pediatric test 3 questions

An infant with a patent ductus arteriosus is admitted to the pediatric unit ward. The nurse anticipates which of the following medications will be given to the infant? A. Prednisone B. Ibuprofen C. Penicillin D. Albuterol

B. Ibuprofen

How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G? a. 1 year b. 2 years c. 5 years d. 10 years

c. 5 years

A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates? a. Seizure activity b. Hypoxia c. Sydenhams chorea d. Decreasing level of consciousness

c. Sydenhams chorea

A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate? a. Barium swallow b. Chest x-ray c. Electrocardiogram d. Echocardiogram

d. Echocardiogram

An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity? a. Restlessness b. Decreased respiratory rate c. Increased urinary output d. Vomiting

d. Vomiting

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the MOST APPROPRIATE nursing action? 1. Initiate strict enteric precautions. 2. Move the infant to a room with another child with RSV. 3. Leave the infant in the present room because RSV is not contagious. 4. Inform the staff that they must wear a mask, gloves, and a gown when caring for the child.

2

Which of these statements regarding the conduction system of the heart is NOT correct? Select all that apply. A. The sinoatrial (SA) node of the heart acts as the pacemaker. B. The SA node is located on the upper wall of the left atrium. C. The AV node conducts action potentials rapidly through it. D. Action potentials are carried slowly through the atrioventricular bundle.

B. The SA node is located on the upper wall of the left atrium. D. Action potentials are carried slowly through the atrioventricular bundle.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include: a. forcing fluids. b.monitoring pulse oximetry. c. instituting seizure precautions. d. encouraging a high-protein diet.

B Monitoring cardiopulmonary status is an important evaluation tool in the care of the child with ARDS. Maintenance of vascular volume and hydration is important and should be done parenterally. Seizures are not a side effect of ARDS. Adequate nutrition is necessary, but a high-protein diet is not helpful.

The Foley Family is caring for their youngest child, Justin, who is suffering from tetralogy of Fallot. Which of the following are defects associated with this congenital heart condition? A. Aorta exits from the right ventricle, pulmonary artery exits from the left ventricle, and two noncommunicating circulations B. Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy C. Coarctation of aorta, aortic valve stenosis, mitral valve stenosis, and patent ductus arteriosus D. Tricuspid valve atresia, atrial septal defect, ventricular septal defect, and hypoplastic right ventricle

B. Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy

A nurse is providing instructions to a mother who has a child with congestive heart failure regarding Digoxin (Lanoxin). Which statement made by the mother indicates further teaching? A. "I will administer the medication 1 hour before or 2 hours after meal". B. "I will use a special dose-measuring spoon or cup, not a regular table spoon for the liquid preparation". C. "If my child vomits after administration, I will repeat the dose". D. "If more than one dose is missed, I will inform the physician".

C. "If my child vomits after administration, I will repeat the dose".

Clay is an 8-year-old boy diagnosed with heart failure. Which of the following shows that he is strictly following the directed therapeutic regimen? A. Daily use of an antibiotic B. Pulse rate less than 50 beats/minute C. Normal weight for age D. Elevation in red blood cell (RBC) count

C. Normal weight for age

Veronica's parents were told that their daughter needs ribavirin (Virazole). This drug is used to treat which of the following? A. Cystic fibrosis B. Otitis media C. Respiratory syncytial virus (RSV) D. Bronchitis

C. Respiratory syncytial virus (RSV)

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which intervention should be included in the child's care? (Select all that apply.) a. Place in a mist tent. b. Administer antibiotics. c. Administer cough syrup. d. Encourage to drink 8 ounces of formula every 4 hours. e.Cluster care to encourage adequate rest. f. Place on noninvasive oxygen monitoring.

D, E, F Hydration is important in children with RSV bronchiolitis to loosen secretions and prevent shock. Clustering of care promotes periods of rest. The use of noninvasive oxygen monitoring is recommended. Mist tents are no longer used. Antibiotics do not treat illnesses with viral causes. Cough syrup suppresses clearing of respiratory secretions and is not indicated for young children.

