NU260 Exam 3 Chapt.'s 40, 42 & 43

Typically the measure used to control the transmission of infection in the immunocompromised child during hospitalization includes:

Handwashing

The student nurse is caring for an infant with a tracheostomy and preparing to suction the infant. The nursing instructor should intervene if the nursing student stated she would take which action to perform this procedure?

Limit insertion and suctioning time to 15 seconds to prevent hypoxia. Should be limited to 5 seconds.

Nursing care management of the 6 month old infant with RSV bronchiolitis will include:

Monitoring oxygenation with pulse oximetry, suctioning nasal secretions before nursing, and ensuring adequate oral fluid intake.

Therapeutic management of sickle cell crisis generally includes:

Oral or intravenous hydration for hemodilution.

List the four cardinal signs of impending respiratory failure:

Restlessness, Tachypnea, Tachycardia, and Diaphoresis.

What is rheumatic fever?

Rheumatic fever is an inflammatory autoimmune disease that affects the connective tissues of the heart, joints, skin (subcutaneous tissues), blood vessels, and central nervous system.

Tetralogy of Fallot consists of these defects:

VSD, Right ventricular hypertrophy, pulmonic stenosis, and overriding aorta

During influenza epidemics, it is generally believed the age group that provides a major source of transmission is the:

school-age child.

An early sign of congestive heart failure that the nurse should recognize is:

tachypnea.

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?

"Did the child have a sore throat or fever within the last 2 months?" Rheumatic fever characteristically manifests 2 to 6 weeks after an untreated or partially treated group A b-hemolytic streptococcal infection of the upper respiratory tract.

The nurse is preparing to administer an MMR (measles, mumps, and rubella) vaccine to a 15-month-old child. Before administering the vaccine, which question should the nurse ask the mother of the child?

"Is the child allergic to any antibiotics?" MMR is used with caution in a child with a history of an allergy to gelatin, eggs, or neomycin, because the live measles vaccine is produced by chick embryo cell culture and MMR also contains a small amount of the antibiotic neomycin.

At birth, the healthy full-term newborn has maternal store of iron sufficient to last:

5 to 6 months

The nurse is teaching a mother how to administer digoxin, Lanoxin, at home to her 3 year old child. The nurse tells the mother that as a general rule, digoxin should not be administered to the older child whose pulse is:

68

The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF?

A chronic multisystem disorder affecting the exocrine glands. The mucus produced by these glands, particularly those of the bronchioles, small intestine, and pancreatic and bile ducts, is abnormally thick, causing obstruction of the small passageways of these organs. It is transmitted as an autosomal recessive trait.

What is Patent ductus arteriosus?

A failure of the fetal ductus arteriosus, the artery connecting the aorta and the pulmonary artery, to close. A characteristic machinery-like murmur is present, and the infant may show signs of heart failure.

The primary concern of the nurse when giving tips for how to increase humidity in the home of a child with a respiratory infection should be to make sure the child has:

A humidification source that is safe.

The term latent tuberculosis infection (LTBI) is used to indicate infection in a person with:

A positive TST, absence of physical findings of disease, and a normal chest radiograph.

A 1-year-old infant with a diagnosis of heart failure is prescribed digoxin, Lanoxin. The nurse takes the apical pulse for 1 minute before administering the medication and obtains a result of 102 beats/min. Which action should the nurse take?

Administer the medication. The apical pulse rate for a 1-year-old infant is 90 to 130 beats a minute.

One of the most important factors in preventing bacterial endocarditis is:

Administration of prophylactic antibiotic therapy.

The pediatric nurse educator is providing a teaching session to nursing staff. The topic is hemophilia, which is genetically passed through a sex-linked recessive gene. Which statement is a specific hemophilia-related concern?

Affected prepubescent girls should be counseled concerning menorrhagia, which may be life threatening.

Which of the following is the best choice for the child with a respiratory disorder who needs rest but is resisting staying in bed?

Allow the child to play quietly on the bed or floor.

Children who develop moon face form short term steroid therapy used to treat cancer may experience symptoms of what?

Altered body image.

The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. How should the nurse interpret this finding?

