Peds T6 questions

The nurse is caring for an infant with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands? a. Organize nursing activities to allow for uninterrupted sleep. b. Allow the infant to sleep through feedings during the night. c. Wait for the infant to cry to show definite signs of hunger. d. Discourage parents from rocking the infant

a. Organize nursing activities to allow for uninterrupted sleep.

...Hema

...

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain that narcotic analgesics: a. Are often ordered but not usually needed. b. Rarely cause addiction because they are medically indicated. c. Are given as a last resort because of the threat of addiction. d. Are used only if other measures such as ice packs are ineffective.

b. Rarely cause addiction because they are medically indicated.

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if what conditions occur (Select all that apply)? a. Respiratory rate of 36 at rest b. Appetite slowly increasing c. Temperature above 37.7 C (100 F) d. New, frequent coughing e. Turning blue or bluer than normal

c. Temperature above 37.7 C (100 F) d. New, frequent coughing e. Turning blue or bluer than normal

The parents of a young child with congestive heart failure tell the nurse that they are nervous about giving digoxin. The nurses response should be based on knowing that: a. It is a safe, frequently used drug. b. It is difficult to either overmedicate or undermedicate with digoxin. c. Parents lack the expertise necessary to administer digoxin. d. Parents must learn specific, important guidelines for administration of digoxin.

d. Parents must learn specific, important guidelines for administration of digoxin.

Surgical closure of the ductus arteriosus would: a. Stop the loss of unoxygenated blood to the systemic circulation. b. Decrease the edema in legs and feet. c. Increase the oxygenation of blood. d. Prevent the return of oxygenated blood to the lungs.

d. Prevent the return of oxygenated blood to the lungs.

Several complications can occur when a child receives a blood transfusion. An immediate sign or symptom of an air embolus is: a. Chills and shaking. b. Nausea and vomiting. c. Irregular heart rate. d. Sudden difficulty in breathing.

d. Sudden difficulty in breathing

When caring for the child with Kawasaki disease, the nurse should understand that: a. The childs fever is usually responsive to antibiotics within 48 hours. b. The principal area of involvement is the joints. c. Aspirin is contraindicated. d. Therapeutic management includes administration of gamma globulin and aspirin.

d. Therapeutic management includes administration of gamma globulin and aspirin.

For what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right-to-left shunt receive prostaglandin E1? a. To decrease inflammation b. To control pain c. To decrease respirations d. To improve oxygenation

d. To improve oxygenation

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" The nurse bases a response on the understanding that clubbing occurs as a result of: a. untreated congestive heart failure. b. a left-to-right shunting of blood. c. decreased cardiac output. d. chronic hypoxia.

d. chronic hypoxia.

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

d. lower in the legs than in the arms.

The nursing diagnosis Decreased Cardiac Output related to cardiac anomaly (VSD) has been identified for a child with congestive heart failure. An intervention associated with this diagnosis is a. measure abdominal girth as ordered. b. elevate the extremities. c. weigh child every other day. d. place child in semi-Fowler's position.

d. place child in semi-Fowler's position.

Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7 C (101 F). The nurse should: a. Keep the child warm with blankets. b. Apply a hypothermia blanket. c. Record the temperature on nurses notes. d. Report findings to physician.

d. report to physician

A nurse providing discharge instructions to parents of an infant with congestive heart failure advises them to have developmental assessment performed on the baby at 2- to 3-month intervals. The rationale for this recommendation is a. to determine if the heart medications prescribed are causing developmental slowness. b. to see if the parents are coping with the child's heart problems effectively. c. to ensure the child is receiving maximum stimulation. d. to evaluate disease management and observe development.

d. to evaluate disease management and observe development.

When auscultating the heart of a patient with an atrial septal defect (ASD), the healthcare provider hears a split S2. What is the significance of this heart sound? a. When the ventricles fill rapidly the split S2 is produced. b. The split S2 is produced when the mitral valve opens with a snap. c. Because closure of the pulmonary valve is delayed in ASD, a split S2 is produced. d. The S2 is normally split so this is not a significant finding.

c. Because closure of the pulmonary valve is delayed in ASD, a split S2 is produced.

