Peds
What condition is the most common cause of acute renal failure in children? a. Pyelonephritis b. Tubular destruction c. Severe dehydration d. Upper tract obstruction
c. Severe dehydration
Which of the following diet plans would be appropriate for the nurse to discuss with the family of a child with acute renal failure? 1. High carbohydrate and protein.2. High fat and carbohydrate. 3. Low fat and protein. 4. Low in carbohydrate and fat.
2. High fat and carbohydrate.
After undergoing surgical correction of pyloric stenosis, an infant is returned to the room instable condition. While standing by the crib, the mother says, "Perhaps if I had brought my baby to thehospital sooner, the surgery could have been avoided." Which of the following should be the nurse'sbest response? "Surgery is the most effective treatment for pyloric stenosis." "Try not to worry; your baby will be fine." "Do you feel that this problem indicates that you are not a good mother?" "Do you think that earlier hospitalization could have avoided surgery?"
"Do you think that earlier hospitalization could have avoided surgery?"
What is most descriptive of atopic dermatitis (eczema) in the infant? a. Eczema is worse in summer months. b. Eczema is worse in humid climates. c. Eczema is associated with upper respiratory tract infections. d. Eczema is associated with hereditary allergies.
. Eczema is associated with hereditary allergies.
A nurse is teaching a parent of an infant about gastrointestinal reflux disease (GERD). The following interventions should be included in the teaching plan, except for? 1. Encourage to hold infant in an upright position .2. Offer small frequent feedings. 3. Thicken formula with rice cereal. 4. Use a wide based nipple for feedings.
. Use a wide based nipple for feedings.
An occlusive dressing, is applied to a large abrasion. This is advantageous because the dressing will a. provide an antiseptic for the wound. b. deliver vitamin C to wound. c. maintain a moist environment for healing d. promote mechanical friction for healing.
. maintain a moist environment for healing
A nurse is assessing an 8-year-old with diabetes who is experiencing hyperglycemia.Which symptom(s) indicate(s) that the hyperglycemia requires immediate intervention?Select all that apply .1. Weakness. 2. Thirst. 3. Shakiness. 4. Hunger. 5. Headache. 6. Dizziness.
.1. Weakness. 2. Thirst. 6. Dizziness.
A nurse is preparing to care for a child with a diagnosis of intussusception prior to surgery. The nurse reviews the child's medical chart and expects to find documentation of which of the following symptoms? 1. Currant jelly-like stools 2. Watery diarrhea 3. Ribbon-like stools 4. Profuse projectile vomiting
1. Currant jelly-like stools
n adolescent with insulin-dependent diabetes is being taught the importance ofrotating the sites of insulin injections. The nurse should judge that the teaching wassuccessful when the adolescent identifies which of the following as a result of using thesame site? 1. Destruction of the fat tissue and poor absorption. 2. Destruction of nerves and painful neuritis. 3. Destruction of the tissue and too-rapid insulin uptake. 4. Development of resistance to insulin and need for increased amounts.
1. Destruction of the fat tissue and poor absorption.
The Client with a Fracture35. A 10-year-old has 5 lb (2.27 kg) of Buck's extension traction on his left leg. The nurse shouldassess the child for which of the following? Select all that apply. 1. Dryness of the skin, by removing the foam wraps and boot. 2. Alignment of the shoulder, hips, and knees. 3. Frayed rope near pulleys .4. Correct amount of traction weight on fracture. 5. Pressure on the coccyx.
2. Alignment of the shoulder, hips, and knees. 3. Frayed rope near pulleys .4. Correct amount of traction weight on fracture. 5. Pressure on the coccyx.
A nurse is teaching an 8-year-old with diabetes and her parents about managingdiabetes during illness. The nurse determines the parents understand the instruction whenthey indicate that, when the child is ill, they will provide: 1. More calories. 2. More insulin. 3. Less insulin. 4. Less protein and fat.