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by a respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? SELECT ALL THAT APPLY. 1. Place the infant in a private room. 2. Ensure that the infant's head is in a flexed position. 3. Wear mask at all times when in contact with the infant. 4. Place the infant in a tent that delivers warm humidified air. 5. Position the infant on the side, with the head lower than the chest. 6. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

1 6

The mother of a hospitalized 2 year old child with viral laryngotracheobronchitis (croup) asks the nurse why the health care provider did not prescribe antibiotics. Which response should the nurse make? 1. "The child may be allergic to antibiotics." 2. "The child is too young to receive antibiotics." 3. "Antibiotics are not indicated unless a bacterial infection is present." 4. "The child still has the maternal antibodies from birth and does not need antibiotics."

3

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the MOST APPROPRIATE nursing action? 1.Tell the mother that the child must stay in the tent. 2. Place a toy in the tent to make the child feel more comfortable. 3. Call the health care provider and obtain a prescription for a mild sedative. 4. Let the mother hold the child and direct the cool mist over the child's face.

4

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which interventions? (Select all that apply.) a. Cluster care to conserve energy b. Round-the-clock administration of antitussive agents c.Strict intake and output to avoid congestive heart failure d.Administration of antibiotics

A, D Antibiotics are indicated for a bacterial pneumonia. Often the child will have decreased pulmonary reserve, and the clustering of care is essential. Antitussive agents are used sparingly. It is desirable for the child to cough up some of the secretions. Fluids are essential to kept secretions as liquefied as possible.

How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the childs weakness and fatigue? (Select all that apply.) a. Feeding more frequently with smaller feedings b. Using a soft nipple with enlarged holes c. Holding and cuddling the child during feeding d. Substituting glucose water for formula e. Offering high-caloric formula

ANS: A, B, C, E

A child is diagnosed with influenza, probably type A disease. Management includes which recommendation? a. Clear liquid diet for hydration b. Aspirin to control fever c. Amantadine hydrochloride (Symmetrel) to reduce symptoms d. Antibiotics to prevent bacterial infection

C Amantadine hydrochloride may reduce symptoms related to influenza A if administered within 24 to 48 hours of onset. It is ineffective against type B or C. A clear liquid diet is not necessary for influenza, but maintaining hydration is important. Aspirin is not recommended in children because of increased risk of Reye syndrome. Acetaminophen or ibuprofen is a better choice. Preventive antibiotics are not indicated for influenza unless there is evidence of a secondary bacterial infection.

red is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess? A. Mild cough B. Slight fever C. Chest pain D. Bulging fontanel

C. Chest pain

Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect? a. He is always hungry. b. He tires out during feedings. c. He is fussy for several hours every day. d. He sleeps all the time

b. He tires out during feedings

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, Why do my childs fingertips look like that? On what understanding does the nurse base a response? a. Clubbing occurs as a result of untreated congestive heart failure. b. Clubbing occurs as a result of a left-to-right shunting of blood. c. Clubbing occurs as a result of decreased cardiac output. d. Clubbing occurs as a result of chronic hypoxia.

d. Clubbing occurs as a result of chronic hypoxia.

The nurse takes into consideration that the most common congenital heart defect is the _____________ _______________ defect.

ventricular septal

________________ is a systemic disease involving the joints, heart, central nervous system (CNS), skin, and subcutaneous tissues. It belongs to a group of disorders known as collagen diseases.

Rheumatic fever (RF)

Arrange these parts of the conduction system of the heart in the correct order as an action potential would pass through them. SA node AV node Purkinje fibers Atrioventricular bundle R and L bundle of His

SA node AV node Atrioventricular bundle R and L bundle of His Purkinje fibers

The mother of an 8 year old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen (Motrin IB) is not effective. Which instruction should the nurse provide to the mother? 1. Increase the dose of ibuprofen. 2. Increase the frequency of ibuprofen. 3. Encourage the child to lie on the left side. 4. Encourage the child to lie on the right side.

4

The Heimlich maneuver is recommended for airway obstruction in children older than _____ year(s). a. 1 b. 4 c. 8 d. 12

A The Heimlich maneuver is recommended for airway obstruction in children older than 1 year. Younger than 1 year, back blows and chest thrusts are administered. The Heimlich maneuver can be used in children older than 1 year.

