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Test 3- child health
child health test 3
94
Nursing
Not Applicable
10/07/2013
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Term
A pediatric client has congestive heart failure and is receiving digoxin therapy. Which laboratory value is most important to evaluate when preparing to administer the digoxin?
 Definition
Serum potassium levels
Term
A 1 week old infant has been in the pediatric unit for 18 hours following placement of a spica cast. The nurse notes that the respiratory rate is less than 24 breaths/min. NO other changes are observed, and because the infant is apparently well, there is no report or documentation of the slow respiratory rate. Several hours later, the infant experience severe respiratory distress and emergency care is necessary. Legal responsibility in this instance should take into consideration that:
 Definition
Vital signs that are outside the expected parameters are significant and should be documented.
Term
A child is admitted to the hospital with a diagnosis of laryngotracheobronchitis. The nurse should be prepared to:
 Definition
Administer racemic epinephrine and oral dexamethasone.

Sputum specimen and throat swabs are not warranted. Antibiotics and intubation are associated with epiglottis. Nebulized epinephrine and steroids are indicated for LTB
Term
When caring for a child with croup, what should be the nurse's priority action?
 Definition
Continually assess respiratory status
Term
A chld with cystic fibrosis has been hospitalized with bacterial pneumonia. the nurse determines that the child has no known allergies. Selection of the antibiotic to treat the pneumonia depends primarily on the:
 Definition
Sensitivity of the bacteria
Term
A child is admitted with epiglottitis and needs an xray. The nurse orders the xray to be done:
 Definition
by portable radiograph in the child's hospital room.

The child needs to stay in the emergency room with emergency equipment and trained personnel. Portable xray in the exam room will be ordered.
Term
A toddler has had recurrent respiratory infections. The mother of the child expressed concern that her infant seemed to be at increased risk for complications from infection in comparison with her older children. The best response from the nurse would be:
 Definition
Airways are smaller and more easily occluded in the younger child
Term
A toddler has been started on digoxin (Lanoxin) for cardiac failure. If the child develops digoxin toxicity, the first sign the nurse might note would be:
 Definition
Nausea and vomiting
Term
Symptoms of digitalis toxicity:
 Definition
1. Anorexia
2. nausea and vomiting (Notify health care provider if client vomits more than QD).
3. dizziness
4. diarrhea
5. headache
6. arrhythmia.
Term
If the ductus arteriosis remains patent in extrauterine life, nursing care will be directed toward management of which of the following problems?
 Definition
Increased pulmonary blood flow and decreased cardiac output.
Term
A child is admitted with a cyanotic heart lesion (Right to Left shunt). The initial lab results might show which of the following?
 Definition
A high hemoglobin

The bone marrow responds to the hypoxemia by producing more oxygen carrying red blood cells, increasing the amount of hemoglobin to carry oxygen to the tissues.
Term
When preparing for the admission of a child with acute epiglottis, what should be the nurse's priority intervention?
 Definition
Place a tracheotomy set at the bedside
Term
The nurse has admitted a child with a ventricular septal defect (L to R shunt)to the unit. An appropriate nursing diagnosis for this child is:
 Definition
Impaired gas exchange related to pulmonary congestion secondary to the increased pulmonary blood flow.
Term
A 3 month old infant has been hospitalized with respiratory syncytial virus (RSV). What is the priority nursing intervention?
 Definition
Clustering care to conserve energy
Term
Before administering oral digoxin (lanoxin) to a pediatric client, a nurse notes that the child has bradycardia and mild vomiting. Which is the nurse's most appropriate action?
 Definition
Hold the medication and notify the physician as these are signs of toxicity.
Term
A child is admitted with infective endocarditis. The nurse is prepared to:
 Definition
Start an intravenous line.

Infective endocarditis is treated with intravenous antibiotics for 2-8 weeks
Term
A 2 year old male child arrived in the emergency department with complaints of sore throat, difficulty swallowing, and suspected diagnosis of acute epiglottis. Which of the following interventions should be included in the child's immediate care and assessment? (Select all that apply.)
 Definition
Health history
Assessment of breath sounds
Vital signs
Term
What kind of culture should not be performed on a child suspected of having epiglottis?
 Definition
throat
Term
The nurse is teaching the parents of a group of cardiac patients. The nurse includes the following information for the child who has undergone cardiac surgery.
 Definition
They should receive prophylactic antibiotics for any oral, dental, or upper respiratory tract procedures.
Term
Nursing assessment of the child’s respiratory system must be done quickly because of which of the following?
