peds exam 2
The nurse is calculating the amount of expected urinary output for a 24-hour period on a child with bacterial pneumonia who weighs 22 lb. The nurse recognizes the formula to be used is 1 www.testbanktank.com ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number.
240
23. What condition is the leading cause of chronic illness in children? A.Asthma B.Pertussis C.Tuberculosis D.Cystic fibrosis
A
The nurse is caring for a child after cardiac surgery. What interventions should the nurse implement with regard to chest tubes placed to a water-seal drainage system? (Select all that apply.) A.Maintain sterility. B.Check for tube patency. C.Do not interrupt the water-seal drainage system. D.Clamp the chest tube when ambulating the child.
A,b,c
10. The nurse is preparing to admit a 7-year-old child with pulmonary edema. What clinical manifestations should the nurse expect to observe? (Select all that apply.) A.Fever B.Bradycardia C.Diaphoresis D.Pink frothy sputum E.Respiratory crackles
ANS: C, D, E
22. What statement is the most descriptive of asthma? A.It is inherited. B.There is heightened airway reactivity. C.There is decreased resistance in the airway. D.The single cause of asthma is an allergic hypersensitivity.
B
29. What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? A.Fever B.Polyarthritis C.Osler nodes D.Janeway spots
B
10. Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms? A.Severe pain in the ear B.Anorexia and vomiting C. A feeling of fullness in the ear D.Fever as high as 40 C (104 F)
C
14. Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal? A.Irritability when awake B.Capillary refill of more than 5 seconds C.Appropriate weight gain for age
C
3. The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition? A.Has a cough B.Becomes fussy C.Shows signs of an earache D.Has a fever higher than 37.5 C (99 F)
C
44. A 1-year-old has been admitted for complete repair of a tetralogy of Fallot. What assessment finding should the nurse expect to be documented? A.Weight gain B.Pale skin color C.Increasing cyanosis
C
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation? A.Reverse isolation B.Airborne isolation C.Contact Precautions D.Standard Precautions
C
12. The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge? A.It is a safe, frequently used drug. B.Parents lack the expertise necessary to administer digoxin. C.It is difficult to either overmedicate or undermedicate with digoxin. D.Parents need to learn specific, important guidelines for administration of digoxin.
D
16. A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action? A.Assess for neurologic defects. B.Prepare the family for imminent death. C.Begin cardiopulmonary resuscitation. D.Place the child in the kneechest position.
D
19. The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? a.Hypoxemia b.Right-to-left shunt of blood c.Decreased workload on the left side of the heart d.Pulmonary vascular congestion
D
29. Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? A.Hyperactivity of sweat glands B.Hypoactivity of autonomic nervous system C.Atrophic changes in mucosal wall of intestines D.Mechanical obstruction caused by increased viscosity of mucous gland secretions
D
What condition is the leading cause of death after heart transplantation? A.Infection B.Rejection C.Cardiomyopathy D.Heart failure
b
18. A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition? A.Allergies B.Acute pharyngitis C.Foreign body in the nose D.Acute nasopharyngitis
c
After returning from cardiac catheterization, the nurse monitors the childs vital signs. The heart rate should be counted for how many seconds? a. 15 b. 30 c. 60 d. 120
c
13. What nutritional component should be altered in the infant with heart failure (HF)? A.Decrease in fats B.Increase in fluids C.Decrease in protein D. Increase in calories
d
Pancreatic enzymes are administered to the child with cystic fibrosis. What nursing consideration should be included in the plan of care? A.Give pancreatic enzymes between meals if at all possible. B.Do not administer pancreatic enzymes if the child is receiving antibiotics. C.Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools. D.Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
d
The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet? Straw Spoon Sippy cup Open cup
d
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. What nursing action is most appropriate to institute initially? A.Notify the physician. B.Place the child in Trendelenburg position. C.Apply a new bandage with more pressure. D.Apply direct pressure above the catheterization site.
d
The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? A.Hypoxemia B.Right-to-left shunt of blood C.Decreased workload on the left side of the heart D.Pulmonary vascular congestion
d
2. The nurse is calculating the amount of expected urinary output for a 24-hour period on a child with laryngotracheobronchitis who weighs 33 lb. The nurse recognizes the formula to be used is 1 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a who
360
. Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4 C (101.1 F). What action should the nurse perform? A.Report findings to the practitioner. B.Apply a hypothermia blanket. C.Keep the child warm with blankets. D.Record the temperature on the assessment flow sheet.