A school-age child has been admitted with an acute asthma episode. The child is receiving oxygen by nasal prongs at 2 liters. How often should the nurse plan to monitor the child's pulse oximetry status? a. Continuous b.Every 30 minutes c. Every hour d. Every 2 hours

A The child on supplemental oxygen requires intermittent or continuous oxygenation monitoring, depending on severity of respiratory compromise and initial oxygenation status. The child in status asthmaticus should be placed on continuous cardiorespiratory (including blood pressure) and pulse oximetry monitoring.

A nurse is handling a child who is on furosemide (Lasix) IV infusion. The nurse instructs the mother to encourage the child to eat which of the following? A. Apricot and baked potato skin. B. Bread and butter. C. Gelatin and Cauliflower. D. Ginger ale and cereal.

A. Apricot and baked potato skin.

A child with Kawasaki disease is admitted to the pediatric ward. Which of the following medications will you expect to be a part of the treatment? Select all that apply. A. Gamma Globulin B. Warfarin. C. Acetaminophen D. Aspirin E. Atenolol

A. Gamma Globulin B. Warfarin. D. Aspirin

Which of the following is most likely associated with a cerebrovascular accident (CVA) resulting from congenital heart disease? A. Polycythemia B. Cardiomyopathy C. Endocarditis D. Low blood pressure

A. Polycythemia

Mr. and Mrs. Baker's only daughter is diagnosed with heart failure. Which of the following interventions would be appropriate to promote optimal nutrition for the infant? A. Replacing regular nipples with easy-to-suck ones B. Allowing the infant to feed for at least 1 hour C. Providing large feedings evenly spaced every 4 hours D. Offering formula that is high in sodium and calories

A. Replacing regular nipples with easy-to-suck ones

Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever? A. Treating streptococcal throat infections with an antibiotic B. Giving penicillin to patients with rheumatic fever C. Using corticosteroid to reduce inflammation D. Providing an antibiotic before dental work

A. Treating streptococcal throat infections with an antibiotic

What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? (Select all that apply.) a. Spontaneous cyanosis b. Dyspnea c. Weakness d. Dry cough e. Syncope

ANS: A, B, C, E

What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select the four that apply.) a. Hypertrophied right ventricle b. Patent ductus arteriosus c. Ventral septal defect d. Narrowing of pulmonary artery e. Dextroposition of aorta

ANS: A, B, D, E

Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? (Select all that apply.) a. Atrial septal defects (ASDs) b. Tetralogy of Fallot c. Dextroposition of aorta d. Patent ductus arteriosus e. Ventricular septal defects (VSDs)

ANS: A, D, E

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratory tract infection

B If a child has acute epiglottitis, examination of the throat may cause complete obstruction and should be performed only when immediate intubation can take place. Stridor is aggravated when a child with epiglottitis is supine. Sore throat and pain on swallowing are early signs of epiglottitis. Epiglottitis is caused by H. influenzae in the respiratory tract.

The ductus arteriosus is another fetal structure that is important in the intrauterine life. It functions to: A. Shunts the combined cardiac output from the pulmonary artery to the aorta going to the lungs B. Shunts the combined cardiac output from the pulmonary artery to the systemic circulation C. Shunts the combined cardiac output from the aorta to the pulmonary artery and later to the pulmonary veins D. Shunts the combined cardiac output from the aorta to the pulmonary artery to the right ventricle

B. Shunts the combined cardiac output from the pulmonary artery to the systemic circulation

Which drug is considered the most useful in treating childhood cardiac arrest? a.Bretylium tosylate (Bretylium) b. Lidocaine hydrochloride (Lidocaine) c.Epinephrine hydrochloride (Adrenaline) d.Naloxone (Narcan)

C Epinephrine works on alpha and beta receptors in the heart and is the most useful drug in childhood cardiac arrest. Bretylium is no longer used in pediatric cardiac arrest management. Lidocaine is used for ventricular arrhythmias only. Naloxone is useful only to reverse effects of opioids.