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures? a. Pulmonary congestion b. Congenital heart defect c. Congestive heart failure d. Systemic venous congestion

c. Congestive heart failure

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include (Select all that apply)? a. Warm flushed extremities b. Weight loss c. Decreased urinary output d. Sweating (inappropriate) e. Fatigue

c. Decreased urinary output d. Sweating (inappropriate) e. Fatigue

Children receiving long-term systemic corticosteroid therapy are most at risk for: a. Hypotension. b. Dilation of blood vessels in the cheeks. c. Growth delays. d. Decreased appetite and weight loss.

c. Growth delays

Which statement best describes b-thalassemia major (Cooleys anemia)? a. All formed elements of the blood are depressed. b. Inadequate numbers of red blood cells are present. c. Increased incidence occurs in families of Mediterranean extraction. d. Increased incidence occurs in persons of West African descent.

c. Increased incidence occurs in families of Mediterranean extraction

Which statement most accurately describes the pathologic changes of sickle cell anemia? a. Sickle-shaped cells carry excess oxygen. b. Sickle-shaped cells decrease blood viscosity. c. Increased red blood cell destruction occurs. d. Decreased red blood cell destruction occurs.

c. Increased red blood cell destruction occurs.

A nurse is teaching an adolescent about primary hypertension. The nurse knows that which of the following is correct? a. Primary hypertension should be treated with diuretics as soon as it is detected. b. Congenital heart defects are the most common cause of primary hypertension. c. Primary hypertension may be treated with weight reduction. d. Primary hypertension is not affected by exercise.

c. Primary hypertension may be treated with weight reduction.

The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child? a. Game of hide and seek in the childrens outdoor play area b. Participation in dance activities in the playroom c. Puppet play in the childs room d. A walk down to the hospital lobby

c. Puppet play in the childs room

Which action by the school nurse is important in the prevention of rheumatic fever? a. Encourage routine cholesterol screenings. b. Conduct routine blood pressure screenings. c. Refer children with sore throats for throat cultures. d. Recommend salicylates instead of acetaminophen for minor discomforts.

c. Refer children with sore throats for throat cultures.

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurses first action should be to: a. Assess for neurologic defects. b. Place the child in the knee-chest position. c. Begin cardiopulmonary resuscitation. d. Prepare the family for imminent death.

b. Place the child in the knee-chest position.

A 5-year-old child with a congenital heart defect is to receive digoxin PO. Prior to administration, the healthcare provider checks the most recent laboratory report. Which laboratory value should be of most concern to the healthcare provider? A. Potassium 3.2 B. Digoxin level 0.8 C. Hemoglobin 10 D. Creatinine 0.4

A. Potassium 3.2

The healthcare provider is planning the discharge for a child with a 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 season. B. Ensure the parents know how to take the child's blood pressure at home. C. Advise the family provide meals that are low in fat and calories. D. Suggest quiet activities for the child to decrease physical activity.

A. Provide instructions for a monthly immunoglobulin shot during RSV season.

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:

Apply direct pressure above the catheterization site.

The healthcare provider has an order to administer indomethacin to an infant with a patent ductus arteriosus. Which intervention is a priority to implement? B. Assess peripheral pulses C. Auscultate lung sounds D. Monitor urine output E. Monitor heart rate and rhythm

D. Monitor urine output

The healthcare provider is caring for an infant with a diagnosis of a congenital heart defect. The baby's pulse is 158 and the respiratory rate is 74. Which of the following is the best position for the baby to be placed? B. Side-lying with a blanket roll at the back C. Supine with the legs slightly elevated D. Prone position with the head elevated E. Upright in an infant seat

E. Upright in an infant seat

Which statement best explains why iron deficiency anemia is common during toddlerhood? a. Milk is a poor source of iron. b. Iron cannot be stored during fetal development. c. Fetal iron stores are depleted by age 1 month. d. Dietary iron cannot be started until age 12 months.

a. Milk is a poor source of iron.