 Definition
-The child is more vulnerable to allergic reactions.
-The child is more prone to aspiration.
-Airways are smaller, with resulting resistance as air moves through the airway.
Term
A child is showing signs of acute respiratory distress. The child should be positioned:
 Definition
Upright.
Term
A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). The nurse should be prepared to:
 Definition
Administer nebulized epinephrine and oral or IM dexamethasone.
Term
A child is admitted with epiglottitis, and needs a radiograph. The nurse orders the radiograph to be done by:
 Definition
Portable radiograph in the child’s hospital room.
Term
A nurse is assessing a neonate. The assessment that might indicate that the neonate’s respiratory status is worsening is:
 Definition
Grunting respirations with nasal flaring.
Term
A nurse delegates the task of neonatal vital sign assessment to a nurse technician. The nurse should instruct the technician to:
 Definition
Report any neonate with a breathing pause that lasts 20 seconds or longer.
Term
An appropriate nursing diagnosis for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV) would be:
 Definition
Activity intolerance.
Term
A child is admitted to the hospital with pneumonia. The child’s oximetry reading is 88% upon admission to the Pediatric floor. The priority nursing activity for this child would be to:
 Definition
Begin oxygen per nasal cannula at 1 liter.
Term
Which of the following statements is true of apnea?
 Definition
1. The etiology is sometimes unknown.
Term
Which of the following suggests theophylline toxicity in the infant treated for central apnea?
 Definition
1. Nausea and vomiting
Term
Supportive care for the family of an infant who died from sudden infant death syndrome (SIDS) includes:
 Definition
Allowing parents to hold, touch, and rock the infant.
Term
The nurse is teaching a group of mothers of infants about the benefits of immunization. The nurse will explain that the life-threatening disease epiglottitis can be prevented by immunization against:
 Definition
Haemophilus influenzae type B (HIB).
Term
A child is on rifampin (Rimactane) for treatment of tuberculosis. The parents call the clinic and report that the child’s urine is orange. The nurse should advise the parents to:
 Definition
Expect orange-colored urine while the child is on rifampin.
Term
The physician has changed the medications for the child with asthma to salmeterol (Serevent). The mother asks the nurse what this drug will do. The nurse should explain that salmeterol (Serevent) is used to treat asthma because the drug:
 Definition
Is a bronchodilator.
Term
A child with asthma will be receiving an oral dose of prednisone. The order reads: Prednisone 2 mg/kg per day. The child weighs 50 pounds. How many mg will the child receive daily? (Round the answer to the nearest tenth.)
Write in your answer: ___________
 Definition
45.5
Term
Following parental teaching, the nurse is evaluating the parent’s understanding of environmental control for their child’s asthma management. Teaching has been understood by the parents if they state:
 Definition
“We will replace the carpet in our child’s bedroom with tile.”
Term
A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse what symptoms made the physician suspect cystic fibrosis. The nurse would reply that the clinical manifestation of cystic fibrosis that is seen first is:
 Definition
Meconium ileus.
Term
The nurse is teaching the parents of a newly diagnosed cystic fibrosis patient how to administer the pancreatic enzymes. The nurse will advise the parents to administer the enzymes:
 Definition
With meals and snacks.
Term
Which of the following structures are classified as fetal shunts? Select all that apply.
 Definition
The foramen ovale
The ductus arteriosus
Term
Which congenital cardiac defect is the foramen ovale classified as if it fails to close after the infant transitions from fetal circulation to pulmonary circulation?
 Definition
An atrial septal defect
Term
If the ductus arteriosus remains patent in extrauterine life, nursing care will be directed toward management of which of the following problems?
 Definition
Both increased pulmonary blood flow and decreased cardiac output
Term
The nurse is checking peripheral perfusion to a child’s extremity following a cardiac catheterization. If there is adequate peripheral circulation, the nurse would find that the extremity:
 Definition
Is warm, with a capillary refill of less than three seconds.
Term
Cardiac output in children under the age of 5 years is dependent on which of the following factors?
 Definition
Heart rate
Term
During the newborn assessment, a systolic blood pressure that is higher in the legs than in the arms is suggestive of which of the following findings?
 Definition
A normal finding for an infant
Term
The nurse has admitted a child with a cyanotic heart defect. The nurse would expect the initial lab result to show:
 Definition
A high hemoglobin
Term
The nurse has admitted a child with a ventricular septal defect (VSD) to the unit. An appropriate nursing diagnosis for this child is:
 Definition
Impaired gas exchange related to pulmonary congestion secondary to the increased pulmonary blood flow.
