PEDs Exam 2 Sample Questions.
The mother of a 4-week-old infant is tearful. She reports the healthcare provider has told her that her son has a small atrial septal defect. She reports she is worried and asks the nurse more about the condition. Which statement by the parents best indicates an understanding of the nurse's teaching?
"Most of the time this condition spontaneously resolves."
The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which statement by the mother would warrant further investigation?
"The baby seems more comfortable over my shoulder."
The nurse is caring for a newborn diagnosed with an atrial septal defect (ASD). The parents voice concern and state, "I can't believe this is happening. Will our child be okay?" What is the nurse's best response?
"While each case is different, the majority of these defects correct on their own. Let's see what the tests show, then speak with the healthcare provider."
A 7-year-old child with a family history of cardiovascular disease is being screened for hyperlipidemia. When reviewing the child's laboratory test results, which total cholesterol level would be of significant concern?
210 mg/dL (5.44 mmol/L)
An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less ----- than beats/min.
70 beats/min.
The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the healthcare provider if the infant's apical pulse rate was:
80 beats/min.
A 6-month-old infant is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than beats/min.
90 to 110 Beats/mins
Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by:
A feeling of fullness in the ear.
A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?
Dyspnea
Which type of croup is always considered a medical emergency?
Epiglottitis
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which medication for immediate administration?
Epinephrine (Adrenalin)
Clinical manifestations of toxic shock syndrome include:
Erythematous macular rash.
Which is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?
Give small amounts of favorite fluids frequently to prevent dehydration.
Auscultation of a child's heart reveals a loud murmur with a precordial thrill. The nurse documents this as which grade?
Grade IV - A grade IV murmur is loud with a precordial thrill
The nurse is caring for an infant with suspected patent ductus arteriosus. Which assessment finding would the nurse identify as helping to confirm this suspicion?
Harsh, continuous, machine-like murmur under the left clavicle
Which is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?
Heart failure
The nurse is conducting a physical examination of a child with a ventricular septal defect. Which finding would the nurse expect to assess?
Holosystolic harsh murmur along the left sternal border
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
I have to stay on strict bed rest for 3 days.
An 18-month-old child is seen in the clinic with AOM. Trimethoprim- sulfamethoxazole (Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of the instructions?
I should administer all the prescribed medication.
The nurse is caring for a child after heart surgery. Which should the nurse do if evidence is found of cardiac tamponade?
Immediately report this to physician.
The mother of a toddler yells to the nurse, Help! He is choking to death on his food. The nurse determines that lifesaving measures are necessary based on which symptom?
Inability to speak
Which occurs in septic shock?
Increased cardiac output
A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the healthcare provider will most likely order which medication?
Indomethacin
During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital heart disease tell the nurse, "We're just so tired and emotionally spent. All these tests and examinations are overwhelming. We just want to have a normal life. We're so focused on the baby that it seems like our 3-year-old is lost in the shuffle." Which nursing diagnosis would the nurse identify as most appropriate?
Interrupted family processes related to demands of caring for the ill child
A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the healthcare provider to prescribe?
Intravenous immunoglobulin Aspirin
he nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?
It decreases edema.
After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding?
Jerky movements of the face and upper extremities - Sydenham chorea is a movement disorder of the face and upper extremities associated with acute rheumatic fever
Which should the nurse consider when preparing a school-age child and the family for heart surgery?
Let child hear the sounds of an ECG monitor.
A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur?
Loud without a thrill
The nurse is preparing a teaching plan for the parents of a child who has been diagnosed with a congenital heart defect. What would the nurse be least likely to include?
Maintenance of strict bed rest
The nurse is reviewing the medical record of a child with infective endocarditis. What would the nurse expect to find?
Microscopic hematuria with urinalysis Electrocardiogram with prolonged PR interval Petechiae on palpebral conjunctiva
The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which is essential in this childs care?
Monitor arterial blood gases.
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include:
Monitoring pulse oximetry.
The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which finding would the nurse most likely expect to assess if the child had transposition of the great vessels?
Significant cyanosis without presence of a murmur
The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant displays which clinical manifestation?
Signs of an ear-ache
It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because which disease or assessment findings may develop?
Slowed growth
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess?
Strawberry tongue - Dry, fissured lips and a strawberry tongue are common findings
Which is the most common causative agent of bacterial endocarditis?
Streptococcus viridans
A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
Tetralogy of Fallot
he nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. The nurses rationale for this action is described primarily in which statement?
The mothers presence will reduce anxiety and ease childs respiratory efforts.
The nurse is caring for a child that just returned from a coronary arteriogram in which the catheter was placed through the left femoral artery. Which nursing actions demonstrate knowledge of the procedure?
The nurse assesses the dorsalis pedis pulse in the left foot. The nurse assesses the puncture site frequently. The nurse tells the parents that the healthcare provider will discuss the results of the procedure with them.
When caring for the child with Kawasaki disease, the nurse should know which information?
Therapeutic management includes administration of gamma globulin and aspirin.
A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?
There is heightened airway reactivity.
Which explains why cool-mist vaporizers rather than steam vaporizers are recommended in home treatment of childhood respiratory tract infections?
They are safer.
A child with a suspected cardiovascular disorder is to undergo diagnostic testing and is scheduled for an echocardiogram. When explaining this test to the child, what would the nurse most likely include?
"A special wand that picks up sound is used to check your heart."
An infant with congenital heart disease is to undergo surgery to correct the defect. The mother states, "I guess I'm going to have to stop breastfeeding her." Which response by the nurse would be most appropriate?
