Pedi Exam 1 Respiratory and Cardiac system questions

T/F: Children with this disorder should not be allowed to to sit in the knee-chest position.

false

T/F: The sound of less wheezing is always better.

false

T/F: It is necessary to obtain a child's blood pressure before administering a dose of scheduled digoxin

false; HR

T/F: Michael, who had loud stridor when he was admitted, suddenly has no stridor present. This means that his condition is getting better.

false; could be worsening or not enough air entering airway

T/F: Inspiration refers to breathing out

false; inspiration is breathing in, expiration is breathing out

T/F: Cardiac output is calculated by multiplying stroke volume by the heart rate.

true

T/F: There can be an instance when too much oxygen is not good.

true

A child who has anemia requires a blood transfusion. Which form of blood product is most often used in children? a. Plasma b. Washed RBCs c. Whole Blood d. Packed RBCs

d

A 5 year old child is brought to the clinic for a routine check on his asthma. The nurse observes the child interacting with other children. What type of play does the nurse expect of the child? a. Cooperative b. Team c. Parallel d. Initiative

a

A 5 year old child returns to PICU after cardiac surgery. The child has a left chest tube attached to water-seal drainage, an IV of D5 1/2 NS at 4 ml/hr, and a double-lumen nasogastric tube to continuous suction. The child is attached to a cardiac monitor and has a left chest dressing. What is the priority nursing intervention? a. Obtain vital signs b. Test for level of consciousness c. Measure drainage from both tubes d. Determine suction pressure of the nasogastric tube

a

A child is to use an incentive spirometer four times daily. Which statement suggests that the child understands the purpose and correct technique of the procedure? a. "To do this right, I take in a very deep breath." b. "Using this will help me cough less." c. "The harder I blow out, the better I am doing." d. "This will make more room for my heart in my chest."

a

A clinic nurse receives a call from a mother of a 2 year old child. The mother states that the child has a temperature of 104 F (40 C), a sore throat, and has been drooling for a few days. The child is now sleepy. Which is the best advice by the nurse? a. "Take your child to an ER immediately." b. "Bring your child into the clinic to be seen as soon as possible." c. "Administer acetaminophen (Tylenol) for the temperature and allow your child to sleep." d. "Use a spoon to look inside your child's mouth and throat and tell me what you see"

a

A parent asks the nurse, "The doctor said my baby has pulmonic stenosis. What does that mean?" How should the nurse respond? a. "What else did you doctor say?" b. "Your baby has a heart problem." c. "Are you concerned about your baby?" d. "I'll page your doctor so that you can discuss this again."

a

The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess urine output? a. Weighing the diapers b. Inserting a Foley catheter c. Comparing intake with output d. Measuring the amount of water added to formula

a

When a 4-year-old child with a tracheostomy tube eats, a primary nursing responsibility would be to a. prevent aspiration of food or fluids into the tube. b. limit ingestion of too much fluid. c. foster smooth passage of foods through the tube opening. d. prevent dyspnea from eating too rapidly.

a

Which goal should a nurse deem as essential when caring for a 14 month old infant with bronchiolitis? a. Promoting and maintaining adequate hydration b. Setting up and facilitating the use of a mist tent c. Ensuring that antibiotics are ordered d. Providing a cough suppressant as necessary

a

You would teach the mother of a child with thalassemia minor which of the following information to eliminate her deficient knowledge? a. No treatment is indicated for her daughter's disorder. b. Her daughter's activity tolerance may be affected. c. A minimal decrease in life expectancy can be expected. d. A child with this disorder is prone to bleeding.

a

A 1-year-old child is diagnosed with nutritional iron deficiency anemia. What nursing interventions are important when caring for an infant with iron deficiency anemia? SELECT ALL THAT APPLY. a. Conserving the infant's energy b. Protecting the infant from infection c. Teaching the parents about nutrition d. Telling the parents to offer small, frequent feedings e. Instructing the parents to increase the amount of milk offered f. Instruct parents that the stool will appear black when on ferrous sulfate therapy

a, b, c, f

A 10 year old child who has sickle cell anemia is admitted to the hospital with a vaso-occlusive painful episode. The nurse manager plans to place the child in the same room as a child with the diagnosis of: a. Pneumonia b. Thalassemia c. Acute pharyngitis d. Chronic osteomyelitis

b

A 10-year-old child with asthma is treated for acute exacerbation in the ER. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? a. Warm, dry skin b. Decreased wheezing c. Pulse rate of 90 bpm d. Respirations of 10 breaths/min

b

A 3 1/2 year old child returns to the room after a cardiac catheterization. What is the priority nursing intervention after this procedure? a. Encouraging early ambulation b. Monitoring the insertion site for bleeding c. Comparing the blood pressure in each extremity d. Restricting fluids until the blood pressure stabilizes

b

A female adolescent who has had a stem cell transplant will need teaching about possible side effects from the post-transplant medications. Which side effect would be of most concern for this adolescent? a. Hirsutism b. Hair loss c. Weight loss d. Joint pain

b

A nurse is assessing a child with the diagnosis of hemophilia. In what part of the body does the nurse expect bleeding to occur? a. Brain b. Joints c. Intestines d. Pericardium

b

A nurse is caring for a child with tetralogy of Fallot. What clinical finding should the nurse expect when assessing this child? a. Slow respirations b. Clubbing of fingers c. Subcutaneous hemorrhages d. Decreased red blood cell count

b

After a tonsillectomy, the nurse reviews the health care provider's postoperative prescriptions. Which prescription should the nurse question? a. Monitor for bleeding b. Suction every 2 hours c. Give no milk or milk products d. Give clear, cool liquids when awake and alert

b

The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? a. The child exhibits nasa flaring and bradycardia. b. The child is leaning forward, with the chin thrust out. c. The child has a low-grade fever and complaints of a sore throat. d. The child is leaning backward, supporting himself or herself with the hands and arms.

