peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
1. The nurse is providing educa- ANS: A
tion to parents of a child with Rationale: With a child in the 90th percentile for blood pressure,
a blood pressure in the 90th diet and physical activity
percentile. What would be should be the main focus. Blood pressures should be measured,
included in the intervention but daily measurement is not
strategies? necessary. Children are not routinely put on beta blockers, and
A. The nurse would review the child should be allowed to
the child's 24-hour diet re- participate in sports if monitored.
call.
B. The child should not
be allowed to participate in
sports.
C. Blood pressures should be
measured daily.
D. Beta blocker education
should be given to the par-
ents.
2. An infant with poor feeding ANS: A
is suspected of having a con- Rationale: Chest x-rays are performed to see if the heart is
genital heart defect. The par- enlarged. This will determine if the
ents are heart muscle is increasing in size. Disturbances in heart conduc-
asking why a chest x-ray tion are detected by an EKG.
is necessary in their infant. Visualizing where blood is being shunted is through the
What is the best response echocardiogram. The image used to
from the clarify the structures of the heart is the MRI.
nurse?
A. It will determine if the
heart is enlarged.
B. It will determine distur-
bances in heart conduction.
C. It will show if blood is be-
, peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
ing shunted.
D. This image will clarify the
structures within the heart.
3. The nurse is caring for a child ANS: A, B
diagnosed with rheumatic Rationale: Pain control and relief are the highest priorities for
fever. When addressing the the child with rheumatic fever.
child's Position the child to relieve joint pain. Large joints, including the
pain, the nurse should per- knees, ankles, wrists, and
form which intervention(s)? elbows, are usually involved. Carefully handle the joints when
Select all that apply. moving the child to help
A. Carefully handle the child's minimize pain. Salicylates are administered in the form of as-
knees, ankles, elbows and pirin to reduce fever but
wrists when moving the primarily to relieve joint inflammation and pain.They are also
child. used as a heart protective. They
B. Administer salicylates af- are prescribed in high dosages. These are more commonly
ter meals or with milk. administered instead of opioids.
C. Teach the child how to use Patient-controlled anesthesia is not typically used. Nonpharma-
a patient-controlled analge- cologic interventions can be
sia system. used as an adjunct to pain medications.
D. Administer intravenous
morphine as prescribed.
E. Prioritize nonpharma-
cologic interventions over
pharmacologic interven-
tions.
4. In developing a plan of care ANS: D
for the child diagnosed with Rationale: As long as the rheumatic process is active, progressive
rheumatic fever, the nursing heart damage is possible.
intervention that takes high- To prevent heart damage, bed rest is essential to reduce the
est priority for this child is to: heart's workload. Laboratory tests
, peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
A. position the child to relieve for ESR and C-reactive protein can be used to evaluate disease
joint pain. activity and guide treatment,
B. monitor the C-reactive but they do not improve the child's health itself. The child's
protein and ESR levels. comfort is important, so it is
C. provide age-appropriate essential to relieve joint pain and prevent injury with padded
diversional activities. bed rails. But these measures are
D. promote rest periods and less important than rest when it comes to preventing long-term
bed rest. complications such as residual
heart disease.
5. The nurse is reviewing the ANS: A, B, C
health history and physical Rationale: Manifestations of heart failure include difficulty feed-
examination of a child diag- ing or eating or becoming
nosed with tired easily when feeding or eating, shortness of breath with
heart failure. What would the exercise intolerance, crackles and
nurse expect to find? Select wheezes on lung auscultation, tachycardia, and hypotension.
all that apply.
A. Tiring easily when eating
B. Shortness of breath when
playing
C. Crackles on lung ausculta-
tion
D. Bradycardia
E. Hypertension
6. The nurse is administering ANS: D
digoxin as ordered and the Rationale: Digoxin should be administered at regular intervals,
child vomits the dose. What every 12 hours, 1 hour before
should the or 2 hours after feeding. If the child vomits digoxin, the nurse
nurse do next? should not give a second dose
A. Contact the physician. and should wait until the next scheduled dose. It is not necessary
B. Offer a snack and adminis- to contact the physician.
, peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
ter another dose.
C. Immediately administer
another dose.
D. Administer next dose as
ordered in 12 hours.
7. The nurse is assessing a ANS: B
child with suspected infec- Rationale: Roth spots are splinter hemorrhages with pale cen-
tive endocarditis. Which as- ters on the sclerae, palate, buccal
sessment finding mucosa, chest, fingers, or toes, and are signs of extracardiac
would the nurse interpret as emboli. Delayed capillary refill
a sign of extracardiac em- time does not point to extracardiac emboli. Wheezing and pru-
boli? ritus are indicative of a
A. Pruritus hypersensitivity reaction. Erythema marginatum is a classic rash
B. Roth spots associated with acute
C. Delayed capillary refill rheumatic fever.
D. Erythema marginatum
8. A child is diagnosed with ANS: A, C, D
Kawasaki disease and is in Rationale: In the acute phase, high-dose aspirin in four divided
the acute phase of the disor- doses daily and a single
der. What infusion of intravenous immunoglobulin are used. Aceta-
would the nurse expect the minophen is used to reduce fever.
physician to prescribe? Select Nonsteroidal anti-inflammatory agents such as ibuprofen are
all that apply. avoided while the child is
A. Intravenous immunoglob- receiving aspirin therapy. Alprostadil is used to temporarily keep
ulin the ductus arteriosus patent
B. Ibuprofen in infants with ductal-dependent congenital heart defects.
C. Acetaminophen
D. Aspirin
E. Alprostadil
Study online at https://quizlet.com/_b7byh7
1. The nurse is providing educa- ANS: A
tion to parents of a child with Rationale: With a child in the 90th percentile for blood pressure,
a blood pressure in the 90th diet and physical activity
percentile. What would be should be the main focus. Blood pressures should be measured,
included in the intervention but daily measurement is not
strategies? necessary. Children are not routinely put on beta blockers, and
A. The nurse would review the child should be allowed to
the child's 24-hour diet re- participate in sports if monitored.
call.