The most appropriate nursing diagnosis for a child with anemia is: a. Activity Intolerance related to generalized weakness. b. Decreased Cardiac Output related to abnormal hemoglobin. c. Risk for Injury related to depressed sensorium. d. Risk for Injury related to dehydration and abnormal hemoglobin.

a. Activity Intolerance related to generalized weakness.

The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement? a. Administering penicillin b. Avoiding salicylates (aspirin) c. Imposing strict bed rest for 4 to 6 weeks d. Administering corticosteroids if chorea develops

a. Administering penicillin

In which condition are all the formed elements of the blood simultaneously depressed? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Iron deficiency anemia

a. Aplastic anemia

What is the nurses first action when planning to teach the parents of an infant with a congenital heart defect (CHD)? a. Assess the parents anxiety level and readiness to learn. b. Gather literature for the parents. c. Secure a quiet place for teaching. d. Discuss the plan with the nursing team.

a. Assess the parents anxiety level and readiness to learn.

A 30-year-old patient with a congenital atrial septal defect has lived with the defect without significant problems until now. Which of the following is an indication that the patient is becoming hemodynamically symptomatic? a. Bronchoconstriction and wheezing b. Exertional dyspnea c. Intermittent claudication d. Blood pressure 140/90

a. Bronchoconstriction and wheezing

The school nurse is informed that a child with human immunodeficiency virus (HIV) will be attending school soon. Which is an important nursing intervention? a. Carefully follow universal precautions. b. Determine how the child became infected. c. Inform the parents of the other children. d. Reassure other children that they will not become infected.

a. Carefully follow universal precautions.

Which home care instructions should the nurse provide to the parents of a child with acquired immunodeficiency syndrome (AIDS) (Select all that apply)? a. Give supplemental vitamins as prescribed. b. Yearly influenza vaccination should be avoided. c. Administer trimethoprim-sulfamethoxazole (Bactrim) as prescribed. d. Notify the physician if the child develops a cough or congestion. e. Missed doses of antiretroviral medication do not need to be recorded.

a. Give supplemental vitamins as prescribed. c. Administer trimethoprim-sulfamethoxazole (Bactrim) as prescribed. d. Notify the physician if the child develops a cough or congestion.

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia? a. Immobilization and elevation of the affected joint b. Administration of acetaminophen for pain relief c. Assessment of the childs response to hospitalization d. Assessment of the impact of hospitalization on the family system

a. Immobilization and elevation of the affected joint

The healthcare provider is caring for a patient with a congenital heart defect and is reviewing fetal circulation. Which of the following statements most accurately explains the major difference between fetal circulation and the circulation established after birth? Select all that apply. a. Oxygenated blood flows from the placenta through the umbilical vein to the fetus. b. After the umbilical cord is cut, the foramen ovale opens to allow more blood flow to the lungs. c. In the fetus, the ductus arteriosus diverts most of the blood away from the lungs. d. The ductus venosis closes after birth so blood is no longer diverted from the ventricles to the atria. e. Systemic vascular resistance is lower than pulmonary vascular resistance in the fetus.

a. Oxygenated blood flows from the placenta through the umbilical vein to the fetus. c. In the fetus, the ductus arteriosus diverts most of the blood away from the lungs. e. Systemic vascular resistance is lower than pulmonary vascular resistance in the fetus.

What is the most common mode of transmission of human immunodeficiency virus (HIV) in the pediatric population? a. Perinatal transmission b. Sexual abuse c. Blood transfusions d. Poor hand washing

a. Perinatal transmission

A major clinical manifestation of rheumatic fever is: a. Polyarthritis. b. Oslers nodes. c. Janeway spots. d. Splinter hemorrhages of distal third of nails.

a. Polyarthritis. Polyarthritis is swollen, hot, red, and painful joints. The affected joints will change every 1 to 2 days. Primarily the large joints are affected.