2. More insulin.
The nurse talks to an adolescent about how she can tell her friends about her newdiagnosis of diabetes. Which of the following behaviors by the adolescent indicates that theadolescent has responded positively to the discussion? 1. She asks the nurse for material on diabetes for a school paper. 2. She introduces the nurse to her friends as "the one who taught me all about mydiabetes. "3. She says, "I'll try to tell my friends, but they'll probably quit hanging out with me." 4. She asks her friends what they think about someone who has a lifelong illness.
2. She introduces the nurse to her friends as "the one who taught me all about mydiabetes.
A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated? 1. Normal blood pressure; moist mucous membranes 2. No presence of tears; undetectable blood pressure. 3. Fontanels depressed; capillary refill greater than three seconds 4. Irritable, inconsolable; dry mucous membranes
3. Fontanels depressed; capillary refill greater than three seconds
4-week-old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse should anticipate that the infant's vomitus would contain gastric contents and which of the following? 1 . Bile and streaks of blood. 2. Mucus and bile. 3. Mucus and streaks of blood. 4. Stool and bile.
3. Mucus and streaks of blood.
n 8-year-old with diabetes is placed on neutral protamine Hagedorn (NPH) andregular insulin before breakfast and before dinner. She will receive a snack of milk andcereal at bedtime. The snack will: 1. Help her regain lost weight. 2. Provide carbohydrates for immediate use. 3. Prevent late night hypoglycemia. 4. Help her stay on her diet.
3. Prevent late night hypoglycemia
The Client with Developmental Dysplasia of theHip20. A 16-month-old child is seen in the clinic for a checkup for the first time. The nurse noticesthat the toddler limps when walking. Which of the following would be appropriate to use whenassessing this toddler for developmental dysplasia of the hip? 1. Ortolani's maneuver. 2. Barlow's maneuver. 3. Adam's position .4. Trendelenburg's sign.
4. Trendelenburg's sign.
After surgery to correct pyloric stenosis, the nurse instructs the parents about thepostoperative feeding schedule for their infant. The parents exhibit understanding of these instructionswhen they state that they can start feeding the child within which of the following time frames? 6 hours. 8 hours. 10 hours 12 hours.
6 hours.
What cardiovascular defect results in obstruction to blood flow? A. Aortic stenosis B. Tricuspid atresia C. Atrial septal defect D. Transposition of the great arteries
A. Aortic stenosis
A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38° C (100.4° F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother? A. Immediately bring the child to the clinic for evaluation. B. Come to the clinic next week on a scheduled appointment. C. Treat the signs and symptoms with acetaminophen and fluids because it is most likely a viral illness. D. Recognize that the child is trying to manipulate the parent by complaining of vague symptoms.
A. Immediately bring the child to the clinic for evaluation
The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication? A. Pulmonary hypertension B. Right-to-left shunt of blood C. Pulmonary embolism D. Left ventricular hypertrophy
A. Pulmonary hypertension
What structural defects constitute tetralogy of Fallot? A. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy B. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy C. Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy D. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
A. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4° C (101.1° F). What action should the nurse perform? A. Report findings to the practitioner .B. Apply a hypothermia blanket .C. Keep the child warm with blankets. D. Record the temperature on the assessment flow sheet.
A. Report findings to the practitioner.
Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? A. Wheezing B. Increased blood pressure C. Increased urine output D. Decreased heart rate
A. Wheezing
A nasogastric tube inserted during surgery to correct an infant's intussusception is no longerfreely removing gastric secretions. Which of the following should the nurse do next? Aspirate the tube with a syringe. Irrigate the tube with distilled water. Increase the level of suction. Rotate the tube.
Aspirate the tube with a syringe.
A preschooler with a fractured femur of the left leg in traction tells the nurse that his leg hurts. It is too early for pain medication. The nurse should: 1. Place a pillow under the child's buttocks to provide support. 2. Remove the weight from the left leg. 3. Assess the feet for signs of neurovascular impairment. 4. Reposition the pulleys so the traction is looser.
Assess the feet for signs of neurovascular impairment.
