Peds Exam 3 Practice Questions

After cardiac cath of a child, which assessment finding is a cause of concern to the nurse? A. the pulse distal to the cath is weak B. the affected extremity feels cool when touched C. the child has resumed oral intake with clear liquids D. the child is in bed with the affected extremity straight

B

What is a priority pt outcome for a child with CHF? A. the child will have a rapid HR B. the child will have skin that is cool to touch C. the child will not have distended neck veins D. the child will sleep with the head down and feet elevated

C

What nursing intervention is the most important in preventing complications of dig administration? A. assessing BP in all extremities B. assessing BP with the pt lying, sitting, standing C. checking the apical pulse for 60s before administering the med D. checking the carotid pulse for 30s before administering the med

C

What position does the nurse caring for a young child with tetralogy of Fallot see the child assuming in an attempt to compensate for the congenital heart defect? A. prone B. supine C. knee-chest D. low fowler

C

A child is admitted with possible Reye Syndrome. Which of the following findings would the nurse expect to see? SATA. A. child has had vomiting episodes for past 24 hours B. child's ammonia levels are lower than normal C. child was administered ibuprofen when the child had the flu D. child is unusually argumentative and aggressive E. sclera yellow F. elevated temps

A, D, F

A 5yo child with a congenital heart defect is to receive digoxin PO. Prior to administration, the HCP checks most recent lab report. Which lab value should be of most concern to the HCP? A. Hgb 10 B. K+ 3.2 C. Creatinine 0.4 D. Dig level of 0.8

B

A baby, exhibiting no obvious signs of CHF, has been diagnosed with a VSD. Which of the following should the nurse explain to the parents? A. the baby will likely need open heart surgery within a week B. the defect will likely close without therapy C. the defect likely developed early in the second trimester D. the baby will likely be placed on a high-calorie formula

B

A child is recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen? A. 2-3 oral anticonvulsant medications so that dosing can be low and side effects can be minimized B. 1 oral anticonvulsant medications to observe effectiveness and minimize side effects C. 1 rectal gel to be administered in the event of a seizure D. placed on ketogenic diet to see if diet alone can keep the child's seizures under control

B

An infant who was just born is tachypneic, tachycardic, and has marked cyanosis. A STAT echo shows a congenital heart defect. Which is consistent with these findings? A. PDA B. Transposition C. ASD D. VSD

B

The HCP is preparing to administer indomethicin to an infant with a persistent patent ductus arteriosus (PDA). The mother of the baby asks why the medication is being given to her baby. What is the HCP's best response? A. Your baby needs help clearing the extra fluid from the lungs B. Your baby needs this drug bc it interferes with substances that keep the PDA open. C. this drug will help your baby's heart contract with a stronger force D. this drug is a NSAID, so it will help control your baby's pain

B

The nurse is caring for an 8yo girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances, they state it seems worse when she is anxious and does not occur when she is sleeping. The nurse questions the parents about what recent illness? A. Kawasaki Disease B. RF C. malignant HTN D. a fib

B

Which position initially is most beneficial for an infant who has just returned from having a VP shunt placed? A. semi-Fowler in an infant seat B. flat in crib C. trendelenburg D. in the crib with head elevated 90 degrees

B

A 14yo is admitted with a dx of "rule out RF." Based on Jones criteria, the nurse assesses for which of the following? A. polyarthritis and dental caries B. fever, HA, and low blood cell count C. chorea, muscle weakness, and decreased sed rate D. erythema, polyarthritis, and elevated ASO titer

D

A child admitted with a dx of "rule out RF" has all of the following lab findings. Which findings support the dx of RF? A. elevated antistreptolysin-O B. elevated hct C. blood cultures neg D. WBC within normal limits

A

An infant is being prepared for surgical repair of a VSD. Which of the following problems will be prevented by closing the defect? A. failure to thrive B. ventricular dysrhythmias C. heart block D. respiratory alkalosis

A

The HCP is planning the discharge for a child with ventricular septal defect. Which of the following is a priority to include in the discharge instructions? A. provide instructions for a monthly immunoglobulin shot during RSV B. Ensure the parents know how to take the child's BP at home C. advise the family provide meals that are low in fat and calories D. suggest quiet activities fr the child to decrease physical activity

A

Which statement by the mother of a male toddler with RF shows that she has god understanding of the care of her child? A. I will apply heat to his swollen joints to promote circulation B. I will have him to gentle stretching to prevent contractures C. I will give him the aspirin that is ordered for his pain and inflammation D. I will apply cold packs to his swollen joints to reduce pain

C

You are caring for a patient with hydrocephalus who is post-op from a shunt revision. Which assessment finding is your priority for increased ICP? A. nausea and refusal to eat post-operatively B. complaint of a HA C. irritability and wanting to sleep D. decrease in HR over the last hour

D

Which heart defect causes narrowing or the aortic valve? A. aortic stenosis B. ASD C. coarctation of the aorta D. patent ductus arteriosus

A

During an exam of an infant with a patent ductus arteriosus, the HCP should expect to observe: SATA A. profound cyanosis B. widening pulse pressure C. systolic murmur D. bounding peripheral pulses E. clubbing of fingers and toes

BCD

Which order should a nurse question for a child just admitted with diagnosis of bacterial meningitis? A. maintain isolation precautions until 24hrs after receiving IV antibiotics B. IV fluids at 1.5 regular maintenance C. Neuro checks q 1hr D. Administer tylenol for temps higher than 100.4