The nurse is planning care for an adolescent with acquired immunodeficiency syndrome. The priority nursing goal is to: a. Prevent infection. b. Prevent secondary cancers. c. Restore immunologic defenses. d. Identify source of infection.

a. Prevent infection

Which structural defects constitute tetralogy of Fallot? a. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy b. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy d. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

a. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

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. The nurses reply should be based on knowing that: a. The child needs opportunities to play with peers. b. The child needs to understand that peers activities are too strenuous. c. Parents can meet all the childs needs. d. Constant parental supervision is needed to avoid overexertion.

a. The child needs opportunities to play with peers.

In which situation is there the greatest risk that a newborn infant will have a congenital heart defect (CHD)? a. Trisomy 21 detected on amniocentesis b. Family history of myocardial infarction c. Father has type 1 diabetes mellitus d. Older sibling born with Turners syndrome

a. Trisomy 21 detected on amniocentesis

Which intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure? a. Weigh the infant every day on the same scale at the same time. b. Notify the physician when weight gain exceeds more than 20 g/day. c. Put the infant in a car seat to minimize movement. d. Administer digoxin (Lanoxin) as ordered by the physician.

a. Weigh the infant every day on the same scale at the same time.

The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct? a. You may need to increase the caloric density of your infants formula. b. You should feed your baby every 2 hours. c. You may need to increase the amount of formula your infant eats with each feeding. d. You should place a nasal oxygen cannula on your infant during and after each feeding.

a. You may need to increase the caloric density of your infants formula.

The assessment that would lead the nurse to suspect that a newborn infant has a ventricular septal defect is: a. a loud, harsh murmur with a systolic tremor. 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 tremor.

The nurse explains 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.

An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because blood is: a. circulated through the lungs again, causing pulmonary circulatory congestion. b. shunted past the pulmonary circulation, causing pulmonary hypoxia. c. shunted past cardiac arteries, causing myocardial hypoxia. d. circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

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

A beneficial effect of administering digoxin (Lanoxin) is that it: a. Decreases edema. b. Decreases cardiac output. c. Increases heart size. d. Increases venous pressure.

a. decreases edema

A possible cause of acquired aplastic anemia in children is: a. Drugs. b. Injury. c. Deficient diet. d. Congenital defect.

a. drugs

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

a. hold him against my shoulder with his knees bent up toward his chest."

When a father asks why his child with tetralogy of Fallot seems to favor a squatting position, the nurse would explain that squatting: a. increases the return of venous blood back to the heart. b. decreases arterial blood flow away from the heart. c. is a common resting position when a child is tachycardic. d. increases the workload of the heart.

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

The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" The nurse's response is based on the understanding that: 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.

The nurse caring for a child with congestive heart failure knows the symptoms of fatigue and dizziness are associated with a. peripheral vasoconstriction and decreased blood flow to internal organs. b. increased blood flow to the internal organs. c. a compensatory response by the cardiac system. d. a sign of pulmonary edema.

a. peripheral vasoconstriction and decreased blood flow to internal organs.

A child with congestive heart failure has an apical pulse rate of 72. The child tells the nurse that he was sick yesterday and vomited up his pills and that is why he feels weak and tired and had to come to the hospital. The doctor's orders are to discontinue home medication except for the child's digoxin and furosemide. Prior to giving the child his digoxin the nurse should a. take his apical pulse and contact the physician if the rate is below 80. b. perform a respiratory assessment; if crackles are present, give the medication. c. evaluate intake and output; if within normal limits, give the medication. d. check potassium level; if it is normal, give the medication.

a. take his apical pulse and contact the physician if the rate is below 80.

Which defect results in increased pulmonary blood flow?

atrial septal defect

The comment made by a parent of a 1-month-old that would alert the nurse about the presence of a congenital heart defect is: 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."

A school-age child is admitted in vaso-occlusive sickle cell crisis. The childs care should include: a. Correction of acidosis. b. Adequate hydration and pain management. c. Pain management and administration of heparin. d. Adequate oxygenation and replacement of factor VIII.

b. Adequate hydration and pain management.