The nurse is assessing the infant shown in the figure. On observing the client from this angle,the nurse should document that this infant has which of the following? Ortolani's "click." Limited abduction. Galeazzi's sign. Asymmetric gluteal folds.
Asymmetric gluteal folds.
Which of the following assessments should be the priority for an infant who has had surgeryto correct an intussusception and is now at risk for development of a paralytic ileus postoperatively? Measurement of urine specific gravity. Auscultation of bowel sounds. Inspection of the first stool passed. Measurement of gastric output.
Auscultation of bowel sounds.
Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infant's status, which finding is indicative of achieving this goal? A. Irritability when awake B. Capillary refill of more than 5 seconds C. Appropriate weight gain for age D. Positioned in high Fowler position to maintain oxygen saturation at 90%
C. Appropriate weight gain for age
After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond? A. Elevate the affected extremity. B. Notify the practitioner of the observation. C. Record data on the assessment flow record. D. Apply warm compresses to the insertion site.
C. Record data on the assessment flow record.
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time? A. Administer oxygen. B. Record data on the nurses' notes. C. Report data to the practitioner. D. Place the child in the high Fowler position.
C. Report data to the practitione
When teaching the parents of a child with a ventricular septal defect who is scheduled for acardiac catheterization, the nurse explains that this procedure involves the use of which of thefollowing? Ultra-high-frequency sound waves. Catheter placed in the right femoral vein. Cutdown procedure to place a catheter. General anesthesia.
Catheter placed in the right femoral vein.
What name is given to inflammation of the bladder? a. Cystitis b. Urethritis c. Urosepsis d. Bacteriuria
Cystitis
What nursing consideration is important when suctioning a young child who has had heart surgery? A. Perform suctioning at least every hour. B. Suction for no longer than 30 seconds at a time. C. Expect symptoms of respiratory distress when suctioning. D. Administer supplemental oxygen before and after suctioning.
D. Administer supplemental oxygen before and after suctioning.
What type of drug reduces hypertension by interfering with the production of angiotensin II? A. Diuretics B. Vasodilators C. Beta-blockers D. Angiotensin-converting enzyme (ACE) inhibitors
D. Angiotensin-converting enzyme (ACE) inhibitors
What term is defined as the volume of blood ejected by the heart in 1 minute?A. Afterload B. Cardiac cycle C. Stroke volume D. Cardiac output
D. Cardiac output
What nutritional component should be altered in the infant with heart failure (HF)? A. Decrease in fats B. Increase in fluids C. Decrease in protein D. Increase in calories
D. Increase in calories
The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which knowledge? A. It is a safe, frequently used drug. B. Parents lack the expertise necessary to administer digoxin. C. It is difficult to either overmedicate or undermedicate with digoxin. D. Parents need to learn specific, important guidelines for administration of digoxin.
D. Parents need to learn specific, important guidelines for administration of digoxin.
After emphasizing to an adolescent with renal failure the importance of maintaining a positiveself-concept, which of the following behaviors by the adolescent should the nurse identify as anindicator that the plan is working? Reports of headaches, abdominal pain, and nausea. Insistence on making diet choices even if the foods chosen are restricted. Verbalization of plans to quit all after-school activities when returning home. Demonstration of desire to do the dressing changes and take care of the medications.
Demonstration of desire to do the dressing changes and take care of the medications.
Which of the following behaviors exhibited by the parents of an infant with pyloric stenosisshould the nurse correctly interpret as a positive indication of parental coping? Telling the nurse that they have to get away for a while. Discussing the infant's care realistically. Repeatedly asking if their child is normal. Exhibiting fear that they will disturb the infant.
Discussing the infant's care realistically.
A 4-year-old has been scheduled for a cardiac catheterization. To help prepare the family, thenurse should: Advise the family to bring the child to the hospital for a tour a week in advance. Explain that the child will need a large bandage after the procedure. Discourage bringing favorite toys that might become associated with pain. Explain that the child may get up as soon as the vital signs are stable.
Explain that the child will need a large bandage after the procedure.