An airway obstruction.

A diagnosis of rheumatic fever is being ruled out for a child. Which lab test(s) is/are the most reliable?

Antistreptolysin-O titer, ASO, titer

What should the nurse recognize as an early clinical sign of compensated shock in a child?

Apprehension.

An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse should place which instructions on the list?

Avoid hot fluids, avoid raw vegetables, and rest in bed or on a couch for 24 hours.

In Wiskott-Aldrich syndrome, the most notable effect of the disease at birth is:

Bloody diarrhea.

The nurse is caring for a child with a diagnosis of a right-to-left cardiac shunt. On review of the child's record, the nurse should expect to note documentation of which most common assessment finding?

Bluish discoloration of the skin. The child with a right-to-left shunt will be considerably sicker than a child with a left-to-right shunt. The child may also become dyspneic after feeding, crying, and other exertional activities.

Treatment for the child with aplastic anemia will most likely include:

Bone marrow transplant.

Group A beta-hemolytic streptococcal (GABHS) infection is usually a:

Brief illness that places the child at risk for serious sequelae.

The school nurse is discussing prevention of acquired immune deficiency syndrome with some adolescents. In the discussion the nurse should include that the: A. virus is easily transmitted. B. virus is only transmitted through blood. C. intravenous drug users should not share needles. D. condoms should be used if adolescents are sexually active and homosexual.

C. intravenous drug users should not share needles.

Dehydration must be prevented in children who are hypoxemic because dehydration places the child at risk for:

Cerebral vascular accident

The nurse is reviewing the health care provider's prescriptions for a child with rheumatic fever (RF) who is suspected of having a viral infection. The nurse notes that acetylsalicylic acid (aspirin) is prescribed for the child. Which nursing action is most appropriate?

Consult with the health care provider to verify the prescription. Anti-inflammatory agents, including aspirin, may be prescribed for the child with RF. Aspirin should not be given to a child who has chickenpox or other viral infections.

The nurse is providing instructions to the mother of a child who has been exposed to human immunodeficiency virus (HIV) infection. The nurse should include notifying the health care provider if which symptom occurs in the child?

Coughing

An important nursing responsibility when a dysrhythmia is suspected is to:

Count the apical rate for 1 full minute and compare it with the radial rate.

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?

Decreased wheezing. It may actually signal an inability to move air. A "silent chest" is an ominous sign during an asthma episode.

A child with b-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed?

Deferoxamine, Desferal. Deferoxamine is classified as an antidote for acute iron toxicity.

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease?

Easy bruising occurs, gum bleeding occurs, it is a hereditary bleeding disorder, treatment and care are similar to that for hemophilia, and the disorder causes platelets to adhere to damaged endothelium.

The nurse should instruct a child to remain completely still during which procedure in which high frequency sound waves are translated into images by a transducer?

Echocardiography

The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measure should the nurse do until factor replacement therapy can be instituted?

Elevate area above the level of the heart.

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?

Encourage the child to lie on the right side. This may provide some comfort.

Since the advent of immunization for Haemophilus influenza, there has been a decrease in the incidence of:

Epiglottitis

The nurse should prepare for an impending emergency situation to care for the child with suspected:

Epiglottitis

What does sitting upright, drooling, agitation, and a froglike cough indicate?

Epiglottitis. This is a medical emergency.

A 16 year old is receiving radiation for Hodgkin Lymphoma. When providing information about the radiation treatments, the nurse informs the adolescent and his mother that the most common effect of radiation is what?

Fatigue.

During fetal life oxygenated blood travels into the left atrium through a structure known as the what?

Foramen ovale

Common clinical manifestations of HIV in young children include all of the following except: Oral candidiasis, chronic diarrhea, failure to thrive or frequent URIs?

Frequent URIs

A 5-year-old child is brought to the Emergency Department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. What are the most appropriate nursing interventions?

Get vital signs, medical history, Assessment of breath sounds, and have Emergency airway equipment readily available.

What is the most appropriate action for stopping an occasional episode of epistaxis (nose bleeding)?