Term
The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities, and higher blood pressure readings in the arms than in the legs. This could be indicative of what heart defect?
 Definition
Coarctation of the aorta
Term
An infant with tetralogy of Fallot (TOF) is having a hypercyanotic episode (“tet” spell). Which of the following nursing interventions should the nurse implement? Select all that apply.
 Definition
Place the child in knee–chest position.
Administer oxygen.
Administer morphine and propranolol intravenously as ordered.
Term
An infant has been diagnosed with a mild cyanotic heart defect. Surgery to correct the defect will not be performed for at least two years. The nurse teaches the parents that a child with a mild cyanotic heart defect should:
 Definition
Maintain normal activity.
Term
Which of the following would be included in nursing care of the infant with congestive heart failure?
 Definition
Organize activities to allow for uninterrupted sleep.
Term
A toddler has been started on digoxin (Lanoxin) for cardiac failure. If the child develops digoxin (Lanoxin) toxicity, the first sign the nurse might note would be:
 Definition
Nausea and vomiting.
Term
The nurse is teaching the parents of a group of cardiac patients. The nurse includes in the information that any child who has undergone cardiac surgery:
 Definition
Should receive prophylactic antibiotics for any dental, oral, or upper respiratory tract procedures.
Term
A child has had a heart transplant. The nurse recognizes that postoperative teaching has been successful when the parents state that the child is on cyclosporin A to:
 Definition
Prevent rejection
Term
A child has been admitted to the hospital unit in congestive heart failure (CHF). Symptoms related to this admission diagnosis would include:
 Definition
Tachycardia
Term
The mother of a child with a heart defect is questioning the nurse about the child’s medication. The nurse explains that spironolactone (Aldactone) is a diuretic that:
 Definition
Spares potassium.
Term
A diagnosis of rheumatic fever is being ruled out for a child. The nurse teaches the parents that the lab test to check for a recent streptococcal infection is:
 Definition
Antistreptolysin-O (ASLO) titer.
Term
An athletic activity the nurse could recommend for a school-age child with pulmonary-artery hypertension is:
 Definition
Golf
Term
A child is admitted with infective endocarditis. The nurse is prepared to:
 Definition
Start an intravenous line.
Term
A nursing intervention for an unstable infant who has supraventricular tachycardia is: (Select all that apply.)
 Definition
Administration of intravenous adenosine (Adenocard).
Administration of intravenous amiodarone (Cardarone).
Preparation for cardioversion.
Term
Which of the following are signs of early hypovolemic shock in children? Select all that apply.
 Definition
Increased work of breathing
Prolonged capillary refill time
Tachycardia
Term
Which of the following treatment measures would be given the highest priority for a child with hypovolemic shock?
 Definition
Establish an open airway and administer oxygen.
Term
A child is admitted to the ED with a diagnosis of hypovolemic shock secondary to traumatic injury. Which of the following normal parental responses would the nurse expect to see?
 Definition
Feelings of guilt and negligence
Term
Which of the following is an anatomic difference between the GI tract of the child and that of the adult?
 Definition
The capacity of the stomach is less in the child as compared with the adult.
Term
Which of the following describes the correct sequence of food entering the digestive system and being digested without the system?
 Definition
1. Mouth, esophagus, stomach, duodenum, jejunum, ileum, ascending colon, transverse colon, descending colon, and rectum
Term
Which of the following are functions of the GI tract? Select all that apply.
 Definition
Digestion and absorption of nutrients and water
Elimination of waste products
Term
The nurse is administering several medications to an infant with neurologic impairment and delay secondary to a MVA. Which of the following medications is a proton pump inhibitor administered for gastroesophageal reflux?
 Definition
Omeprazole (Prilosec)
Term
A child with inflammatory bowel disease is taking prednisone daily. The family should be taught to administer the prednisone at what time?
 Definition
With meals
Term
A child is suspected of having Hirschsprung’s disease. Which of the following assessment factors would support such a medical diagnosis?
 Definition
History of constipation with large, foul-smelling stools
Term
The nurse is evaluating an infant’s tolerance of a feeding post-pyloromyotomy. Which finding indicates the infant is not tolerating the feeding?
 Definition
Emesis after two feedings
Term
A child with severe gastroenteritis is being admitted to a semi-private room on the pediatric unit. The nurse in charge should place this client with which roommate?
 Definition
Another child with gastroenteritis
Term
An adolescent complains of abdominal pain with diarrhea and bloody stools. The nurse should recognize these as symptoms of which inflammatory bowel disease?