After 6 months of treatment with diet and exercise, a 12-year-old with type 2 diabetesstill has a fasting blood glucose level of 140 mg/dL. The primary care provider has decidedto begin metformin (Glucophage). The adolescent asks how the medication works. The nurseshould tell the client that the medicine decreases the glucose production and: 1. Replaces natural insulin. 2. Helps the body make more insulin. 3. Increases insulin sensitivity. 4. Decreases carbohydrate adsorption.
Increases insulin sensitivity.
When developing the discharge teaching plan for a child with chronic renal failure and thefamily, the nurse should emphasize restriction of which of the following nutrients? Ascorbic acid. Calcium. Magnesium. Phosphorus.
Phosphorus.
Urinary tract anomalies are frequently associated with what irregularities in fetal development? a. Myelomeningocele b. Cardiovascular anomalies c. Malformed or low-set ears
Malformed or low-set ears
Which of the following would be most appropriate for the nurse to teach the mother of a 6-month-old infant hospitalized with severe diarrhea to help her comfort her infant who is fussy? Offering a pacifier. Placing a mobile above the crib. Sitting at crib side talking to the infant. Turning the television on to cartoons.
Offering a pacifier.
Based on the nurse's knowledge of wounds and wound healing, what are factors that can delay or cause dysfunctional wound healing? (Select all that apply) a. Overweight b. Hypoxemia c. Hypervolemia d. Prolonged infection e Corticosteroid therapy
Overweight c. Hypervolemia e Corticosteroid therapy
An adolescent tells the nurse that the area below his knee has been hurting for several weeks.The nurse should obtain history information about participation in which of the following? Soccer. Golf. Diving. Swimming.
Soccer.
The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration?1. Tachycardia2. Bradycardia3. Increased blood pressure4. Decreased blood pressure
Tachycardia
A toddlers mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurses response should be based on which premise? a. An emergency laparotomy is very likely. b. The location needs to be confirmed by radiographic examination. c. Surgery will be necessary if the battery has not passed in the stool in 48 hours. d. Careful observation is essential because an ingested battery cannot be accurately detected.
The location needs to be confirmed by radiographic examination.
A 9-month-old is admitted because of dehydration. How should the nurse go about accuratelymonitoring fluid intake and output? Select all that apply. Weighing and recording all wet diapers. Change breast-feedings to bottle-feedings. Obtaining an accurate daily weight. Restricting fluids prior to weighing the child. Obtaining an accurate stool count.
Weighing and recording all wet diapers. Obtaining an accurate daily weight. Obtaining an accurate stool count.
What test is used to screen for carbohydrate malabsorption? a. Stool pH b. Urine ketones c. C urea breath test d. ELISA stool assay
a. Stool pH
What measure of fluid balance status is most useful in a child with acute glomerulonephritis? a. Proteinuria b. Daily weight c. Specific gravity d. Intake and output
b. Daily weight
What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis? a. Infarction of renal vessels b. Immune complex formation and glomerular deposition c. Bacterial endotoxin deposition on and destruction of glomeruli d. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
b. Immune complex formation and glomerular deposition c.
What statement is an advantage of peritoneal dialysis compared with hemodialysis? a. Protein loss is less extensive. b. Dietary limitations are not necessary. c. It is easy to learn and safe to perform. d. It is needed less frequently than hemodialysis.
c. It is easy to learn and safe to perform. d.
A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition? a. School phobia b. Glomerulonephritis c. Urinary tract infection (UTI) d. Attention deficit hyperactivity disorder (ADHD)
c. Urinary tract infection (UTI)
What major complication is associated with a child with chronic renal failure? a. Hypokalemia b. Metabolic alkalosis c. Water and sodium retention d. Excessive excretion of blood urea nitrogen
c. Water and sodium retention d.