Have child sit up and lean forward. THEN pressure is indicated, it is recommended for 10 minutes.

The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. FIRST the nurse should:

Have someone call for an ambulance/paramedic rescue squad.

A nurse is caring for a hospitalized infant with a diagnosis of bronchiolitis. In which position should the nurse place the infant?

Head and chest at a 30-degree angle with the neck slightly extended.

The nurse is developing a plan of care for a child admitted with a diagnosis of Kawasaki disease. In developing the initial plan of care, the nurse should include to monitor the child for signs of which condition?

Heart failure (HF). The nurse monitors for increased respiratory rate, increased heart rate, dyspnea, crackles, and abdominal distention.

Which of the following sets of assessment findings are the most frequent clinical manifestations of an atrial septal defect in an infant or child?

Heart failure and a murmur

A 5 year old boy previously diagnosed with hemophilia A is being admitted with hemarthrosis. The nurse knows that which of the following would most likely be included in the plan of care?

Ice packs to the affected area, application of a splint of sling to immobilize the area, administration of factor VIII, and active range of motion exercises.

An infant who weighs 7 kg has just returned to the intensive care unit following cardiac surgery. The urine output has been 5mL in the past hour. In this situation, what is the first action the nurse should take?

Identify any other signs of renal failure.

A 7 year old with leukemia is receiving an intravenous dose of a chemotherapeutic drug when he tells his mother that the I.V. site is burning and stinging. The nurse's priority intervention is to what?

Immediately stop the infusion.

An acquired hemorrhagic disorder characterized by excessive destruction of platelets and a discoloration caused by petechiae beneath the skin with normal bone marrow is what?

Immune thrombocytopenia.

In an 8 month old infant admitted to the hospital with pertussis, the nurse should inquire about what?

Immunization status of the infant.

The primary consequences of leukemia in children are:

Infection from neutropenia, anemia from decreased RBC's, and bleeding from decreased platelets.

Following cardiac surgery, fluid intake calculations for a child would include:

Intravenous fluids, arterial and CVP line flushes, and fluid used to dilute medications.

In controlling severe pain related to vasooclusive sickle cell crisis, the plan of care will most likely include:

Intravenous or oral opioids.

The common childhood anemia that occurs more frequently in toddlers between the ages of 12 and 36 months is what?

Iron deficiency

the best dietary sources of iron for a 7 month old infant are:

Iron fortified rice cereal, and iron fortified commercial formula.

When assessing for hypertension in an infant, the nurse will expect the infant to exhibit which signs?

Irritability, Head rubbing, and waking up screaming in the night.

The Reed-Sternberg cell is a significant finding because of why?

It is a characteristic of Hodgkin disease.

A child is status post-hematopoietic stem cell transplantation (HSCT) and is preparing for discharge home. Based on the nurse's knowledge of HSCT, which concepts are important to include in the discharge teaching plan of care?

Keeping the child on a high-calcium diet, avoiding live plants and fresh vegetables, and Practicing good hygiene.

The nurse is caring for an infant with a diagnosis of tetralogy of Fallot. The infant suddenly becomes cyanotic, and the nurse recognizes that the infant is experiencing a hypercyanotic spell (blue or tet spell). The nurse immediately places the infant in what position?

Knee-chest position. This position improves systemic arterial oxygen saturation.

The cancer that occurs with the most frequency in children is what?

Leukemia

The nurse is reviewing the laboratory results of a child with aplastic anemia and notes that the white blood cell (WBC) count is 2000 cells/mm3 and the platelet count is 150,000 cells/mm3. Which intervention should the nurse incorporate into the plan of care?

Maintain strict neutropenic precautions. The normal WBC count ranges from 4500 to 11,000 cells/mm3, and the normal platelet count ranges from 150,000 to 400,000 cells/mm3.

Nursing considerations related to the administration of chemotherapeutic drugs include:

Many chemotherapeutic agents are vesicants that can cause severe cellular damage if the drug infiltrates.

The most likely reason that the respiratory infection rate increases drastically in the age range from 3 to 6 months is that the:

Maternal antibodies have decreased and the infant's own antibody production is immature.