b

The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? a. Administer the iron at mealtimes b. Administer the iron through a straw c. Mix the iron with cereal to administer d. Add the iron to formula for easy administration

b

The nursing student is presenting a clinical conference and discusses the cause of B-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which one? a. A child of Mexican descent b. A child of Mediterranean descent c. A child whose intake of iron is extremely poor d. A breast-fed child of a mother with chronic anemia

b

When assessing a child for cyanosis, the nurse should keep in mind that a. cyanosis is an early indicatory of respiratory distress. b. the degree of cyanosis is not an accurate indicator of the degree of hypoxia. c. cyanosis is caused by a decrease in the depth of respirations. d. A.cyanosis will be present if the child has had a large loss of blood volume.

b

When planning the care for a child with Kawasaki disease, which of the following would be most important? a. Making sure he performs postural drainage daily b. Observing him for symptoms of bowel obstruction c. Encouraging him to cough and deep-breathe d. Teaching him to live with a chronic illness

b

Which nursing assessment findings and therapy should a nurse expect for a child diagnosed with cystic fibrosis? a. Pica appetite; increasing nutritional choices b. Abnormal accumulation of mucus in respiratory and other mucous duct tracts; managing infection c. Steatorrhea; increasing oral fluids d. Decreased sodium and chloride secretion; vitamin and mineral supplements

b

Which of the following criteria is used to define childhood hypertension? a. A systolic reading over 70 b. A systolic reading above the 95th percentile for the child's age c. Sustained increased systolic and diastolic readings of 20 or more after minimal exercise d. An increase in either systolic or diastolic reading after exercise

b

A 3 month old child is hospitalized with acute laryngotracheobronchitis (LTB). In formulating a nursing care plan, which nursing diagnosis should be a nurse's priority? a. Anxiety b. Risk for deficient fluid volume c. Ineffective breathing pattern d. Deficient knowledge

c

A nurse is caring for a 3 year old client who is postoperative tonsil and adenoidectomy (T&A) surgery. The nurse should suspect complications when assessing: a. complaints of sore throat and difficulty swallowing b. secretions and dried blood at the corners of the mouth c. frequent swallowing and clearing of the throat d. the presence of "dark coffee ground" emesis

c

A triage nurse determines that a child brought to an ER is experiencing severe respiratory distress when observing: a. diaphoresis, restlessness, tachypnea, and anorexia b. pallor, coughing, wheezing, and confusion c. retractions, grunting, cyanosis, and bradycardia d. agitation, decreased level of consciousness, diarrhea, and tachypnea

c

An 18-year-old with hypertension attends your ambulatory clinic. She currently takes an oral contraceptive and an over-the-counter vitamin pill daily. What health teaching would you initiate with her? a. Teach her not to take the oral contraceptive in the morning when blood pressure is highest. b. Suggest she discontinue the vitamin tablet to help reduce her blood pressure. c. Suggest she speak to her physician about whether she should remain on the oral contraceptive. d. A.Nothing. There is no relationship between use of oral contraceptives or vitamins and hypertension.

c

On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease? a. Cracked lips b. Normal appearance c. Conjunctival hyperemia d. Desquamation of the skin

c

The mother of a hospitalized 2-year-old child with croup asks the nurse why the HCP did not prescribe antibiotics. Which response should the nurse make? a. "The child may be allergic to antibiotics. " b. "The child is too young to receive antibiotics. " c. "Antibiotics are not indicated unless a bacterial infection is present. " d. "The child still has the maternal antibodies from birth and does not need antibiotics."

c

The nurse is monitoring an infant with congenital heart disease closely for signs or heart failure. The nurse should assess the infant for which early sign? a. Pallor b. Cough c. Tachycardia d. Slow and shallow breathing

c

The mother of a 3 month old infant asks the nurse in the well baby clinic what toys to give her child. What is the nurse's response? Select all that apply. a. Push-pull toy b. Stuffed animal c. Metallic mirror d. Colorful mobile e. Large plastic ball

c, d

A child has open heart surgery to repair a cardiac defect. The practitioner informs the parents that antibiotics are required before any dental work is performed. Later the parents ask the nurse why this is necessary. When responding, the nurse incorporates the fact that this is done to prevent: a. Gingivitis b. Pericarditis c. Myocarditis d. Endocarditis

d

A child with asthma is being discharged to home and has an order for a bronchodilator (Albuterol) to be administered via a metered dose inhaler (MDI). Which point should a nurse address for appropriate administration of the med? a. When administering medication via a MDI, avoid shaking the canister before discharging the medication. b. Medication is ordered in two "puffs"; press on the canister twice in succession to discharge. c. There should be a tight seal around the mouthpiece of the inhaler before discharging the medication. d. There should be a 2-3 inch space (or spacer device) between the inhaler and the open mouth of the child.

d

A child with rheumatic fever will be arriving in the nursing unit for admission. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever? a. "Has the child complained of back pain?" b. "Has the child complained of headaches?" c. "Has the child had any nausea or vomiting?" d. "Did the child have a sore throat or fever within the last 2 months?"

d

The clinic nurse instructs the parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instructions? a. Stress b. Trauma c. Infection d. Fluid overload

d

The nurse analyzes the lab results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? a. Platelet count b. Hematocrit level c. Hemoglobin level d. Partial thromboplastin time

d

A nurse is preparing to perform chest physiotherapy on a 7 year old client diagnosed with CF. When should the nurse plan to perform the treatment? a. Before performing postural drainage b. Before a nebulized aerosos treatment c. After suctioning the upper respiratory tract d. One hour before meals

d; to prevent reflux