B. The child should not
be allowed to participate in
sports.
C. Blood pressures should be
measured daily.
D. Beta blocker education
should be given to the par-
ents.
2. An infant with poor feeding ANS: A
is suspected of having a con- Rationale: Chest x-rays are performed to see if the heart is
genital heart defect. The par- enlarged. This will determine if the
ents are heart muscle is increasing in size. Disturbances in heart conduc-
asking why a chest x-ray tion are detected by an EKG.
is necessary in their infant. Visualizing where blood is being shunted is through the
What is the best response echocardiogram. The image used to
from the clarify the structures of the heart is the MRI.
nurse?
A. It will determine if the
heart is enlarged.
B. It will determine distur-
bances in heart conduction.
C. It will show if blood is be-
, peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
ing shunted.
D. This image will clarify the
structures within the heart.
3. The nurse is caring for a child ANS: A, B
diagnosed with rheumatic Rationale: Pain control and relief are the highest priorities for
fever. When addressing the the child with rheumatic fever.
child's Position the child to relieve joint pain. Large joints, including the
pain, the nurse should per- knees, ankles, wrists, and
form which intervention(s)? elbows, are usually involved. Carefully handle the joints when
Select all that apply. moving the child to help
A. Carefully handle the child's minimize pain. Salicylates are administered in the form of as-
knees, ankles, elbows and pirin to reduce fever but
wrists when moving the primarily to relieve joint inflammation and pain.They are also
child. used as a heart protective. They
B. Administer salicylates af- are prescribed in high dosages. These are more commonly
ter meals or with milk. administered instead of opioids.
C. Teach the child how to use Patient-controlled anesthesia is not typically used. Nonpharma-
a patient-controlled analge- cologic interventions can be
sia system. used as an adjunct to pain medications.
D. Administer intravenous
morphine as prescribed.
E. Prioritize nonpharma-
cologic interventions over
pharmacologic interven-
tions.
4. In developing a plan of care ANS: D
for the child diagnosed with Rationale: As long as the rheumatic process is active, progressive
rheumatic fever, the nursing heart damage is possible.
intervention that takes high- To prevent heart damage, bed rest is essential to reduce the
est priority for this child is to: heart's workload. Laboratory tests
, peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
A. position the child to relieve for ESR and C-reactive protein can be used to evaluate disease
joint pain. activity and guide treatment,
B. monitor the C-reactive but they do not improve the child's health itself. The child's
protein and ESR levels. comfort is important, so it is
C. provide age-appropriate essential to relieve joint pain and prevent injury with padded
diversional activities. bed rails. But these measures are
D. promote rest periods and less important than rest when it comes to preventing long-term
bed rest. complications such as residual
heart disease.
5. The nurse is reviewing the ANS: A, B, C
health history and physical Rationale: Manifestations of heart failure include difficulty feed-
examination of a child diag- ing or eating or becoming
nosed with tired easily when feeding or eating, shortness of breath with
heart failure. What would the exercise intolerance, crackles and
nurse expect to find? Select wheezes on lung auscultation, tachycardia, and hypotension.
all that apply.
A. Tiring easily when eating
B. Shortness of breath when
playing
C. Crackles on lung ausculta-
tion
D. Bradycardia
E. Hypertension
6. The nurse is administering ANS: D
digoxin as ordered and the Rationale: Digoxin should be administered at regular intervals,
child vomits the dose. What every 12 hours, 1 hour before
should the or 2 hours after feeding. If the child vomits digoxin, the nurse
nurse do next? should not give a second dose
A. Contact the physician. and should wait until the next scheduled dose. It is not necessary
B. Offer a snack and adminis- to contact the physician.
, peds exam 2 test banks
Study online at https://quizlet.com/_b7byh7
ter another dose.
C. Immediately administer
another dose.
D. Administer next dose as
ordered in 12 hours.
7. The nurse is assessing a ANS: B
child with suspected infec- Rationale: Roth spots are splinter hemorrhages with pale cen-
tive endocarditis. Which as- ters on the sclerae, palate, buccal
sessment finding mucosa, chest, fingers, or toes, and are signs of extracardiac
would the nurse interpret as emboli. Delayed capillary refill
a sign of extracardiac em- time does not point to extracardiac emboli. Wheezing and pru-
boli? ritus are indicative of a
A. Pruritus hypersensitivity reaction. Erythema marginatum is a classic rash
B. Roth spots associated with acute
C. Delayed capillary refill rheumatic fever.
D. Erythema marginatum
8. A child is diagnosed with ANS: A, C, D
Kawasaki disease and is in Rationale: In the acute phase, high-dose aspirin in four divided
the acute phase of the disor- doses daily and a single
der. What infusion of intravenous immunoglobulin are used. Aceta-
would the nurse expect the minophen is used to reduce fever.
physician to prescribe? Select Nonsteroidal anti-inflammatory agents such as ibuprofen are
all that apply. avoided while the child is
A. Intravenous immunoglob- receiving aspirin therapy. Alprostadil is used to temporarily keep
ulin the ductus arteriosus patent
B. Ibuprofen in infants with ductal-dependent congenital heart defects.
C. Acetaminophen
D. Aspirin
E. Alprostadil