The American Academy of Pediatrics recommends that all children infected with HIV receive the routine childhood immunizations, but the nurse recognizes that children with HIV who are receiving intravenous immunoglobulin, IVIG, prophylaxis may not respond to the:

Measles-mumps-rubella vaccine.

A 2-year-old boy with a diagnosis of hemophilia is admitted to the hospital with bleeding into the joint of the right knee. Which intervention should the nurse plan to implement with this child?

Measure the injured knee joint every shift.

Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is:

Mechanical obstruction caused by increased viscosity of mucous gland secretions.

The clinic nurse reads the results of a tuberculin skin test performed on a 5-year-old child who is at low risk for contracting tuberculosis. The results indicate an area of induration measuring 10 mm. How would the nurse interpret these results?

Negative. Induration measuring 15 mm or greater is considered a positive result in a child 4 years of age or older who has no associated risk factors.

The parent of a child receiving an iron preparation tells the nurse that the child's stools are a tarry green color. The nurse should explain that this is a/an:

Normally expected change caused by the iron preparation.

The nurse is preparing to give digoxin to a 9-month-old infant. He or she checks the dose and draws up 4 ml of the drug. The MOST appropriate nursing action is to:

Not give the dose; suspect dosage error. Digoxin is often prescribed in micrograms. Rarely is more than 1 ml administered to an infant.

A 4-year-old girl is brought to the emergency room. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should:

Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. The FIRST action by the nurse is to:

Notify the practitioner because chest syndrome is suspected.

An infant who weights 7 kg has just returned to the intensive care unit following cardiac surgery. The chest tube has drained 40mL in the past hour. In this situation,, what is the first action for the nurse to take?

Notify the surgeon

A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?

Obtain a throat culture. Because any stimulation with a tongue depressor or culture swab could cause laryngospasm, thus completing airway obstruction.

The use of monoclonal antibody palivizumab for the prevention of RSV is preferred in high-risk children because:

Of its ease of administration, safety, and effectiveness.

Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia (IDA). The nurse should instruct the mother to administer the iron with which food item?

Orange juice. Vitamin C (ascorbic acid) increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or juice high in vitamin C.

Nursing care of the infant or child with congestive heart failure would include:

Organizing activities to allow for uninterrupted sleep.

The principal treatment for the insufficiency that occurs in cystic fibrosis is the administration of ?

Pancreatic enzymes

Discharge teaching for a child with Kawasaki disease who received IVIG should include:

Peeling of the hands and feet should be reported immediately, arthritis, especially in the weight-veering joints, should be reported immediately, defer measles, mumps, and rubella vaccine for 11 months.

In children and adolescents, HIV is most likely to be transmitted how?

Perinatally from the mother, through contaminated blood or blood products, and to adolescents engaged in IV drug use.

A 12 month old would be classified as significantly hypertensive with a blood pressure that what?

Persistently falls between the 95th and 99th percentiles

What are the most common signs and symptoms of leukemia related to bone marrow involvement?

Petechiae, infection, and fatigue. These are signs of infiltration of the bone marrow.

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care?

Place the infant in a private room, and Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

In the postoperative period following a tonsillectomy, the child should be:

Placed on bed rest for the day of surgery.

What is the most common opportunistic infection of children infected with HIV? It occurs most frequently between 3 and 6 months of age.

Pneumocystis Carinii Pneumonia.

The parent of a child with cystic fibrosis calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these symptoms are suggestive of:

Pneumothorax.

Parents of the child with a congenital heart defect should know the signs of congestive heart failure which include:

Poor feeding, sudden weight gain, and increased efforts to breathe.

The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as which finding?

Positive. Induration measuring 10 mm or more is considered to be a positive result in children younger than 4 years of age and in children with chronic illness or at high risk for exposure to tuberculosis.

A 12 month old infant in heart failure is taking enalapril, ace inhibitor, and spironolactone. The nurse should be especially alert for what?

Potassium 5.0 mEq/L

The nurse reviews the laboratory results for a child with rheumatic fever and would expect to note which findings?

Presence of Aschoff's bodies, Elevated antistreptolysin O titer, and an elevated erythrocyte sedimentation rate.