What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate, is sweating, and is not feeding well? a. Recheck the infants blood pressure. b. Alert the physician. c. Withhold oral feeding. d. Increase the oxygen rate.

b. Alert the physician.

The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child (Select all that apply)? a. Fingersticks for blood work instead of venipunctures b. Avoidance of intramuscular (IM) injections c. Acetaminophen (Tylenol) for mild pain control d. Soft toothbrush for dental hygiene e. Administration of packed red blood cells

b. Avoidance of intramuscular (IM) injections c. Acetaminophen (Tylenol) for mild pain control d. Soft toothbrush for dental hygiene

A young child with human immunodeficiency virus is receiving several antiretroviral drugs. The purpose of these drugs is to: a. Cure the disease. b. Delay disease progression. c. Prevent spread of disease. d. Treat Pneumocystis jiroveci pneumonia.

b. Delay disease progression

Chelation therapy is begun on a child with b-thalassemia major. The purpose of this therapy is to: a. Treat the disease. b. Eliminate excess iron. c. Decrease the risk of hypoxia. d. Manage nausea and vomiting.

b. Eliminate excess iron.

The healthcare provider is caring for a 48-hour-old neonate showing clinical signs of a patent ductus arteriosus. Which of the following would the healthcare provider expect to find in this baby's perinatal history? Select all that apply. a. Blood glucose: 50mg/dL (2.8 mmol/L) b. Late decelerations during labor c. 35 5/7 weeks gestation d. Cesarean section delivery e. Apgar scores: 5 at 1 minute, 7 at 5 minutes

b. Late decelerations during labor e. Apgar scores: 5 at 1 minute, 7 at 5 minutes

When preparing a school-age child and the family for heart surgery, the nurse should consider: a. Not showing unfamiliar equipment. b. Letting child hear the sounds of an electrocardiograph monitor. c. Avoiding mentioning postoperative discomfort and interventions. d. Explaining that an endotracheal tube will not be needed if the surgery goes well.

b. Letting child hear the sounds of an electrocardiograph monitor.

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease (Select all that apply)? a. Limit fluids at bedtime. b. Notify the health care provider if a fever of 38.5 C (101.3 F) or greater occurs. c. Give penicillin as prescribed. d. Use ice packs to decrease the discomfort of vaso-occlusive pain in the legs. e. Notify the health care provider if your child begins to develop symptoms of a cold.

b. Notify the health care provider if a fever of 38.5 C (101.3 F) or greater occurs. c. Give penicillin as prescribed. e. Notify the health care provider if your child begins to develop symptoms of a cold.

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect? a. Pulmonary stenosis b. Patent ductus arteriosus c. Ventricular septal defect d. Coarctation of the aorta

b. Patent ductus arteriosus

The nurse is caring for a child with aplastic anemia. Which nursing diagnoses are appropriate (Select all that apply)? a. Acute Pain related to vaso-occlusion b. Risk for Infection related to inadequate secondary defenses or immunosuppression c. Ineffective Protection related to thrombocytopenia d. Ineffective Tissue Perfusion related to anemia e. Ineffective Protection related to abnormal clotting

b. Risk for Infection related to inadequate secondary defenses or immunosuppression c. Ineffective Protection related to thrombocytopenia d. Ineffective Tissue Perfusion related to anemia

A condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin is: a. Aplastic anemia. b. Sickle cell anemia. c. Thalassemia major. d. Iron deficiency anemia.

b. Sickle cell anemia.