Which factor promotes wound healing? a. Antiseptics b. Eschar formation c. Dry wound environment d. Moist, crust-free wound environment
d. Moist, crust-free wound environment
he school nurse is conducting an assessment for pediculosis capitis (head lice) on a group of school-age children. Which describes a child with a positive head check? a. Maculopapular lesions behind the ears b. White, flaky particles throughout the entire scalp area c. Lesions in the scalp extending from the hairline to the neck d. White sacs attached to the hair shafts in the occipital area
d. White sacs attached to the hair shafts in the occipital area
When assessing a 4-month-old infant diagnosed with possible intussusception, the nurseshould expect the mother to relate which of the following about the infant's crying and episodes ofpain? 1. Constant accompanied by leg extension. 2. Intermittent with knees drawn to the chest. 3. Shrill during ingestion of solids. 4. Intermittent while being held in the mother's arms.
intermittent with knees drawn to the chest.
A child is being seen in the emergency department with multiple facial abrasions and lacerations. A combination agent containing lidocaine, adrenaline, and tetracaine (LAT gel) is applied topically to the wounds. The purpose of this combination therapy is to a. cleanse the wound.b. promote scab formation.c. prevent infection of the wound.d. provide anesthesia to the wound.
provide anesthesia to the wound.
A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which? A. Serum sodium B. Serum potassium C. Serum glucose D. Serum chloride
B. Serum potassium
An adolescent is on the football team and practices in the morning and afternoon before schoolstarts for the year. The temperature on the field has been high. The school nurse has been called to thepractice field because the adolescent is now reporting that he has muscle cramps, nausea, anddizziness. Which of the following actions should the school nurse do first? Administer cold water with ice cubes. Take the adolescent's temperature. Have the adolescent go to the swimming pool. Move the adolescent to a cool environment
Move the adolescent to a cool environment
When developing the discharge teaching plan for the parents of a child who has undergone acardiac catheterization for ventricular septal defect, which of the following should the nurse expect toinclude? Restriction of the child's activities for the next 3 weeks. Use of sponge baths until the stitches are removed. Use of prophylactic antibiotics before receiving any dental work. Maintenance of a pressure dressing until a return visit with the primary health care provider.
Use of prophylactic antibiotics before receiving any dental work.
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply? a. The antibiotic therapy contributes to labile blood pressure values. b. Hypotension leading to sudden shock can develop at any time. c. Acute hypertension is a concern that requires monitoring. d. Blood pressure fluctuations indicate that the condition has become chronic.
c. Acute hypertension is a concern that requires monitoring.
What statement is descriptive of renal transplantation in children? a. It is an acceptable means of treatment after age 10 years. b. Children can receive kidneys only from other children. c. It is the preferred means of renal replacement therapy in children. d. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
c. It is the preferred means of renal replacement therapy in children. d.
What diet is most appropriate for the child with chronic renal failure (CRF)? a. Low in protein b. Low in vitamin D c. Low in phosphorus d. Supplemented with vitamins A, E, and K
c. Low in phosphorus
A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication? a. Propranolol (Inderal) b. Calcium gluconate c. Mannitol (Osmitrol) or furosemide (Lasix) (or both) d. Sodium, chloride, and potassium
c. Mannitol (Osmitrol) or furosemide (Lasix) (or both)
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause? a. Poor hygiene b. Constipation c. Urinary stasis d. Congenital anomalies
c. Urinary stasis
What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls? a. Avoid public toilet facilities. b. Limit long baths as much as possible. c. Cleanse the perineum with water after voiding. d. Ensure clear liquid intake of 2 L/day.
d. Ensure clear liquid intake of 2 L/day.
Twelve hours after cardiac surgery, the nurse is assessing a 3-year-old who weighs 15 kg. Thenurse should notify the surgeon about which of the following clinical findings? A urine output of 60 mL in 4 hours. Strong peripheral pulses in all four extremities. Fluctuations of fluid in the collection chamber of the chest drainage system. Alterations in levels of consciousness.
Alterations in levels of consciousness.
After teaching the mother of an infant with pyloric stenosis about the disease, which of thefollowing, if stated by the mother as a cause, indicates effective teaching? "An enlarged muscle below the stomach sphincter." "A telescoping of the large bowel into the smaller bowel." "A result of giving the baby more formula than is necessary." "A result of my baby taking the formula too quickly."