A 12-year-old is admitted to the hospital with a low-grade fever and joint pain. Which diagnostic test finding will assist to determine a diagnosis of rheumatic fever?

Presence of Aschoff's bodies.

A child is scheduled for a tonsillectomy. A nurse plans care, knowing that which condition would be a priority because it presents the highest risk of aspiration during surgery?

Presence of loose teeth.

If bleeding occurs at the insertion site after a cardiac catheterization, the nurse should apply what?

Pressure above the insertion site

The nurse is reviewing the laboratory results for a child scheduled for tonsillectomy. The nurse determines that which laboratory value is most significant to review?

Prothrombin time.

Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?

Red blood cells that are microcytic and hypochromic. The results of a complete blood cell count in children with iron deficiency anemia show decreased hemoglobin levels and microcytic and hypochromic red blood cells. The red blood cell count is decreased. The reticulocyte count is usually normal or slightly elevated.

A child is admitted to the pediatric unit with a diagnosis of acute stage Kawasaki disease. In performing an assessment on the child, which findings are characteristic of this disorder?

Red throat, Conjunctival hyperemia, and Enlargement of the cervical lymph nodes.

Primary prophylaxis in hemophilia patients involves the infusion of factor VIII:

Regularly at home before the onset of joint damage.

The leading cause of death in the first 3 years after heart transplantation, the greatest risk in the first 6 months, in children is:

Rejection

A child in whom sickle cell anemia is suspected is seen in a clinic, and laboratory studies are performed. The nurse checks the laboratory results, knowing that which value would be increased in this disease?

Reticulocyte count. Reticulocyte, which are immature red blood cells without a nucleus, counts are increased in children with sickle cell disease because the life span of their sickled red blood cells is shortened.

A nurse is caring for an infant with congenital heart disease. Which, if noted in the infant, should alert the nurse to the early development of heart failure (HF)?

Slow and shallow breathing. Tachycardia would occur during feeding. Paleness of the skin, pallor, may be noted in the infant with HF, but it is not an early symptom.

Which of the following clinical manifestations is a sign of chronic hypoxemia in a child?

Squatting, Polycythemia and Clubbing

Because of the potential for empyema, closed chest drainage is most likely to be used in the treatment of:

Staphylococcal pneumonia.

The nurse suspects that a child is having an adverse reaction to a blood transfusion. The FIRST action by the nurse should be to:

Stop transfusion and maintain a patent intravenous line with normal saline and new tubing.

After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the nurse question?

Suction every 2 hours.

Which of the following strategies would most likely be contraindicated for a child with cystic fibrosis to use?

Supplemental oxygen as desired.

Diagnosis of severe combined immunodeficiency disease, SCID, is primarily based on what?

Susceptibility to infections.

The nurse is monitoring an infant with congenital heart disease closely for signs of heart failure (HF). The nurse should assess the infant for which early sign of HF?

Tachycardia

The nurse is collecting data on a 12-month-old child with iron deficiency anemia. Which finding should the nurse expect to note in this child?

Tachycardia. Clinical manifestations usually include extreme pallor with a porcelain-like skin, tachycardia, lethargy, and irritability.

The MOST important nursing consideration when caring for a child with sickle cell anemia is to:

Teach parents and child how to minimize crises, such as watch for, penicillin administration, adequate hydration, and environmental concerns.

What is Tetralogy of Fallot?

Tetralogy of Fallot includes four defects-ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.

Which one of the following children is most likely to be hospitalized for treatment of croup:

The 2-year-old child with inspiratory stridor when upright and supine.

A nurse is reviewing the immunization schedule for a child with human immunodeficiency virus (HIV) infection with the mother. Which instruction should the nurse provide to the mother?

The child and the siblings will need to receive inactivated polio vaccine. This is because the child with HIV infection is immunocompromised.

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?

The child is leaning forward, with the chin thrust out.

A parent and child visit to the intensive care unit before open-heart surgery should ideally take place:

The day before surgery.