A
1. Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections? A.They are safer. B.They are less expensive. C.Respiratory secretions are dried by steam vaporizers. D.A more comfortable environment is produced.
A
20. What cardiovascular defect results in obstruction to blood flow? A.Aortic stenosis B.Tricuspid atresia C.Atrial septal defect D.Transposition of the great arteries
A
21. What structural defects constitute tetralogy of Fallot? A.Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy B.Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy C.Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy D.Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
A
24. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition? A.Asthma B.Pneumonia C.Bronchiolitis D.Foreign body in trachea
A
25. A child with asthma is having pulmonary function tests. What rationale explains the purpose of the peak expiratory flow rate? A.To assess severity of asthma B.To determine cause of asthma C.o identify triggers of asthma D.To confirm diagnosis of asthma
A
30. What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? A.Meconium ileus B.History of poor intestinal absorption C.Foul-smelling, frothy, greasy stools D.Recurrent pneumonia and lung infections
A
31. What tests aid in the diagnosis of cystic fibrosis (CF)? A.Sweat test, stool for fat, chest radiography B.Sweat test, bronchoscopy, duodenal fluid analysis C.Sweat test, stool for trypsin, biopsy of intestinal mucosa D.Stool for fat, gastric contents for hydrochloride, radiography
A
34. The parent of a child with cystic fibrosis (CF) 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 signs and symptoms are suggestive of what condition? a. Pneumothorax b. Bronchodilation c. Carbon dioxide retentiond. d.Increased viscosity of sputum
A
36. The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? a.I can use an ice collar on my child for pain control along with analgesics. b.My child should clear the throat frequently to clear the secretions. c.I should allow my child to be as active as tolerated. d.My child should gargle and brush teeth at least three times per day.
A
42. Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? A.Wheezing B.Increased blood pressure C.Increased urine output D.Decreased heart rate
A
47. A 3-month-old infant is admitted to the pediatric unit for treatment of bronchiolitis. The infants vital signs are T, 101.6 F; P, 106 beats/min apical; and R, 70 breaths/min. The infant is irritable and fussy and coughs frequently. IV fluids are given via a peripheral venipuncture. Fluids by mouth were initially contraindicated for what reason? A.Tachypnea B.Paroxysmal cough C.Irritability D.Fever
A
58. What medication is contraindicated in children post tonsillectomy and adenoidectomy? A.Codeine B. Ondansetron (Zofran) C.Amoxil (amoxicillin) D.Acetaminophen (Tylenol)
A
8. An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent? A.Administer all of the prescribed medication. B.Continue medication until all symptoms subside. C.Immediately stop giving medication if hearing loss develops.
A
9. An infants parents ask the nurse about preventing otitis media (OM). What information should be provided? A.Avoid tobacco smoke. B.Use nasal decongestants. C.Avoid children with OM. D.Bottle- or breastfeed in a supine position
A
A 1-year-old child has acute otitis media (AOM) and is being treated with oral antibiotics. What should the nurse include in the discharge teaching to the infants parents? A.A follow-up visit should be done after all medicine has been given. B.After an episode of acute otitis media, hearing loss usually occurs. C.Tylenol should not be given because it may mask symptoms. D.the infant will probably need a myringotomy procedure and tubes.
A
A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which? A.Racemic epinephrine and corticosteroids B.Nebulizer treatments and oxygen C.Antibiotics and albuterol D.Chest physiotherapy and humidity
A
A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother? A.Immediately bring the child to the clinic for evaluation. B.Come to the clinic next week on a scheduled appointment. C.Treat the signs and symptoms with acetaminophen and fluids because it is most likely a viral illness. D.Recognize that the child is trying to manipulate the parent by complaining of vague symptoms.
A
An infant with a congenital heart defect is to receive a dose of palivizumab (Synagis). What is the purpose of this? A.Prevent RSV infection. B.Prevent secondary bacterial infection. C.Decrease toxicity of antiviral agents.
A
Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which information? A.Do not use for more than 3 days. B.Keep drops to use again for nasal congestion. C.Administer drops after feedings and at bedtime. D.Give two drops every 5 minutes until nasal congestion subsides.