An enlarged muscle below the stomach sphincter."
A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition? A. Cyanosis B. Heart failure C. Decreased pulmonary blood flow D. Bounding pulses in upper extremities
B. Heart failure
What blood flow pattern occurs in a ventricular septal defect? A. Mixed blood flow B. Increased pulmonary blood flow C. Decreased pulmonary blood flow D. Obstruction to blood flow from ventricles
B. Increased pulmonary blood flow
A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? A. Preoperative teaching should be directed at his parents because he is too young to understand. B. Preoperative teaching should be adapted to his level of development so that he can understand. C.Preoperative teaching should be done several days before the procedure so he will be prepared .D. Preoperative teaching should provide details about the actual procedures so he will know what to expect.
B. Preoperative teaching should be adapted to his level of development so that he can understand.
A nurse is taking care of four different pediatric clients. Which client poses the great risk for dehydration? 1. 15-year-old working out in a weight room for an hour before football practice 2. 10-year-old playing baseball outdoors in 85 degree heat 3. 5-year-old refusing to eat because of a virus 4. A newborn under a radiant warmer for an hour after the first bath
10-year-old playing baseball outdoors in 85 degree heat
A student with type 1 diabetes tells the nurse she is feeling light-headed. The student's bloodsugar is 60 mg/dL (3.3 mmol/L). Using the 15-15 rule, the nurse should give:1 . 15 mL of juice and give another 15 mL in 15 minutes. 2. 15 g of carbohydrate and retest the blood sugar in 15 minutes. 3. 15 g of carbohydrate and 15 g of protein. 4. 15 oz of juice and retest in 15 minutes
15 g of carbohydrate and retest the blood sugar in 15 minutes.
he nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk? A. Minimize seizures. B. Prevent dehydration. C. Promote cardiac output .D. Reduce energy expenditure.
B. Prevent dehydration
The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern? A. The parents should meet all the child's needs. B. The child needs opportunities to play with peers. C. Constant parental supervision is needed to avoid overexertion. D. The child needs to understand that peers' activities are too strenuous.
B. The child needs opportunities to play with peers
When obtaining the nursing history from the mother of an infant with suspectedintussusception, which of the following questions would be most helpful? "What do the stools look like?" "When was the last time your child urinated?" "Is your child eating normally?" "Has your child had any episodes of vomiting?"
What do the stools look like?"
Which of the following would most likely alert the nurse to the possibility that a preschooler is experiencing moderate dehydration? 1. Absence of tear formation. 2. Decreased urine specific gravity. 3. Deep, rapid respirations .4. Diaphoresis.
Absence of tear formation.
Which of the following is the greatest priority for the therapeutic management of a child withcongestive heart failure (CHF) caused by pulmonary stenosis? Educating the family about the signs and symptoms of infection. Administering enoxaparin (Lovenox) to improve left ventricular contractility. Assessing heart rate and blood pressure every 2 hours. Administrating furosemide (Lasix) to decrease systemic venous congestion.
Administrating furosemide (Lasix) to decrease systemic venous congestion.
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate? A. 60 beats/min B. 90 beats/min C. 100 beats/min D. 120 beats/min
B. 90 beats/min
hat clinical manifestation is a common sign of digoxin toxicity? A. Seizures B. Vomiting C. Bradypnea D. Tachycardia
B. Vomiting
What statement best identifies the cause of heart failure (HF)? A. Disease related to cardiac defects B.Consequence of an underlying cardiac defect C. Inherited disorder associated with a variety of defects D. Result of diminished workload imposed on an abnormal myocardium
B.Consequence of an underlying cardiac defect
When teaching a preschool-age child how to perform coughing and deep-breathing exercisesbefore corrective surgery for tetralogy of Fallot, which of the following teaching and learningprinciples should the nurse address first? Organizing information to be taught in a logical sequence. Arranging to use actual equipment for demonstrations. Building the teaching on the child's current level of knowledge. Presenting the information in order from simplest to most complex.