B

The nurse should assess a teenage child suspected of having early stage scoliosis for which of the following clinical manifestations? SATA A. truncal asymmetry B. curved spinal column C. unequal shoulder height D. prominence of one scapula E. altered gait with a limp F. limited use of one arm

A, B, C, D

The nurse caring for a infant with a cyanotic heart defect. Symptoms that would indicate risk for CHF include which of the following? SATA A. respiratory crackles and frothy secretions B. increased BP C. O2 sat increase D. hepatomegaly E. rapid weight gain

A, D, E

The nurse is caring for an infant with CHF. The following are interventions to decrease cardiac demands on the infant. SATA A. allow parents to hold and rock their infant B. feed only when infant is crying C. keep the child uncovered to promote low body temp D. make frequent position changes E. feed the child when sucking the fists F. change the bed linens only when necessary G. organize nursing activities

A, D, E, F, G

The nurse assessing a 3mo during a well child visit. Which of the following findings would warrant the nurse to recommend that the baby have an ultrasound for possible dx of DDH? A. unequal knee heights B. bilateral polydactyly C. + Babinski test D. bilateral plantar flexion

A

The nurse is caring for an unconscious 6yo who has had severe closed head injury and notes the following changes: HR dropped from 120 to 55, BP increased from 110/44 to 195/62, and respirations becoming more irregular. What should the nurse do first after calling the physician? A. Call for additional help, and prepare to give mannitol B. Continue to monitor pt and prepare to give a bolus of fluids C. Call for additional help, and prepare to administer an antihypertensive D. Continue to monitor patient and prepare to give supplemental O2

A

A 2yo child has a known cardiac defect is in CHF. Which assessment findings best indicate to the nurse a toxic dose of dig? A. tachycardia and dysrhymia B. HA and diarrhea C. bradycardia, N/V D. tinnitus and nuchal rigidity

C

A child with cyanotic heart defect is being discharged home to await surgical repair. In the discharge teaching, the nurse instructs the parents to do which of the following? A. prevent children from crying at all B. observe the child for signs of increased ICP C. obtain training in CPR D. identify growth and development milestones

C

The HCP has an order to administer indomethacin to an infant with a patent ductus arteriosus. Which intervention is a priority to implement? A. assess peripheral pulses B. Auscultate lung sounds C. monitor UO D. monitor HR and rhythm

C

What is the primary therapy for secondary HTN in children? A. low salt diet B. weight reduction C. treatment of cause D. improved exercise and fitness

C

SATA: Which signs best indicate increased ICP in a infant? A. sunken anterior fontanel B. complaints of blurred vision C. high pitched cry D. increased appetite E. sleeping more than usual

C, E

A child with a VP shunt complains of HA and blurry vision and now experiences irritability and sleeping more than usual. The parent ask the nurse what they should do. Select the nurse's best response. A. Give her some acetaminophen, and see if her symptoms improve. If they do not improve, bring her into the ped office. B. It is common for girls to have these symptoms, especially prior to beginning their menstrual cycle. Give her a few days and see if she improves. C. You are probably worried that she is having a problem with her shunt. This is very unlikely as it has been working well for 9 years. D. You should immediately take her to the ED as these may be symptoms of a shunt malfunction.

D

The HCP is caring for a child with congenital heart disease. When planning care, monitoring for which of the following complications will be included in the plan of care? A. Bradycardia and hepatomegaly B. pulmonary HTN and cyanosis C. increased pulmonary compliance and cyanosis D. CHF and hypoxemia

D

The HCP is caring for an infant with a dx of a congenital heart defect. The baby's pulse is 158 and the RR is 74. Which of the following is the best position for the baby to be placed? A. side lying with a blanket roll at the back B. supine with the legs slightly elevated C. prone position with the head elevated D. upright in an infant seat

D

The nurse is caring for an adolescent who remains unconscious 24 hrs after a closed head injury in an MVA. She responds to deep, painful stimulation with decorticate posturing and has an intracranial monitor that shows periodic increased ICP. All vitals are stable. What is the most appropriate nursing action? A. Encourage the teen's peers to visit B. Encourage the parents to hold her hand and speak loudly to her to help her regain consciousness C. Attempt to keep a normal day/night pattern by keeping the teen in a bright, lively environment during the day and a dark environment at night D. Attempt to keep the environment dark and quiet, and encourage minimal stimulation.

D

What clinical manifestation should the nurse expect to find during the assessment of an infant with coarctation of the aorta? A. bounding femoral pulses B. low pressure in the arms C. weak pulses in the arms D. cooler lower extremities

D

What is the name for defects in which blood exiting the heart meets an area of anatomic narrowing? A. mixed B. cyanotic C. acyanotic D. obstructive

D

Which statement by the mother of an infant boy with CHF who is being sent home on dig indicates the need for further education on the care of her child? A. I will give him the med at regular 12hr intervals B. If he vomits I will not repeat the dose C. If I miss a dose, I will not give an extra dose, but keep him on his same schedule D. I will mix the dig in some of his formula to make it taste better for him

D

The HCP is caring for a child with congenital heart disease. When planning care, monitoring for which of the following complications will be included in the plan of care? A. bradycardia and hepatomegaly B. pulmonary HTN and cyanosis C. increased pulmonary compliance and cyanosis D. Congestive heart failure and hypoxemia

D.

A child is being admitted for meningitis. Which procedure should the nurse do first? A. administration of IV antibiotics B. administration of maintenance IV fluids C. placement of foley D. send spinal fluid and blood samples to the lab for culture E. Place child in isolation

E