An infant with a congenital heart defect is receiving palivizumab which is Synagis. The purpose of this is to:

To prevent respiratory syncytial virus infection, also known as R.S.V

Which is considered a mixed cardiac defect? A. Pulmonic stenosis B. Atrial septal defect C. Patent ductus arteriosus D. Transposition of the great arteries

Transposition of the great arteries

The test in which a transducer is placed behind the heart to obtain images of posterior heart structures is the:

Transthoracic echocardiography

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C. The nurse suspects croup and should recommend:

Trying a cool-mist vaporizer at night and watching for signs of difficulty breathing.

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action?

Turn the child to the side.

A 5 year old with sickle cell anemia is admitted because of diminished RBC production triggered by a viral infection. The episode is characterized by distal ischemia and pain. The crisis the child is most likely to be experiencing is:

Vasoocclusive Crisis.

Most respiratory infections in children are caused by:

Viruses

When caring for a child after a tonsillectomy, the nurse should:

Watch for continuous swallowing. Also, the child should be positioned on the side or abdomen to facilitate drainage.

A health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant?

When drawing blood for electrolyte level testing. Oxygen administration may be prescribed for stressful periods, especially during bouts of crying or invasive procedures.

The nurse is assessing a newborn with heart failure before administering the prescribed digoxin (Lanoxin). In reviewing the laboratory data, the nurse notes that the newborn has a digoxin blood level of 2.4 ng/mL and an apical heart rate of 98 beats/min. The mother also tells the nurse that the newborn just vomited her formula. Which intervention should the nurse take?

Withhold the medication and notify the health care provider. The apical pulse rate for a newborn is 120 to 140 beats/min. The therapeutic digoxin level ranges from 0.5 to 2.0 ng/dL.

Respiratory syncytial virus, RSV, is:

a common virus that usually causes moderate-to-severe bronchiolitis.

It is important that a child with Group A ß-hemolytic streptococci (GABHS) infection be treated with antibiotics to prevent:

acute rheumatic fever.

Nursing care for a child with leukemia undergoing chemotherapy with resultant nausea and vomiting should focus on:

administration of an antiemetic before chemotherapeutic drug is given.

The test that provides the most reliable evidence of recent streptococcal infection is the:

antistreptolysin O test

The infant is predisposed to developing otitis media because the Eustachian tubes:

are relatively short and open.

When preparing a child for cardiac catheterization the nurse should:

ask about allergies, assess and mark distal pulses, ask about a fever above 100 degrees Fahrenheit, and provide information about the procedure to the child and parents.

A child with asthma is having pulmonary function tests. The purpose of the peak expiratory flow rate or P.EF.R. is to:

assess the severity of asthma.

The best medication administration regimen fore a child in the initial postoperative period following a tonsillectomy is:

at regular intervals.

What is b-thalassemia?

b-Thalassemia is an autosomal recessive disorder characterized by the reduced production of one of the globin chains in the synthesis of hemoglobin, both parents must be carriers to produce a child with b-thalassemia major. This disorder is found primarily in individuals of Mediterranean descent.

General signs of pneumonia include:

cough, tachypnea, and retractions.

Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress the:

desirability of promoting normalcy within the limits of the child's condition.

Signs and symptoms of supraventricular tachycardia, SVT, in an infant or young child include:

diaphoresis

The nurse should explain to the parents that their child is receiving Lasix for severe congestive heart failure because it is a/an:

diuretic. This is used to eliminate excess water and salt to prevent reaccumulation of the fluid.

A child diagnosed with lymphoma is receiving extensive radiation therapy. The MOST common side effect of this treatment is:

fatigue.

Fluid and nutritional guidelines for an infant with congestive heart failure rarely include:

fluid restriction

The nutritional needs of the infant with congestive heart failure are usually:

greater than a healthy infant's

If the child who is suspected of having epiglottitis, the nurse should:

have intubation equipment available.

The nurse is explaining blood components to an 8-year-old child. The nurse could best describe platelets by explaining that they:

help your body stop bleeding by forming a clot, scab, over the hurt area.