Building the teaching on the child's current level of knowledge.
he mother asks the nurse about using a car seat for her toddler who is in a hip spica cast.The nurse should tell the mother: "You can use a seat belt because of the spica cast." "You will need a specially designed car seat for your toddler." "You can still use the car seat you already have." "You'll need to get a special release from the police so that a car seat won't be needed."
You will need a specially designed car seat for your toddler."
A 3-month-old infant has a hypercyanotic spell. What should be the nurse's first action? A. Assess for neurologic defects .B. Prepare the family for imminent death. C. Begin cardiopulmonary resuscitation. D. Place the child in the knee-chest position.
D. Place the child in the knee-chest position.
The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? A. Hypoxemia B. Right-to-left shunt of blood C. Decreased workload on the left side of the heart D. Pulmonary vascular congestion
D. Pulmonary vascular congestion
A chest radiography examination is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the x-ray show about the heart?" The nurse's response should be based on knowledge that the radiograph provides which information?A. Shows bones of the chest but not the heart B. Evaluates the vascular anatomy outside of the heart C. Shows a graphic measure of electrical activity of the heart D. Supplies information on heart size and pulmonary blood flow patterns
D. Supplies information on heart size and pulmonary blood flow patterns
When developing the teaching plan for parents using the Pavlik harness with their child, whatshould be the nurse's initial step? Assessing the parents' current coping strategies. Determining the parents' knowledge about the device. Providing the parents with written instructions. Giving the parents a list of community resources.
Determining the parents' knowledge about the device.
An 18-month-old with a congenital heart defect is to receive digoxin (Lanoxin) twice a day.The nurse should instruct the parents about which of the following? Digoxin enables the heart to pump more effectively with a slower and more regular rhythm. Signs of toxicity include loss of appetite, vomiting, increased pulse, and visual disturbances. Digoxin is absorbed better if taken with meals. If the child vomits within 15 minutes of administration, the dosage should be repeated.
Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.
The nurse teaches the parents of an infant with developmental dysplasia of the hip how tohandle their child in a Pavlik harness. Which of the following is most appropriate? Fitting the diaper under the straps. Leaving the harness off while the infant sleeps. Checking for skin redness under straps every other day. Putting powder on the skin under the straps every day.
Fitting the diaper under the straps.
mmediately after the first oral feeding after corrective surgery for pyloric stenosis, a 4-week-old infant is fussy and restless. Which of the following actions would be most appropriate atthis time? Encourage the parents to hold the infant. Hang a mobile over the infant's crib. Give the infant more to eat. Give the infant a pacifier to suck on.
Give the infant a pacifier to suck on.
When teaching the family of an older infant who has had a spica cast applied fordevelopmental dysplasia of the hip, which information should the nurse include when describing theabduction stabilizer bar? It can be adjusted to a position of comfort. It is used to lift the child. It adds strength to the cast. It is necessary to turn the child.
It adds strength to the cast.
The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurse's initial intervention? A. Apply warming blankets. B. Notify the practitioner of these findings. C. Give additional pain medication per protocol .D. Encourage child to cough, turn, and deep breathe.
Notify the practitioner of these findings
A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when ablood specimen is obtained. The child's color becomes blue and the respiratory rate increases to 44breaths/min. Which of the following actions should the nurse do first? Obtain a prescription for sedation for the child. Assess for an irregular heart rate and rhythm. Explain to the child that it will only hurt for a short time. Place the child in a knee-to-chest position.
place the child in a knee-to-chest position.
An infant is to be discharged after surgery for intussusception. In developing the dischargeteaching plan, the nurse should tell the mother: The infant will experience a change in the normal home routine. The infant can return to the prehospital routine immediately. The infant needs to ingest more calories at home than what was consumed in the hospital. The infant will continue to experience abdominal cramping for a few days.
The infant will experience a change in the normal home routine.
n overweight adolescent has been diagnosed with type 2 diabetes. To increase the client's self-efficacy to manage their disease, the nurse should: 1. Provide the client with a written daily food and exercise plan. 2. Discuss eliminating junk food in the home with the parents. 3. Arrange for the school nurse to weigh the child weekly. 4. Utilize a peer with type 2 diabetes to role model lifestyle changes.