Parents of a school-age child with hemophilia ask the nurse, Which sports are recommended for children with hemophilia? Which sports should the nurse recommend (Select all that apply)? a. Soccer b. Swimming c. Basketball d. Golf e. Bowling

b. Swimming d. Golf e. Bowling

A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow? a. Atrial septal defect b. Tetralogy of Fallot c. Ventricular septal defect d. Patent ductus arteriosus

b. Tetralogy of Fallot

Which immunization should be given with caution to children infected with HIV? a. Influenza b. Varicella c. Pneumococcus d. Inactivated poliovirus

b. Varicella

During an examination of an infant with a patent ductus arteriosus (PDA), the healthcare provider should expect to observe: Select all that apply. a. Profound cyanosis b. Widening pulse pressure c. Systolic murmur d. Bounding peripheral pulses e. Clubbing of fingers and toes

b. Widening pulse pressure c. Systolic murmur d. Bounding peripheral pulses

A mother asks the nurse if she still can breastfeed her newborn baby if the baby has congestive heart failure. The best nursing response is a. It would be easier for your child to get the breast milk from a bottle so she won't tire so easily. b. Yes, breastfeeding would be good for your baby. Your baby may have to rest frequently during feeding. c. I can understand why you want to breastfeed but it won't be possible. d. No, breast milk is too high in sodium.

b. Yes, breastfeeding would be good for your baby. Your baby may have to rest frequently during feeding.

One of the most frequent causes of hypovolemic shock in children is: a. Myocardial infarction. b. Blood loss. c. Anaphylaxis. d. Congenital heart disease.

b. blood loss

A mother brought her 4-month-old infant into the health department for immunizations. During the pre-screening interview she tells the nurse that her baby was born with a small congenital heart defect and that the baby will see the pediatric cardiologist in a week. The infant seems very lethargic and his general color is poor. The mother states the baby doesn't eat very much and just sleeps most of the time. The most appropriate nursing action is a. provide the immunizations as scheduled and explain to the mother that she needs to discuss the baby's eating problems when she sees the doctor. b. call the infant's doctor and explain your observations. c. call the medical director for permission to give the child the scheduled immunizations. d. provide the immunization as scheduled. A small congenital heart defect is not a reason to defer immunizations.

b. call the infant's doctor and explain your observations.

A child develops carditis from rheumatic fever. The nurse knows that the areas of the heart affected by carditis are the: 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.

The nurse is evaluating a child who is taking digoxin for her cardiac condition. The nurse is cognizant that a common sign of digoxin toxicity is: a. Seizures. b. Vomiting. c. Bradypnea. d. Tachycardia.

b. vomiting

An appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant would be: 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.

Which child should the nurse document as being anemic? a. 7-year-old child with a hemoglobin of 11.5 g/dL b. 3-year-old child with a hemoglobin of 12 g/dL c. 14-year-old child with a hemoglobin of 10 g/dL d. 1-year-old child with a hemoglobin of 13 g/dL

c. 14-year-old child with a hemoglobin of 10 g/dL

Which condition is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ Tcells? a. Wiskott-Aldrich syndrome b. Idiopathic thrombocytopenic purpura (ITP) c. Acquired immunodeficiency syndrome (AIDS) d. Severe combined immunodeficiency disease

c. Acquired immunodeficiency syndrome (AIDS)

When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that: a. They should be given with meals. b. They should be stopped immediately if nausea and vomiting occur. c. Adequate dosage will turn the stools a tarry green color. d. Preparation should be allowed to mix with saliva and bathe the teeth before swallowing.

c. Adequate dosage will turn the stools a tarry green color.

An important nursing consideration when chest tubes will be removed from a child is to: a. Explain that it is not painful. b. Explain that only a Band-Aid will be needed. c. Administer analgesics before the procedure. d. Expect bright red drainage for several hours after removal.

c. Administer analgesics before the procedure.

An important nursing consideration when suctioning a young child who has had heart surgery is to: a. Perform suctioning at least every hour. b. Suction for no longer than 30 seconds at a time. c. Administer supplemental oxygen before and after suctioning. d. Expect symptoms of respiratory distress when suctioning.

c. Administer supplemental oxygen before and after suctioning.

