peds quiz

Nursing care of the infant and child with congestive heart failure includes: 1)force fluids appropriate to age 2)monitor respirations during active periods 3)organize activities to allow uninterrupted sleep 4)give large feedings less often to conserve energy

3

The nurse is monitoring the daily weight of an infant with heart failure. Which finding alerts the nurse to suspect fluid accumulation? 1) Bradypnea 2) Diaphoresis 3) Decreased Blood Pressure 4) A weight gain of 1 lb in 1 day

4

The parent of a child with influenza asks the nurse when the child is most infectious. Which is the nurse's best response? A. "Twenty-four hours before and after the onset of symptoms." B. "Twenty-four hours after the onset of symptoms." C. "One week after the onset of symptoms." D. "One week before the onset of symptoms."

A.

pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dose is 0.07mg/kg/day, and the client weighs 7.2kg. The physician orders the digoxin to be given twice a day. A nurse prepares how much digoxin to administer to the client at each dose?

0.25 mg each dose

A child diagnosed with CHF is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when she is looking at the lights, and her HR is 70 bpm. The nurse expects which laboratory findings? 1) Hypokalemia 2)Hypomagnesemia 3)Hypocalcemia 4) Hypophosphatemia

1

The assessment that would lead the nurse to suspect that a newborn infant has a ventricular septal defect is: 1) a loud, harsh murmur with a systolic thrill 2) cyanosis and crying 3) blood pressure higher in arms than in legs 4)a machinery-like murmur

1

The nurse explains that a ventricular septal defect will allow: 1) blood to shunt left to right, causing increased pulmonary flow and no cyanosis. 2)blood to shunt right to left, causing decreased pulmonary flow and cyanosis. 3) no shunting because of high pressure in the left ventricle. 4)increased pressure in the left atrium, impending circulation of oxygenated blood in circulating volume.

1

The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess the urine output? 1)Weighing the diapers 2)Inserting a urinary catheter 3) Comparing intake and output 4) Measuring water added to formula

1

A pediatrician has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant? 1) During sleep 2) When changing the infant's diaper 3) When the mother is holding the infant 4) When drawing blood for electrolyte level testing

4

The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin. Which statement made by the parent indicates the need for further instructions? 1) "I will not mix the medication with food." 2)"If more than 1 dose is missed, I will call the pediatrician." 3)"I will take my child's pulse before administering the medication." 4)"If my child vomits after medication administration, I will repeat the dose."

4

Twelve hours after cardiac surgery, the nurse is assessing a 3 year old who weighs 15kg. The nurse should notify the surgeon about which of the following clinical findings? 1) a urine output of 60ml in 4 hours 2) strong peripheral pulses in all four extremities 3)fluctuations of fluid in the collection chamber of the chest drainage system 4) Alterations in level of consciousness

4

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. Which of the following is an important objective to decrease this risk? 1) minimize seizures 2) prevent dehydration 3) promote cardiac output 4) reduce energy expenditures

2

The nurse is providing home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement made by the parents indicates a need for further instructions? 1) "A balance of rest and activity is important." 2) I can apply lotion or powder to the incision if it is itchy." 3) "Activities in which my child cold fall need to be avoided for 2-4 weeks." 4) "Larger crowds of people need to be avoided for at least 2 weeks after surgery."

2

The parent's of a 3 month old ask why their baby will not have an operation to correct a ventricular septal defect. The nurse's best response is: 1) "It is always helpful to get a second opinion about any serious condition." 2) "Your baby's defect is small and will likely close on its own by 1 year of age." 3) "It is common for health care providers to wait until an infant develops respiratory distress before they do the surgery." 4) "With a small defect like this, they wait until the child is 10 years old to do the surgery."

