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The nurse is caring for a 3-year-old child who is 2 hours post-op from a
cardiac catheterization via the right femoral artery. which assessment
finding is an indication of arterial obstruction?
a. Blood pressure trend is downward and pulse is rapid and irregular.
b. Right foot is cool to the touch and appears pale and blanched.
c. Pulse distal to the femoral artery is weaker on the left foot than right foot.
d. The pressure dressing at right femoral area is moist and oozing blood. -
✔✔B
Right foot is cool to the touch and appears pale and blanched
Following a motor vehicle collision, a 3-year old girl has a spica cast
applied. Which toy is best for the nurse for this 3 year old child?
1
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,a. duck that squeaks
b. fashion doll and clothes
c. set of cloth and hand puppets
d. hand held video game - ✔✔C
Set of cloth and hand puppets
An infant with tetralogy of Fallot becomes acutely cyanotic and
hyperpneic. Which action should the nurse implement first?
a. administer morphine sulfate
b. start IV fluids
c. place the infant knee to chest
d. provide 100% oxygen via face mask - ✔✔C
Place the infant knee to chest
A child admitted with DKAA is demonstrating Kussmaul repsirations. The
nurse determines that the increased respiratory rate is a compensatory
mechanism for which acid base alteration?
2
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,a. metabolic alkalosis
b. respiratory acidosis
c. respiratory alkalosis
d. metabolic acidosis - ✔✔D
metabolic acidosis
a 7-year-old is admitted to the hospital with persistent vomiting, and a
nasogastric tube attached to low intermittent suction is applied. Which
finding is most important for the nurse to report to the healthcare
provider?
a. gastric output of 100 mL in the last 8 hours
b. shift intake of 640 mL iV fluids plus 30 mL PO ice chips
c. serum potassium of 3.0 mg/dL
d. serum pH of 7.45 - ✔✔C
serum potassium of 3.0
3
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, The nurse is evaluating diet teaching for a client who has nontropical sprue
(celiac disease). Choosing which food indicates that the teaching has been
effective?
a. creamed corn
b. pancakes
c. rye crackers
d. cooked oatmeal - ✔✔A
creamed corn
During a well-baby check, the nurse hides a block under the baby's blanket,
and the baby looks for the block. Which normal growth and development
milestone is the baby developing?
a. separation anxiety
b. associative play
c. object prehension
d. object permanence - ✔✔D
4
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