A
Nursing care of the child with Kawasaki disease is challenging because of which occurrence? a. The childs irritability b.Predictable disease course c.Complex antibiotic therapy d.The childs ongoing requests for food
A
The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication? A.Pulmonary hypertension B.Right-to-left shunt of blood c. Pulmonary embolismd.
A
What do the initial signs of respiratory syncytial virus (RSV) infection in an infant include? A.Rhinorrhea, wheezing, and fever B.Tachypnea, cyanosis, and apnea C.Retractions, fever, and listlessness
A
When caring for a child after a tonsillectomy, what intervention should the nurse do? A.Watch for continuous swallowing. B.Encourage gargling to reduce discomfort. C.Apply warm compresses to the throat. D. Position the child on the back for sleeping.
A
Which is most important in the immediate care of the newborn? A.Maintain a patent airway. B.Administer prophylactic eye care. C.Maintain a stable body temperature. D.Establish identification of the mother and baby.
A
3. What interventions can the nurse teach parents to do to ease respiratory efforts for a child with a mild respiratory tract infection? (Select all that apply.) A.Cool mist B.Warm mist C.Steam vaporizer D.Keep child in a flat, quiet position E.Run a shower of hot water to produce steam
A,B,C,E
5. The clinic nurse is administering influenza vaccinations. Which children should not receive the live attenuated influenza vaccine (LAIV)? (Select all that apply.) A.A child with asthma B.A child with diabetes C.A child with hemophilia A D.A child with cancer receiving chemotherapy E.A child with gastroesophageal reflux disease
A,B,D
An infant with an isolated cleft lip is being bottle fed. Which actions should the nurse plan to implement to assist with the feeding? (Select all that apply.) A.Use an NUK nipple. B.Use cheek support. C.Enlarge the nipple opening. D.Position the infant upright. E.thicken the formula with rice cereal.
A,B,D
4. A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.) A.Cleft palate B.Seizure disorders C.Blood dyscrasias D.Sickle cell disease E.Acute infection at the time of surgery
A,C,E
A 5-year-old child is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process? A.Fever, cough, and chest pain B.Stridor, wheezing, and ear infection C.Nasal discharge, headache, and cough D.Pharyngitis, intermittent fever, and eye infection
A.
14. The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action? A.Mothers of hospitalized toddlers often experience guilt. B.The mothers presence will reduce anxiety and ease the childs respiratory efforts. C.Separation from the mother is a major developmental threat at this age. D.The mother can provide constant observations of the childs respiratory efforts.
B
3. The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37 C (98.6 F). The nurse suspects mild croup and should recommend which intervention? A.Admit to the hospital and observe for impending epiglottitis. B.Provide fluids that the child likes and use comfort measures. C.Control fever with acetaminophen and call if cough gets worse tonight. D.Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement.
B
33. A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true? A.Given subcutaneously B.May cause voice alterations C.May cause mucus to thicken D.Not indicated for children younger than age 12 years
B
37. The nurse is giving discharge instructions to the parent of a 6-year-old child who had a cardiac catheterization 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? A.My child should not attend school for the next 5 days. B.I should change the bandage every day for the next 2 days. C.My child can take a tub bath but should avoid taking a shower for the next 4 days. D.I should expect the site to be red and swollen for the next 3 days.
B
39. An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented? a. Leukopenia b. Polycythemia c. Anemia
B
46. An infant is diagnosed with transposition of the great vessels. Prostaglandin E1 is given intravenously. The parents ask how long the child will remain on the prostaglandin E1. What is the appropriate response by the nurse? A.Prostaglandin E1 will be given intermittently until corrective surgery is performed. B.Prostaglandin E1 will be given continuously until corrective surgery is performed. C.Prostaglandin E1 will be given continuously throughout the preoperative and postoperative periods until the child is stable. D.Prostaglandin E1 will be given intermittently throughout the preoperative and postoperative periods until the child is stable.
B
48. The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose and draws up 4 ml of the drug. The most appropriate nursing action is which? A.Mix the dose with juice to disguise its taste. B.Do not give the dose; suspect a dosage error. C.Check the heart rate; administer digoxin if the rate is greater than 100 beats/min. D.Check the heart rate; administer digoxin if the rate is greater than 80 beats/min.