 Definition
Ulcerative colitis
Term
The nurse is measuring an abdominal girth on a child with abdominal distension. Identify the area on the child’s abdomen where the tape measure should be placed for an accurate abdominal girth.
 Definition
Just above the umbilicus, around the largest circumference of the abdomen
Term
The nurse is planning postoperative care for an infant after a cleft lip repair. Which of the following should the nurse include in this infant’s plan of care?
 Definition
Supine or side-lying positioning
Term
An infant has been born with an esophageal atresia and tracheoesophageal fistula. What is a priority preoperative nursing diagnosis?
 Definition
Aspiration, risk for related to regurgitation
Term
An infant born with an omphalocele defect is being admitted to the intensive care nursery. Which of the following should the nurse in charge instruct the nursing technician to prepare?
 Definition
Radiant warmer
Term
The nurse is preparing to ambulate an 11-year-old child who has had an appendectomy. In addition to pharmacological pain management, which of the following non-pharmacological pain management strategies would be appropriate for this child?
 Definition
A splint pillow against the abdomen when moving or coughing
Term
A neonate is being fed 20 mL every three hours by orogastric lavage. At the beginning of this feeding, the nurse aspirates 15 mL of gastric residual. Which of the following would be the most appropriate action by the nurse?
 Definition
Withhold the feeding and notify the physician.
Term
The nurse has taught the parents of a child with celiac disease about foods that are allowed in the child’s diet. Which of the following would have been included in the education as an allowed meal?
 Definition
Fruit plate with Gatorade
Term
Which of the following statements indicates that parents have understood the nurse’s teaching with regard to colostomy stoma care for their infant?
 Definition
“We will watch for skin irritation around the stoma.”
Term
A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which of the following equipment should the nurse prepare for use?
 Definition
Equipment for intubation
Term
A child returns from exploratory abdominal surgery following a gunshot wound to the abdomen. Which of the following nursing interventions would the nurse omit from the plan of care for this child?
 Definition
Monitor rectal temperature every hour.
Term
The nurse teaches parents that the anticholinergic drug used to treat enuresis is:
 Definition
Oxybutynin (Ditropan).
Term
A child has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS). The clinical manifestations will include which of the following?
 Definition
Massive proteinuria, hypoalbuminemia, and edema
Term
A child with nephritic syndrome is severely edematous. The primary health care provider has placed the child on bedrest. An important nursing intervention for this child would be to:
 Definition
Reposition the child every two hours.
Term
A child with nephritic syndrome has been placed on prednisone. The nurse knows that for this syndrome, the administration will be:
 Definition
Daily for six weeks and then alternate-day doses for six weeks.
Term
A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following?
 Definition
Hematuria and proteinuria
Term
A 4-year-old has acute glomerulonephritis, and is admitted to the hospital. An appropriate nursing diagnosis for this child would be:
 Definition
Fluid Volume Excess related to decreased plasma filtration.
Term
A child with acute glomerulonephritis is in the playroom, and experiences blurred vision and headache. Which of the following actions should be taken by the nurse?
 Definition
Obtain a BP on the child; notify the physician.
Term
A nurse is preparing to admit a child with possible obstructive uropathy. What labs should the nurse expect to draw on this child?
 Definition
Blood urea nitrogen (BUN) and creatinine
Term
Discharge instructions for care of a child who has just had an orchiopexy should include:
 Definition
Explanation to the parents about the need for loose, non-restrictive clothing.

Orchiopexy is the surgical correction of cryptorchidism (failure of the testes to descend into the scrotal sac). Discharge instructions should include information about the need for loose, non-restrictive clothing to avoid pressure on the postoperative site.
Term
Which of the following sets of symptoms are characteristic of a preschool-age child with a urinary tract infection?
 Definition
Urgency, dysuria, and fever
Term
A child has undergone a kidney transplant, and is receiving cyclosporine. The parents ask the nurse about the reason for the cyclosporine. The nurse should explain that the drug is given to:
 Definition
Suppress rejection.
Term
A child in renal failure has hyperkalemia. The nurse plans to instruct the child and her parents to avoid which of the following foods?
 Definition
Carrots and green, leafy vegetables
Term
A child is scheduled for a kidney transplant. The nurse has completed the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. The nurse will know the parents realistically understand the transplantation process that is involved with a kidney transplant if they state:
 Definition
"We know it’s important to see that our child takes prescribed medications after the transplant.”
Term
A child is undergoing hemodialysis. The child should be monitored closely for: (Select all that apply.)
 Definition
Shock.
Hypotension.
Infections.
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