As related to inherited disorders, which statement is descriptive of most cases of hemophilia? a. Autosomal dominant disorder causing deficiency in a factor involved in the blood-clotting reaction b. X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding c. X-linked recessive inherited disorder in which a blood-clotting factor is deficient d. Y-linked recessive inherited disorder in which the red blood cells become moon shaped

c. X-linked recessive inherited disorder in which a blood-clotting factor is deficient

A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response? a. You will be able to hold your child during the procedure. b. Your child can be active during the procedure, but cant sit in your lap. c. Your child must lie quietly; sometimes a mild sedative is administered before the procedure. d. The procedure is invasive so your child will be restrained during the echocardiogram.

c. Your child must lie quietly; sometimes a mild sedative is administered before the procedure.

When assessing a child for possible congenital heart defects (CHDs), where should the nurse measure blood pressure? a. The right arm b. The left arm c. All four extremities d. Both arms while the child is crying

c. all 4 extremities

A nurse has identified Altered Growth and Development related to low energy level as a nursing diagnosis for a child with congestive heart failure. A goal associated with this diagnosis is a. perform baseline developmental assessment. b. child displays normal development for age. c. child will meet developmental milestones for age. d. short play period maintains energy and facilitates play.

c. child will meet developmental milestones for age.

To facilitate feeding in an infant that tires when eating, the nurse should a. provide cold liquid formula. b. put honey on the nipple of the formula bottle. c. hold the infant at a 45-degree angle while feeding. d. encourage activity before eating so the infant is hungry.

c. hold the infant at a 45-degree angle while feeding.

A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is: a. Tachypnea. b. Tachycardia. c. Peripheral edema. d. Pale, cool extremities.

c. peripheral edema

A common, serious complication of rheumatic fever is: a. Seizures. b. Cardiac arrhythmias. c. Pulmonary hypertension. d. Cardiac valve damage.

d. Cardiac valve damage.

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of: a. Air embolism. b. Allergic reaction. c. Hemolytic reaction. d. Circulatory overload.

d. Circulatory overload.

The healthcare provider 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 hypotension and cyanosis c. Increased pulmonary compliance and cyanosis d. Congestive heart failure and hypoxemia

d. Congestive heart failure and hypoxemia

An accurate description of anemia is: a. Increased blood viscosity. b. Depressed hematopoietic system. c. Presence of abnormal hemoglobin. d. Decreased oxygen-carrying capacity of blood.

d. Decreased oxygen-carrying capacity of blood.

What is an expected assessment finding in a child with coarctation of the aorta? a. Orthostatic hypotension b. Systolic hypertension in the lower extremities c. Blood pressure higher on the left side of the body d. Disparity in blood pressure between the upper and lower extremities

d. Disparity in blood pressure between the upper and lower extremities

The nursing care plan for a newborn baby with a possible congenital heart defect has identified Decreased Cardiac Output as a nursing diagnosis for the baby. The rationale for choosing this diagnosis is a. The percentage of body weight that is composed of water is less than normal in a child with a congenital heart defect. b. Oxygen requirements are low during the first eight weeks of life and the infant has little cardiac reserve. c. Children respond to severe hypoxemia by increasing their heart rate; and with low cardiac reserve they quickly go into failure. d. Infants are more sensitive to volume or pressure overload.

d. Infants are more sensitive to volume or pressure overload.

The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breastfed infant. What should she or he suggest? a. Iron (ferrous sulfate) drops after age 1 month. b. Iron-fortified commercial formula can be used by ages 4 to 6 months. c. Iron-fortified infant cereal can be introduced at age 2 months. d. Iron-fortified infant cereal can be introduced at approximately 6 months of age.

d. Iron-fortified infant cereal can be introduced at approximately 6 months of age.

Which postoperative intervention should be questioned for a child after a cardiac catheterization? a. Continue intravenous (IV) fluids until the infant is tolerating oral fluids. b. Check the dressing for bleeding. c. Assess peripheral circulation on the affected extremity. d. Keep the affected leg flexed and elevated.

d. Keep the affected leg flexed and elevated.

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis? a. Circulatory collapse b. Cardiomegaly, systolic murmurs c. Hepatomegaly, intrahepatic cholestasis d. Painful swelling of hands and feet, painful joints

d. Painful swelling of hands and feet, painful joints