The doctor suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent:

increased pulmonary vascular congestion.

the calories are usually modified for an infant with congestive heart failure by:

increasing the caloric density of the formula

A common term used in describing an abnormal CBC is shift to the left, which is usually caused by an:

infection

When an abnormal connection exists between heart chambers, i.e. a septal defect, blood will necessarily flow from an area of higher pressure, left side, to one of the lower pressure, right side, is called a?

left-to-right shunt

Asthma is classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include:

lung function, frequency of symptoms, and frequency and severity of exacerbations.

Following cardiac surgery, in addition to hourly recordings of urine, fluid output calculations in a child should include:

nasogastric secretions, blood drawn for analysis, and chest tube drainage.

Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. The nurse should recognize that in clinical practice this system is:

problematic because children with acyanotic heart defects may develop cyanosis.

After a patient returns from cardiac catheterization, the nurse assesses that the pulse distal to the catheter insertion site is weaker. The nurse should:

record the data on the nurse's notes.

A young child with tetralogy of Fallot may assume a posturing position as a compensatory mechanism. The position automatically assumed by the child is:

squatting

The peak age for the incidence of Kawasaki disease is in the:

toddler age group

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include:

using good handwashing

The mother with human immunodeficiency virus (HIV) infection brings her 10-month-old infant to the clinic for a routine checkup. The health care provider has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV. The nurse should make which most appropriate response to the mother?

"Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old."

The mother of a child being discharged after heart surgery asks the nurse when the child will be able to return to school. Which is the most appropriate response to the mother?

"The child may return to school in 3 weeks but needs to go half-days for the first few days." The mother also should be told that that the child cannot participate in physical education.

Hodgkin disease increases the incidence in children between the ages of what?

15 and 19 years old.

Because the absorption of fat-soluble vitamins is decreased in children with cystic fibrosis, supplementation of which vitamins is necessary?

A, D, E, & K

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?

Conjunctival hyperemia. In the acute stage, the child has a fever, conjunctival hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes.

Two main angiotensin-converting enzyme, ACE, inhibitors most commonly used for children with congestive heart failure are:

Enalapril and Captopril

Most cases of hypertension in young children are a result of what?

Structural abnormality or an underlying pathologic process.

In fetal circulation only a small amount of blood flows through the nonfunctioning:

Pulmonary circulation

The clinical manifestations of influenza usually include all of the following except:

nausea and vomiting

A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because this environment facilitates:

soothing inflamed mucous membrane.

Which of the following congenital heart defects usually has the best prognosis?

Atrial septal defect

Coarctation of the aorta should be suspected when the what?

Blood pressure is higher in the arms than in the legs.

Elevated cholesterol plays an important role in causing what?

atherosclerosis.

The nurse may anticipate intubation as the care management for the young child diagnosed with:

bacterial tracheitis.

A child is scheduled for a tonsillectomy in a day surgical unit. On the day after surgery, the mother calls the surgical unit and expresses concern because the child has a bad mouth odor. Which response is most appropriate?

"Bad mouth odor is normal and may be relieved by drinking more liquids."

A nurse has provided instructions to the mother of a child with cystic fibrosis (CF) about appropriate dietary measures. Which statement by the mother indicates an understanding of these dietary measures?

"The diet needs to be high in calories." Children with CF are managed with a high-calorie, high-protein diet. Pancreatic enzyme replacement therapy and water-soluble vitamin supplements (A, D, E, and K) are administered.

the child who has active tuberculosis infection is:

A combination of Isoniazid, Rifampin, and Pyrazinamide.

The nurse should suspect epiglottitis if the child has:

Absence of cough in the presence of drooling and agitation.

Prostaglandin is administered to the newborn with a congenital heart defect to:

Keep the ductus arteriosus open.

An abnormal otoscopic examination would reveal:

an opaque immobile tympanic membrane

What represents the early subtle signs of hypoxia?

Mood changes and restlessness

Which of the following signs is an early indication of hemorrhage in a child who has had a tonsillectomy?

Continuous swallowing

Because an incision is made through muscle, most children consider the most painful part of cardiac surgery to be the what?

Thoracotomy incision site.

The best technique to prevent spread of nasopharyngitis is:

To avoid contact with infected people.