Peds Test 4

An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify thepractitioner and withhold the medication if the apical pulse is less than _____ beats/min.

70

José is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?

Adapted to his level of development so that he can understand

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

When is it generally recommended that a child with acute streptococcal pharyngitis may return to school?

After taking antibiotics for 24 hours.

Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

Short-acting β2 agonists

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

Which is the most common causative agent of bacterial endocarditis?

Streptococcus viridans

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Sweat chloride test

A child is being admitted to the hospital to be tested for cystic fibrosis (CF). Which tests should the nurse expect?

Sweat chloride test, stool for fat, chest radiograph films

Parents of two school-age children with asthma ask the nurse, "What sports can our children participate in?" The nurse should recommend which sport?

Swimming

A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?

Tetralogy of Fallot

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 nurse's reply should be based on which statement?

The child needs opportunities to play with peers.

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 cystic fibrosis (CF) is receiving recombinant human deoxyribonuclease (DNase). Which is an adverse effect of this medication?

Voice alters

The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is acommon sign of digoxin toxicity?

Vomiting

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 least4 hours.

What is the primary nursing intervention to prevent bacterial endocarditis?

Counsel parents of high-risk children about prophylactic antibiotics.

The nurse is conducting discharge teaching about signs and symptoms of heart failure toparents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include?

Decreased urinary output Sweating (inappropriate) Fatigue

In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?

Diet should be high in carbohydrates and protein

β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. Which describes their action?

Dilate the bronchioles

A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing?

Dyspnea

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which intervention should be included in the child's care? (Select all that apply.)

Encourage the child to drink 8 ounces of formula every 4 hours, Cluster care to encourage adequate rest, Place on noninvasive oxygen monitoring.

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)

Which drug is considered the most useful in treating childhood cardiac arrest?

Epinephrine hydrochloride (Adrenaline)

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.

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

When discussing hyperlipidemia with a group of adolescents, which high level labs should the nurse explain can prevent cardiovascular disease?

High-density lipoproteins (HDLs)

Parents of a child with cystic fibrosis ask the nurse about genetic implications of the disorder. Which statement, made by the nurse, expresses accurately the genetic implications?

If it is present in a child, both parents are carriers of this defective gene.

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

The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heartfailure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?

It decreases edema

A nurse is teaching nursing students about clinical manifestations of cystic fibrosis (CF). Which is/are the earliest recognizable clinical manifestation(s) of CF?

Meconium ileus

Home care is being considered for a young child who is ventilator-dependent. Which factor is most important in deciding whether home care is appropriate?

Preparation and training of family

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.

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.

An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanoticduring a routine blood draw. Which interventions should the nurse implement? Place in order fromthe highest-priority intervention to the lowest-priority intervention. Provide the answer usinglowercase letters separated by commas

b. Place the infant in knee-chest position.a. Administer 100% oxygen by blow-by.d. Give morphine subcutaneously or by an existing intravenous line.c. Remain calm.

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 suchas bananas, oranges, and leafy vegetables. These foods are recommended because they are high inwhich nutrient?

potassium

Effective lone-rescuer CPR on a 5-year-old child should include

two breaths to every 30 chest compressions.

The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?

Complete obstruction

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."

A nurse is teaching an adolescent how to use the peak expiratory flowmeter. The adolescent has understood the teaching if which statement is made?

"I will record the readings at the same time every day."

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."

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 infant's formula."

The Heimlich maneuver is recommended for airway obstruction in children older than _____ year(s).

1

How is chronic otitis media with effusion (OME) differentiated from acute otitis media (AOM)?

A feeling of fullness in the ear

A nurse is admitting an infant with asthma. What usually triggers asthma in infants?

A viral infection

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. What is the priority nursing action?

Apply direct pressure above catheterization site

Which defect results in increased pulmonary blood flow?

Atrial septal defect

An infant's parents ask the nurse about preventing OM. Which should be 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 child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?

Before chest physiotherapy (CPT)

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

Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?

Carotid

A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis?

Nonproductive cough, wheezing

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which action should the nurse include in the child's postoperative care plan? (Select all that apply.)

Notify the surgeon if the child swallows frequently., Place the child on the abdomen until fully wake, Allow the child to have diluted juice after the procedure.

A child is diagnosed with influenza. Management includes which recommendation?

Oseltamivie (Tamiflu)

Pancreatic enzymes are administered to the child with cystic fibrosis (CF). What nursing considerations should be included?

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

The parents of a young child with heart failure tell the nurse that they are "nervous"about giving digoxin (Lanoxin). The nurse's response should be based on which statement?

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

Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?

Peripheral edema

The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?

Polyarthritis