Pediatric Nursing NR 328 Exam PREDICTOR
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The parent of a child hospitalized with acute glomerulonephritis (AGN) asks the nurse why
blood pressure readings are being taken so often. What is the most appropriate response by
the nurse, drawing on knowledge of AGN?
a. Acute hypertension must be anticipated and identified.
b. Hypotension leading to sudden shock can develop at any time.
c. Blood pressure fluctuations are a common side effect of antibiotic therapy.
d. Blood pressure fluctuations are a sign that the condition has become chronic.
A+ TEST BANK 1
, NR 328 Exam
Answer: A
Rationale:
Vital signs, in particular the blood pressure, provide information about the severity of acute
glomerular nephritis (AGN) and early signs of complications. Acute hypertension is anticipated
and requires frequent monitoring for early intervention. Blood pressure does not commonly
fluctuate with antibiotic therapy. Blood pressure fluctuations are not indicative of chronic
disease. Most children with AGN fully recover. Hypertension, not hypotension, is more likely
with AGN.
After reviewing the laboratory reports of a patient with acute glomerulonephritis, the nurse
ensures that the patient is on a low-potassium diet. What is the reason for this intervention?
a. The patient has oliguria.
b. The patient has proteinuria.
c. The patient has hypertension.
d. The patient has chronic inflammation.
Answer: A
Rationale:
The patient with acute glomerulonephritis with oliguria will be at risk for hyperkalemia, an
increase in serum potassium level. Therefore, the nurse ensures that the patient has low-
potassium diet. The patient with acute glomerulonephritis may have proteinuria, but will be
on a protein-restricted diet instead of a low-potassium diet. The patient with hypertension will
be prescribed a sodium-restricted diet, because sodium increases blood pressure. The patient
with chronic inflammation may be on a low-sugar and a fat-free diet.
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, NR 328 Exam
What are some clinical manifestations of gastroesophageal reflux in infants? Select all that
apply.
a. Spitting up
b. Failure to thrive
c. Chronic cough
d. Excessive crying and arching of the back
Answer: A, B, D
Rationale:
Clinical manifestations of gastroesophageal reflux in infants include spitting up, excessive
crying and arching of the back, and failure to thrive. Heartburn and chronic cough are
symptoms of gastroesophageal reflux in children, not infants.
What should the nurse teach the parents about caring for the infant with gastroesophageal
reflux (GER)?
a. Place the infant supine after feeding.
b. Feed the infant just before bedtime.
c. Place the infant on the side to sleep.
d. Avoid vigorous play after feedings.
Answer: D
Rationale:
Parents should avoid vigorous play with the infant after feedings to prevent regurgitation. The
head of the bed may be raised to 30 degrees after feedings to prevent discomfort and
regurgitation. Parents must avoid feeding the infant just before bedtime to avoid GER. The
infant must not be positioned on the side to sleep. The Task Force on Sudden Infant Death
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, NR 328 Exam
Syndrome recommends that the infant be placed in the supine position when sleeping. As the
infant ages foods to avoid are: citrus, fatty foods, peppermint.
What care must the nurse take when obtaining abdominal measurements for a child with
Hirschsprung disease?
a. Obtain abdominal circumference just above the umbilicus.
b. Mark the point of measurement on the abdomen with a pen.
c. Obtain and document the measurement once a day.
d. Remove the tape after each measurement is recorded.
Answer: B
Rationale:
Distention of the abdomen is a serious sign in the child with Hirschsprung disease. The nurse
must obtain the abdominal circumference with a paper tape measure. The abdomen must be
marked with a pen at the point of measurement to maintain reliability of later measurements.
Abdominal circumference is usually taken at the level of the umbilicus or the widest part of
the abdomen. This measurement must be obtained with the vital sign measurements and is
recorded in a serial order so that any change is evident. When frequent measurements are
needed, the tape is left in place beneath the child to reduce the stress each time it is
removed. Remember to teach the parents of the child that has surgery with a colostomy that
the colostomy is usually reversible.
What manifestation in the infant does the nurse associate with hypertrophic pyloric stenosis?
a. Abdominal pain
b. Edema at the extremities
c. Distended lower abdomen
A+ TEST BANK 4