B
7. What statement best identifies the cause of heart failure (HF)? A.Disease related to cardiac defects B.Consequence of an underlying cardiac defect C.inherited disorder associated with a variety of defects D.Result of diminished workload imposed on an abnormal myocardium
B
A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action? a. Notify the health care provider. b.Continue to assess for bleeding. c.Give the child a red flavored ice pop. d.Position the child in a Trendelenburg position.
B
A child is recovering from Kawasaki disease (KD). The child should be monitored for which? A.Anemia B.Electrocardiograph (ECG) changes C.Elevated white blood cell count D.Decreased platelet
B
A school-age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone, this means that the asthma control is what? A.80% of a personal best, and the routine treatment plan can be followed. B.50% to 79% of a personal best and needs an increase in the usual therapy. C.50 % of a personal best and needs immediate emergency bronchodilators. D.Less than 50% of a personal best and needs immediate hospitalization.
B
What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? A.Fever B.Polyarthritis C.Osler nodes D.Janeway spots
B
7. The nurse is preparing to admit a 3-year-old child with acute spasmodic laryngitis. What clinical features of hepatitis B should the nurse recognize? (Select all that apply.) A.High fever B.Croupy cough C.Tendency to recur E.Purulent secretions D.Occurs sudden, often at night
B,C,E
The nurse is preparing to admit a 7-year-old child with acute laryngotracheobronchitis (LTB). What clinical manifestations should the nurse expect to observe? (Select all that apply.) A.Dysphagia B.Brassy cough C.Low-grade fever D.Toxic appearance E.Slowly progressive
B,C,E
Children who are taking long-term inhaled steroids should be assessed frequently for what potential complication? www.testbanktank.com A.Cough B.Osteoporosis C.Slowed growth D.Cushing syndrome
C
In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind? A.Fats and proteins must be greatly curtailed. B.Most fruits and vegetables are not well tolerated. C.Diet should be high in calories, proteins, and unrestricted fats. D.Diet should be low fat but high in calories and proteins.
C
The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the childs throat using a tongue depressor might precipitate what condition? A.Sore throat B.Inspiratory stridor C.Complete obstruction DRespiratory tract infection
C
. A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what? A.Tetralogy of Fallot B.Coarctation of the aorta C.Pulmonary stenosis D.V entricular septal defect
D
11. A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner? A.Make her lie down and rest quietly. B.Examine her oral pharynx and report to the physician. C.Auscultate her lungs and prepare for placement in a mist tent. D.Notify the physician immediately and be prepared to assist with a tracheostomy or intubation
D
2. A chest radiography examination is ordered for a child with suspected cardiac problems. The childs parent asks the nurse, What will the x-ray show about the heart? The nurses response should be based on knowledge that the radiograph provides which information? A.Shows bones of the chest but not the heart B.Evaluates the vascular anatomy outside of the heart C.Shows a graphic measure of electrical activity of the heart DSupplies information on heart size and pulmonary blood flow patterns
D
50. Bacterial infective endocarditis (IE) should be treated with which protocol? A.Oral antibiotics for 6 months B.Oral antibiotics (penicillin) for 10 full days C.IV antibiotics, diuretics, and digoxin D.IV antibiotics (penicillin type) for 2 to 8 weeks
D
54. A family requires home care teaching with regard to preventative measures to use at home to avoid an asthmatic episode. What strategy should the nurse teach? A.Use a humidifier in the childs room. B.Launder bedding daily in cold water. C.Replace wood flooring with carpet. D.Use an indoor air purifier with HEPA
D
7. Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39 C (102.2 F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication? A.Decongestants to ease stuffy nose B.Antihistamines to help the child sleep C.Aspirin for pain and fever management D.Benzocaine ear drops for topical pain relief
D
A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action? A.Throat culture B.Nasal pharynx washing C. Administration of corticosteroids D.Emergency intubation
D
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition? A.Otitis media B.Diabetes insipidus (DI) C.Nephrotic syndrome D.Acute rheumatic fever
D
Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their childs cleft lip. Which statement should the nurse give as a response? A.This is a type of deformation and can sometimes be prevented. B.Studies show that taking folic acid during pregnancy can prevent this defect. C.This is a genetic disorder and has a 25% chance of happening with each pregnancy. D.The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.