Immunization of children with Haemophilus influenzae type B (Hib) vaccine decreases the incidence of which of the following conditions? A. Bronchiolitis B. Laryngotracheobronchitis (LTB) C. Epiglottitis D. Pneumonia

C. Epiglottitis

Which of the following respiratory conditions is always considered a medical emergency? A. Asthma B. Cystic fibrosis (CF) C. Epiglottitis D. Laryngotracheobronchitis (LTB)

C. Epiglottitis

Which of the following organisms is responsible for the development of rheumatic fever? A. Streptococcal pneumonia B. Haemophilus influenza C. Group A beta-hemolytic streptococcus D. Staphylococcus aureus

C. Group A beta-hemolytic streptococcus

A nurse is monitoring the intake and output of an infant receiving furosemide (Lasix) IV. Which of the following methods is the most appropriate in measuring the urine output? A. Ask the mother regarding the number of diaper changes B. Compare intake with output C. Weighing the diaper D. Insert Foley catheter

C. Weighing the diaper

Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? a.Ephedrine b. Theophylline c.Aminophylline d. Short-acting β2 agonists

D Short-acting β2 agonists are the first treatment in an acute asthma exacerbation. Ephedrine is not helpful in acute asthma exacerbations. Theophylline is unnecessary for treating asthma exacerbations. Aminophylline is not helpful for acute asthma exacerbation.

Reye's syndrome is a rare and severe illness affecting children and teenagers. Its development has been linked with the use of aspirin and which of the following? A. Meningitis B. Encephalitis C. Strep throat D. Varicella

D. Varicella

Because the diagnosis of rheumatic fever is difficult, an aid used to identify the presence of rheumatic fever is the _____________ _______________.

Jones criteria

Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect? a. A loud, harsh murmur with a systolic thrill b. Cyanosis when crying c. Blood pressure higher in the arms than in the legs d. A machinery-like murmur

a. A loud, harsh murmur with a systolic thrill

What does the nurse explain that a ventricular septal defect will allow? a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis c. No shunting because of high pressure in the left ventricle d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume

a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis

The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions? a. If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest. b. If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest of his body. c. If the baby turns blue, I will immediately put the baby upright in an infant seat. d. If the baby turns blue, I will put the baby in supine position with his head elevated

a. If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest.

A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurses best response? a. Squatting increases the return of venous blood back to the heart. b. Squatting decreases arterial blood flow away from the heart. c. Squatting is a common resting position when a child is tachycardic. d. Squatting increases the workload of the heart.

a. Squatting increases the return of venous blood back to the heart

A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis? a. Coronary arteries b. Heart muscle and the mitral valve c. Aortic and pulmonic valves d. Contractility of the ventricles

b. Heart muscle and the mitral valve

A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever? a. Subcutaneous nodules and fever b. Painful, tender joints and carditis c. Erythema marginatum and arthralgia d. Chorea and elevated sedimentation rate

b. Painful, tender joints and carditis

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because which disease or assessment findings may develop? a. Cough b. Osteoporosis c. Slowed growth d. Cushing syndrome

C The growth of children on long-term inhaled steroids should be assessed frequently to assess for systemic effects of these drugs. Cough is prevented by inhaled steroids. No evidence exists that inhaled steroids cause osteoporosis. Cushing syndrome is caused by long-term systemic steroids.

Appropriate intervention is vital for many children with heart disease in order to go on to live active, full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload? A. Feeding the infant over long periods B. Allowing the infant to have her way to avoid conflict C. Scheduling care to provide for uninterrupted rest periods D. Developing and implementing a consistent care plan

C. Scheduling care to provide for uninterrupted rest periods

To decrease the likelihood of bradyarrhythmias in children during endotracheal intubation, succinylcholine (Anectine) is used with which of the following agents? A. epinephrine (Adrenalin) B. isoproterenol (Isuprel) C. atropine sulfate (Atropine) D. Lidocaine hydrochloride (Xylocaine)

C. atropine sulfate (Atropine)

A 10 year old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1. Warm, dry skin 2. Decreased wheezing 3. Pulse rate of 90 beats/minute 4. Respirations of 18 breaths/minute

2

A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis? a. Nonproductive cough, wheezing b. Fever, general malaise c. Productive cough, rales d. Stridor, substernal retractions

A Asthma presents with a nonproductive cough and wheezing. Pneumonia appears with an acute onset, fever, and general malaise. A productive cough and rales would be indicative of pneumonia. Stridor and substernal retractions are indicative of croup.

A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which diagnosis? a. Bronchitis b. Bronchiolitis c. Viral-induced asthma d.Acute spasmodic laryngitis

A Bronchitis is characterized by these symptoms and occurs in children older than 6 years. Bronchiolitis is rare in children older than 2 years. Asthma is a chronic inflammation of the airways that may be exacerbated by a virus. Acute spasmodic laryngitis occurs in children between 3 months and 3 years.