Utilize a peer with type 2 diabetes to role model lifestyle changes.
A newborn admitted with pyloric stenosis is lethargic and has poor skin turgor. The primarycare provider has prescribed IV fluids of dextrose water with sodium and potassium. The baby'sadmission potassium level is 3.4 mEq/L (3.4 mmol/L). The nurse should: Notify the primary care provider. Administer the prescribed fluids. Verify that the infant has urinated. Have the potassium level redrawn.
Verify that the infant has urinated
When an infant with pyloric stenosis is admitted to the hospital, which of the followingshould the nurse do first? Weigh the infant. Begin an intravenous infusion. Switch the infant to an oral electrolyte solution. Orient the mother to the hospital unit.
Weigh the infant.
Which of the following would be the best activity for the nurse to include in the plan of carefor an infant experiencing severe diarrhea? Monitoring the total 8-hour formula intake. Weighing the infant each day. Checking the anterior fontanel every shift. Monitoring abdominal skin turgor every shift.
Weighing the infant each day.
What is the narrowing of preputial opening of foreskin called? a. Chordee b. Phimosis c. Epispadias d. Hypospadias
b. Phimosis
The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss? a. Poor appetite b. Reduction of edema c. Restriction to bed rest d. Increased potassium intake
b. Reduction of edema
What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)? a. Children with ESRD usually adapt well to minor inconveniences of treatment. b. Children with ESRD require extensive support until they outgrow the condition. c. Multiple stresses are placed on children with ESRD and their families until the illness is cured. d. Multiple stresses are placed on children with ESRD and their families because childrens lives are maintained by drugs and artificial means.
d. Multiple stresses are placed on children with ESRD and their families because childrens lives are maintained by drugs and artificial means.
What urine test result is considered abnormal? a. pH 4.0 b. WBC 1 or 2 cells/ml c. Protein level absent d. Specific gravity 1.020
pH 4.0
The nurse is teaching parents about administering digoxin (Lanoxin). What instructions should the nurse tell the parents? A. If the child vomits, give another dose. B. Give the medication at regular intervals. C. If a dose is missed, give a give an extra dose. D. Give the medication mixed with the child's formula.
.B. Give the medication at regular intervals
Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin(Lanoxin) should include which of the following? Select all that apply. 1. Give the medication at regular intervals. 2. Mix the medication with a small volume of breast milk or formula. 3. Repeat the dose one time if the child vomits immediately after administration. 4. Notify the primary care provider of poor feeding or vomiting. 5. Make up any missed doses as soon as realized. 6. Notify the primary care provider if more than two consecutive doses are missed.
1. Give the medication at regular intervals. 4. Notify the primary care provider of poor feeding or vomiting. 6. Notify the primary care provider if more than two consecutive doses are missed.
What preparation should the nurse consider when educating a school-age child and the family for heart surgery? A. Unfamiliar equipment should not be shown. B. Let the child hear the sounds of a cardiac monitor, including alarms .C. Explain that an endotracheal tube will not be needed if the surgery goes well. D. Discussion of postoperative discomfort and interventions is not necessary before the procedure.
B. Let the child hear the sounds of a cardiac monitor, including alarms.
A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what? A. Tetralogy of Fallot B.Coarctation of the aorta C. Pulmonary stenosis D. Ventricular septal defect
D. Ventricular septal defect
The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause? a. Physiologic manifestations of renal disease b. The fact that adolescents have few coping mechanisms c. Neurologic manifestations that occur with dialysis d. Resentment of the control and enforced dependence imposed by dialysis
d. Resentment of the control and enforced dependence imposed by dialysis
A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor? a. Flank pain rarely occurs in children with renal injuries. b. Few nonpenetrating injuries cause renal trauma in children. c. Kidneys are immobile, well protected, and rarely injured in children. d. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.
d. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.