D
What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? Ephedrine Theophylline Aminophylline Short-acting 2-agonists
D
1. The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system? (Select all that apply.) A.Children with mild persistent asthma have nighttime signs or symptoms less than two times a month. B.Children with moderate persistent asthma use a short-acting -agonist more than two times per week. C.Children with severe persistent asthma have a peak expiratory flow (PEF) of 60% to 80% of predicted value. D.Children with mild persistent asthma have signs or symptoms more than two times per week. E.Children with moderate persistent asthma have some limitations with normal activity. F.Children with severe persistent asthma have frequent nighttime signs or symptoms.
D,E,F
An adolescent is being placed on an ACE inhibitor. What should the nurse inform the adolescent with regard to this medication? (Select all that apply.) a. Stay well hydrated. b.Increase intake of potassium. c.Avoid rapid position changes. d.Take the medication with meals. e.Side effects may include a cough.
a,c,e
. A child is in the hospital for cystic fibrosis. What health care providers prescription should the nurse clarify before implementing? a. Dornase alfa (Pulmozyme) nebulizer treatment bid b.Pancreatic enzymes every 6 hours c.Vitamin A, D, E, and K supplements daily d.Proventil (albuterol) nebulizer treatments tid
b
. The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The childs SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take? A.Withhold feedings. B.Notify the health care provider. C.Put the infant in an infant seat. D.Keep the infant in the plastic hood.
b
10. A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate? A.60 beats/min B.90 beats/min C.100 beats/min D.120 beats/min
b
11. What clinical manifestation is a common sign of digoxin toxicity? A.Seizures B.Vomiting C.Bradypnea D.Tachycardia
b
18. What blood flow pattern occurs in a ventricular septal defect? A.Mixed blood flow B.Increased pulmonary blood flow C.Decreased pulmonary blood flow D.Obstruction to blood flow from ventricles
b
19. The nurse observes flaring of nares in a newborn. What should this be interpreted as? a.Nasal occlusion b.Sign of respiratory distress c.Snuffles of congenital syphilis d. Appropriate newborn breathing
b
22. The 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. How should the nurse reply to this concern? A.The parents should meet all the childs needs. B.The child needs opportunities to play with peers. c. Constant parental supervision is needed to avoid overexertion. d. The child needs to understand that peers activities are too strenuous.
b
23. What preparation should the nurse consider when educating a school-age child and the family for heart surgery? a.Unfamiliar equipment should not be shown. b.Let the child hear the sounds of a cardiac monitor, including alarms. c.Explain that an endotracheal tube will not be needed if the surgery goes well. d.Discussion of postoperative discomfort and interventions is not necessary before the procedure.
b
26. The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurses initial intervention? A.Apply warming blankets. B.Notify the practitioner of these findings. C.Give additional pain medication per protocol. D.Encourage child to cough, turn, and deep breathe.
b
3. A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? A.Preoperative teaching should be directed at his parents because he is too young to understand. B.Preoperative teaching should be adapted to his level of development so that he can understand. C.Preoperative teaching should be done several days before the procedure so he will be prepared. D.Preoperative teaching should provide details about the actual procedures so he will know what to expect.
b
32. A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? A.After chest physiotherapy (CPT) B.Before chest physiotherapy (CPT) C.After receiving 100% oxygen D.Before receiving 100% oxygen
b
38. A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which? A.Serum sodium B.Serum potassium C.Serum glucose D.Serum chloride
b
41. The nurse is teaching parents about administering digoxin (Lanoxin). What instructions should the nurse tell the parents? A.If the child vomits, give another dose. B.Give the medication at regular intervals. C.If a dose is missed, give a give an extra dose. D.Give the medication mixed with the childs formula.
b
A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition? A.Cyanosis B.Heart failure C.Decreased pulmonary blood flow D.Bounding pulses in upper extremities
b
An infant requires surgery for repair of a cleft lip. An important priority of the preoperative nursing care is which? A.Initiating discharge teaching B.Performing baseline physical and behavioral assessment CObserving for allergic reactions to preoperative antibiotics
b
One of the goals for children with asthma is to maintain the childs normal functioning. What principle of treatment helps to accomplish this goal? A.Limit participation in sports. B.Reduce underlying inflammation. C.Minimize use of pharmacologic agents.