2

A concerned mother brings her 3 month old to the clinic. The mother states the infant seems small for its age. In addition, she states the infant fatigues very easily while feeding and rarely finishes a feeding. While collecting a thorough health history, what other signs and symptoms described by the mother may indicate the child has a congenital heart defect, such as ventricular septal defect? Select all that apply: 1) Diarrhea 2) Frequent treatment for lung infections 3) Excessive wet diapers 4) Diaphoresis when nursing 5) Swelling in the hands and feet

2/4/5

A nurse is caring for a child with congenital heart disease who is being treated with digoxin. Which is included in the family's discharge teaching? 1) make sure the medication is taken with food 2)repeat the dose if he child vomits 3) take the child's pulse prior to administration 4) weigh the child daily

3

The nurse is monitoring an infant with congenital heart disease closely for signs of heart failure. The nurse should assess the infant for which Early sign of HF? 1) Pallor 2) Cough 3) Tachycardia 4) Slow/shallow breathing

3

At what age should annual influenza vaccines first be given to children? A. Newborn B. Six weeks C. Three months D. Six months

D

A 6-week-old is admitted to the hospital with influenza. The child is crying, and the father tells the nurse that his son is hungry. The nurse explains that the baby is not to have anything by mouth. The parent does not understand why the child cannot eat. Which is the nurse's best response to the parent? A. "We are giving your child intravenous fluids, so there is no need for anything by mouth." B. "The shorter and narrower airway of infants increases their chances of aspiration so your child should not have anything to eat now." C. "When your child eats, he burns too many calories; we want to conserve the child's energy." D. "Your child has too much nasal congestion; if we feed the child by mouth, the distress will likely increase."

B.

A nine-month old is admitted with influenza. Which statement made by the nurse would be the best response when caring for this infant? A. "This infection could have been prevented if the parents washed their hands at home." B. "Antibiotics should be given as soon as a diagnosis is made to prevent further infection." C. "Supportive care such as encouraging fluids to liquify secretions will help prevent dehydration." D. "Antiviral medications such as Oseltamivir (Tamiflu) can be given at any time during the illness."

C

Signs of respiratory distress in a newborn are: Grunting, Retractions, Stridor, Wheezing, Unequal breath sounds.

True

A 4 month old is scheduled to take Digoxin for treatment of ventricular septal defect. The patient's apical pulse is 89 bpm. As the nurse you will? Select all that apply: 1) Hold the dose 2) Recheck the pulse via the brachial artery 3) Administer the dose as scheduled 4) Notify the physician

1/4

Discharge teaching for a three month old infant with a cardiac defect who is to receive Digoxin which action would you include? Select All 1) Give medication at regular intervals 2)Mix the medication with a small volume of breastmilk or formula 3) Repeat the dose one time for the child who vomits immediately after administration 4) Notify the provider of poor feeding or vomiting 5) Make up and missed doses as soon as realized 6) Notify the provider if more than two consecutive doses are missed

1/4/6

The nurse is assessing a premature newborn for manifestations of respiratory distress syndrome, which include... 1) nasal flaring 2)clubbing of the fingers 3)tracheal deviation 4)bradypnea

1. nasal flaring

How would the nurse caring for an infant with congestive heart failure modify feeding techniques to adapt for the child's weakness and fatifue? 1) Feeding more frequently with smaller feedings 2) Use a soft nipple with enlarged holes 3) Hold and cuddle the child during feeding 4). Substitute glucose water for formula 5) Offer high caloric formula

1/2/3/5

A 7-month-old has a low-grade fever, nasal congestion, and a mild cough. What should the nursing care management of this child include? Select all that apply. A. Maintaining strict bedrest. B. Avoiding contact with family members. C. Instilling saline nose drops and bulb suctioning. D. Keeping the head of the bed flat. E. Providing humidity, and propping the head of the bed up.

Answer: C,E-Infants are nose breathers and often have increased difficulty when they are congested. Nasal saline drops and gentle suctioning with a bulb syringe are often recommended.

A Ventricular septal defect may spontaneously closes within the first 24 months of life.

False

Ventricular sepal defect blood shunts from right to left.

False

Symptoms of V.S.D. are failure to thrive, frequent respiratory infections, and a murmur.

True

T/F 1-year old's Heart Rate: 90-130 Respirations: 20-40 bpm BP average is 90/56

True