A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma? a. There is heightened airway reactivity. b. There is decreased resistance in the airway. c. The single cause of asthma is an allergic hypersensitivity. d. It is inherited.

A In bronchial asthma, spasm of the smooth muscle of the bronchi and bronchioles causes constriction, producing impaired respiratory function. In bronchial asthma, there is increased resistance in the airway. There are multiple causes of asthma, including allergens, irritants, exercise, cold air, infections, medications, medical conditions, and endocrine factors. Atopy or development of an immunoglobulin E (IgE)-mediated response is inherited but is not the only cause of asthma.

Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following? A. Squatting posture B. Absent or diminished femoral pulses C. Severe cyanosis at birth D. Cyanotic ("tet") episodes

B. Absent or diminished femoral pulses

Mr. and Mrs. Robertson's son was diagnosed with idiopathic thrombocytopenic purpura. They should be aware that the drug to be avoided is: A. Acetaminophen B. Aspirin C. Codeine D. Morphine

B. Aspirin

The procedure that has to be performed in order to shift the high pressure from the right ventricle to the left ventricle in Transposition of the Great Arteries (TGA) is: A. Rashkind Procedure B. Rastelli Procedure C. Pulmonary Artery Banding D. Jatene Procedure

D. Jatene Procedure

Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood? a. The patent ductus arteriosus b. A ventricular septal defect c. The closure of the foramen ovale d. An atrial septal defect

d. An atrial septal defect

An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs? a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion. b. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia. c. Blood is shunted past cardiac arteries, causing myocardial hypoxia. d. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.

What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta? a. Blood pressure higher on the right side b. Blood pressure higher on the left side c. Blood pressure lower in the arms than in the legs d. Blood pressure lower in the legs than in the arms

d. Blood pressure lower in the legs than in the arms

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? 1. The child exhibits nasal flaring and bradycardia. 2. The child is leaning forward, with the chin thrust out. 3. The child has a low-grade fever and complains of a sore throat. 4. The child is leaning backward, supporting himself or herself with the hands and arms.

2

A nurse is admitting an infant with asthma. The nurse understands that asthma in infants is usually triggered by: a. medications. b. a viral infection. c. exposure to cold air. d. allergy to dust or dust mites.

B Viral illnesses cause inflammation that causes increased airway reactivity in asthma. Medications such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and antibiotics may aggravate asthma, but not frequently in infants. Exposure to cold air may exacerbate already existing asthma. Allergy is associated with asthma, but 20% to 40% of children with asthma have no evidence of allergic disease.

The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching? A. "He should increase his fluid intake regularly to thin secretions." B. "We'll make sure that he avoids exercise to prevent attacks." C. "He is to use his bronchodilator inhaler before the steroid inhaler." D. "We need to identify what things trigger his attacks."

B. "We'll make sure that he avoids exercise to prevent attacks."

A nurse is teaching an adolescent how to use the peak expiratory flowmeter. The adolescent has understood the teaching if which statement is made? a. "I will record the average of the readings." b. "I should be sitting comfortably when I perform the readings." c."I will record the readings at the same time every day." d. "I will repeat the routine two times."

C Instructions for use of a peak flowmeter include standing up straight before performing the reading, recording the highest of the three readings (not the average), measuring the peak expiratory flow rate (PEFR) close to the same time each day, and repeating the entire routine three times, waiting 30 seconds between each routine.

The nurse is caring for a child with a diagnosis of Kawasaki disease. The childs parent asks the nurse, How does Kawasaki disease affect my childs heart and blood vessels? On what understanding is the nurses response based? a. Inflammation weakens blood vessels, leading to aneurysm. b. Increased lipid levels lead to the development of atherosclerosis. c. Untreated disease causes mitral valve stenosis. d. Altered blood flow increases cardiac workload with resulting heart failure.

a. Inflammation weakens blood vessels, leading to aneurysm.

Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant? a. Counting the apical rate for 30 seconds before administering the medication b. Withholding a dose if the apical heart rate is less than 100 beats/min c. Repeating a dose if the child vomits within 30 minutes of the previous dose d. Checking respiratory rate and blood pressure before each dose

b. Withholding a dose if the apical heart rate is less than 100 beats/min