old girl diagnosed with acute leukemia who will soon begin chemotherapy. The child tells the nurse that she is worried that when her hair falls out her friend won't like her or want to play with her anymore. The best response by the nurse would be for the nurse to do which of the following? A) Reassure her that her hair will grow back in 3 to 6 months. B) Tell her that having chemotherapy is the only way she'll get better. C) Talk with her and her family about wearing a wig, cap, or scarf. D) Distract her with a book or educational computer games.

C

In developing a plan of care for the child diagnosed with rheumatic fever, the nursing intervention, which is the highest priority for this child, is to A) Position the child to relieve joint pain B) Monitor the C-reactive protein and ESR levels C) Provide age-appropriate diversional activities D) Promote rest periods and bed rest

D

The nurse is caring for a child with congestive heart failure and is administering the drug digoxin. At the beginning of this drug therapy the process of digitalization is done for which of the following reasons? A) To decrease the pain to a tolerable level B) To increase the heart rate C) To establish a maintenance dose of the drug D) To build the blood levels to a therapeutic level

D

The nurse is collecting data from the caregivers of a child brought to the clinic setting. The parents tell the nurse that the child's skin seems to be an unusual color. The nurse notes that the child's skin appears bronze-colored and jaundiced. This observation alerts the nurse to the likelihood that this child has which of the following disorders? A) Hemophilia B) Sickle cell disease C) Kawasaki disease D) Thalassemia

D