b
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. What strategy is an important objective to decrease this risk? A.Minimize seizures. B.Prevent dehydration. C.Promote cardiac output. D.Reduce energy expenditure.
b
1. The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe? (Select all that apply.) A.Osler nodes B.Cervical lymphadenopathy C.Strawberry tongue D.Chorea E.Erythematous palms F.Polyarthritis
b,c,e
9. What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT)? Bed rest Applying ice to the face Administration of atropine Administration of adenosine (Adenocor) Having the child perform a vasalva manuver
b,d,e
Which can be directly attributed to a single-gene disorder? (Select all that apply.) a.Cleft lip b.Cystic fibrosis c.Turner syndrome d.linefelter syndrome e.Neurofibromatosis
b,e
29. During an otoscopic examination on an infant, in which direction is the pinna pulled? A.Up and back B.Up and forward C.Down and back D.Down and forward
c
3. A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next? A.Reduce environmental stimulation to prevent seizures. B.Have the laboratory repeat the analysis with a new specimen. C.Minimize energy expenditure to decrease cardiac workload. D.Administer intravenous fluids to correct the dehydration
c
30. What action by the school nurse is important in the prevention of rheumatic fever (RF)? 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
40. What child has a cyanotic congenital heart defect? A.An infant with patent ductus arteriosus B.A 1-year-old infant with atrial septal defect C.A 2-month-old infant with tetralogy of Fallot
c
47. What medication used to treat heart failure (HF) is a diuretic? A.Captopril (Capten) B.Digoxin (Lanoxin) C.Hydrochlorothiazide (Diuril) D.Carvedilol (Coreg)
c
5. After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond? a.Elevate the affected extremity. b.Notify the practitioner of the observation. c.Record data on the assessment flow record. d.Apply warm compresses to the insertion site.
c
8. The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time? A.Administer oxygen. B.Record data on the nurses notes. C.Report data to the practitioner. D.Place the child in the high Fowler position.
c
A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup? A.A bath in tepid water can help resolve this type of croup. B.Tylenol can help to relieve the cough and stridor. C.A cool mist vaporizer at the bedside can help prevent this type of croup. D.Antibiotics need to be given to reduce the inflammation.
c
A child has a streptococcal throat infection and is being treated with antibiotics. What should the nurse teach the parents to prevent infection of others? A.The child can return to school immediately. B.The organism cannot be transmitted through contact. C.The child can return to school after taking antibiotics for 24 hours. D.The organism can only be transmitted if someone uses a personal item of the sick child.
c
25. What nursing consideration is important when suctioning a young child who has had heart surgery? a.Perform suctioning at least every hour. b.Suction for no longer than 30 seconds at a time. c.Expect symptoms of respiratory distress when suctioning. d.Administer supplemental oxygen before and after suctioning.
d
52. A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal? A.Encourage increased fluid intake. B.Recommend increased use of a budesonide (Pulmicort) inhaler. C.Administer an antitussive to suppress coughing. D.Encourage the child to blow a pinwheel every 6 hours while awake.
d
55. A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having four or five bowel movements per day. The nurses action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what? A.Adequate B.Adequate but should be taken between meals C.Needs to be increased to increase the number of bowel movements per day D.Needs to be increased to decrease the number of bowel movements per day
d
A 6-year-old child is in the hospital for status asthmaticus. Nursing care during this acute period includes which prescribed interventions? A.Prednisolone (Pediapred) PO every day, IV fluids, cromolyn (Intal) inhaler bid B.Salmeterol (Serevent) PO bid, vital signs every 4 hours, spot check pulse oximetry C.Triamcinolone (Azmacort) inhaler bid, continuous pulse oximetry, vital signs once a shift D.Methylprednisolone (Solumedrol) IV every 12 hours, continuous pulse oximetry, albuterol nebulizer treatments every 4 hours and prn
d
A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)? A.Less than 18 mEq/L B.8 to 40 mEq/L C.40 to 60 mEq/L D.Greater than 60 mEq/L
d
What term is defined as the volume of blood ejected by the heart in 1 minute? A.Afterload B.Cardiac cycle C.Stroke volume D.Cardiac output
d
When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? A.Aspirin is contraindicated. B.The principal area of involvement is the joints. C.The childs fever is usually responsive to antibiotics within 48 hours. D.Therapeutic management includes administration of gamma globulin and salicylates.
d