"Breast milk may help to boost her immune system, so you can continue to use it."
A 9-year-old child has undergone a cardiac catheterization and is being prepared for discharge. The nurse is instructing the parents and child about post-procedure care. Which statement by the parents indicates that the teaching was successful?
"He should avoid taking a bath for about 3 days but he can shower."
The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart failure. The nurse is providing teaching about nutrition. Which statement by the mother indicates a need for further teaching?
"I need to feed him every hour to make sure he eats enough."
A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension. They are discussing nutritional management. Which statement by the adolescent demonstrates understanding of the information?
"I should eat plenty of fresh fruits and vegetables."
A school-age child had an upper respiratory tract infection for several days andthen began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which diagnosis?
Bronchitis
Jos is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:
Adapted to his level of development so that he can understand.
Which is an important nursing consideration when chest tubes will be removed from a child?
Administer analgesics before procedure.
The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next?
Administer next dose as ordered in 12 hours.
Which is an important nursing consideration when suctioning a young child who has had heart surgery?
Administer supplemental oxygen before and after suctioning.
The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?
Administering penicillin
It is generally recommended that a child with acute streptococcal pharyngitis can return to school:
After taking antibiotics for 24 hours.
A child is diagnosed with influenza, probably type A disease. Management includes which recommendation?
Amantadine hydrochloride (Symmetrel) to reduce symptoms
Which type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
Anaphylactic
After assessing a child's blood pressure, the nurse determines the pulse pressure and finds that it is narrowed. What would the nurse identify as associated with this finding?
Aortic Stenosis
The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the 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 catheterization site.
After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow?
Atrial septal defect
Which defect results in increased pulmonary blood flow?
Atrial septal defect
An infants parents ask the nurse about preventing OM. Which shouldbe recommended?
Avoid tobacco smoke.
Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which action?
Avoid using for more than 3 days.
A nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor. Which drug should the nurse be administering?
Captopril (Capoten)
The nurse is assessing a child after a cardiac catheterization. Which complication should the nurse be assessing for?
Cardiac arrhythmia
Which is a common, serious complication of rheumatic fever?
Cardiac valve damage
A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect?
Cause vasodilation
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 which statement?
Child needs opportunities to play with peers.
The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue depressor might precipitate which symptom or condition?
Complete obstruction
Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
Confusion and somnolence
The nurse is assessing a child with suspected infective endocarditis. Which assessment finding would the nurse interpret as a sign of extracardiac emboli?
Roth spots - splinter hemorrhages with pale centers on the sclerae, palate, buccal mucosa, chest, fingers, or toes
A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis?
Nonproductive cough, wheezing
The nurse is caring for an infant with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands?
Organize nursing activities to allow for uninterrupted sleep.
Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?
Osler nodes
The parents of a young child with heart failure tell the nurse that they are nervous about giving digoxin (Lanoxin). The nurses response should be based on which statement?
Parents must learn specific, important guidelines for administration of digoxin.
Which frequency is recommended for childhood skin testing for tuberculosis (TB) using the Mantoux test?
Periodically for children who reside in high-prevalence regions
Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
Peripheral edema
A chest radiograph film is ordered for a child with suspected cardiac problems. The childs parent asks the nurse, What will the radiograph show about the heart? The nurses response should be based on knowledge that the x-ray film will show:
Permanent record of heart size and configuration.
Which consideration is the most important in managing tuberculosis (TB) in children?
Pharmacotherapy
An 8-month-old infant has a hypercyanotic spell while blood is being drawn.The nurses first action should be to:
Place the child in the knee-chest position.
The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
Polyarthritis
As part of the treatment for heart failure, the child takes the diuretic furosemide (Lasix). As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in:
Potassium.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?
Prevent dehydration.
Surgical closure of the ductus arteriosus would
Prevent the return of oxygenated blood to the lungs.
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
Which action by the school nurse is important in the prevention of rheumatic fever?
Refer children with sore throats for throat cultures.
Which is the leading cause of death after heart transplantation?
Rejection
The nurse is teaching nursing students about normal physiologic changes in the respiratory system of toddlers. Which best describes why toddlers have fewer respiratory tract infections as they grow older?
Repeated exposure to organisms causes increased immunity.
Seventy-two hours after cardiac surgery, a young child has a temperature of 101 F. Which action should the nurse take?
Report findings to physician.
A child with suspected dyslipidemia undergoes laboratory testing. The nurse is reviewing the results. Which finding would the nurse interpret as supporting the diagnosis?
Total cholesterol level of 220 mg/dL (5.70 mmol/L) LDL level of 140 mg/dL (3.63 mmol/L)
The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity?
Vomiting
Parents have understood teaching about prevention of childhood otitis media if they make which statement?
We will be sure to keep immunizations up to date.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
When the procedure is done, you will have to keep your leg straight for at least 4 hours.
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?
You may need to increase the caloric density of your infants formula.
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?
Your child must lie quietly; sometimes a mild sedative is administered before the procedure.
A nurse is admitting an infant with asthma. The nurse understands that asthmain infants is usually triggered by:
a viral infection.
The nurse is teaching nursing students about shock that occurs in children. One of the most frequent causes of hypovolemic shock in children is:
blood loss.
The primary nursing intervention to prevent bacterial endocarditis is to:
counsel parents of high-risk children about prophylactic antibiotics.
When discussing hyperlipidemia with a group of adolescents, the nurse should explain that cardiovascular disease can be prevented by high levels of:
high-density lipoproteins (HDLs).
