NR 328 EXAMS 2 ALL ANSWERS AND QUESTIONS
SET A+
✔✔The nurse is preparing to admit a 7-year-old child with hepatitis B. What clinical
features of hepatitis B should the nurse recognize? - ✔✔Rash is common.
Jaundice is present
The mode of transmission is principally by the parenteral route.
✔✔The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical
manifestations should the nurse expect to observe? - ✔✔Pain is common.
Weight loss is severe.
Diarrhea is moderate to severe.
✔✔What term is defined as the volume of blood ejected by the heart in 1 minute? -
✔✔Cardiac output
✔✔A chest radiography examination is ordered for a child with suspected cardiac
problems. The childs parent asks the nurse, What will the x-ray show about the heart?
The nurses response should be based on knowledge that the radiograph provides
which information? - ✔✔Supplies information on heart size and pulmonary blood flow
patterns
✔✔A 6-year-old child is scheduled for a cardiac catheterization. What consideration is
most important in planning preoperative teaching? - ✔✔Preoperative teaching should
be adapted to his level of development so that he can understand.
✔✔After returning from cardiac catheterization, the nurse monitors the childs vital signs.
The heart rate should be counted for how many seconds? - ✔✔60
✔✔The nurse is caring for a school-age girl who has had a cardiac catheterization. The
child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed
soaked with blood. What nursing action is most appropriate to institute initially -
✔✔Apply direct pressure above the catheterization site.
,✔✔What statement best identifies the cause of heart failure (HF)? - ✔✔Consequence of
an underlying cardiac defect
✔✔The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min
during sleep. What nursing intervention is most appropriate at this time? - ✔✔Report
data to the practitioner.
✔✔What drug is an angiotensin-converting enzyme (ACE) inhibitor? - ✔✔Captopril
(Capoten)
✔✔A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the
practitioner and withhold the medication if the apical pulse is less than which rate? -
✔✔90 beats/min
✔✔What clinical manifestation is a common sign of digoxin toxicity? - ✔✔Vomiting
✔✔The parents of a young child with heart failure (HF) tell the nurse that they are
nervous about giving digoxin. The nurses response should be based on which
knowledge? - ✔✔Parents need to learn specific, important guidelines for administration
of digoxin.
✔✔What nutritional component should be altered in the infant with heart failure (HF)? -
✔✔Increase in calories
✔✔Decreasing the demands on the heart is a priority in care for the infant with heart
failure (HF). In evaluating the infants status, which finding is indicative of achieving this
goal? - ✔✔Appropriate weight gain for age
✔✔The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect.
The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What
strategy is an important objective to decrease this risk? - ✔✔Prevent dehydration.
✔✔A 3-month-old infant has a hypercyanotic spell. What should be the nurses first
action? - ✔✔Place the child in the kneechest position.
✔✔A cardiac defect that allows blood to shunt from the (high pressure) left side of the
heart to the (lower pressure) right side can result in which condition? - ✔✔Heart failure
✔✔What blood flow pattern occurs in a ventricular septal defect? - ✔✔Increased
pulmonary blood flow
, ✔✔The physician suggests that surgery be performed for patent ductus arteriosus
(PDA) to prevent which complication? - ✔✔Pulmonary vascular congestion
✔✔What cardiovascular defect results in obstruction to blood flow? - ✔✔Aortic stenosis
✔✔. What structural defects constitute tetralogy of Fallot? - ✔✔Pulmonary stenosis,
ventricular septal defect, overriding aorta, right ventricular hypertrophy
✔✔The 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. How should the nurse
reply to this concern? - ✔✔The child needs opportunities to play with peers.
✔✔What preparation should the nurse consider when educating a school-age child and
the family for heart surgery? - ✔✔Let the child hear the sounds of a cardiac monitor,
including alarms.
✔✔Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4 C
(101.1 F). What action should the nurse perform? - ✔✔Report findings to the
practitioner.
✔✔What nursing consideration is important when suctioning a young child who has had
heart surgery? - ✔✔Administer supplemental oxygen before and after suctioning.
✔✔The nurse notices that a child is increasingly apprehensive and has tachycardia
after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the
nurses initial intervention? - ✔✔Notify the practitioner of these findings.
✔✔A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the
cardiology clinic and reports that the child is just not herself. Her appetite is decreased,
she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints
ache. Based on this information, how should the nurse advise the mother? -
✔✔Immediately bring the child to the clinic for evaluation.
✔✔What primary nursing intervention should be implemented to prevent bacterial
endocarditis? - ✔✔Counsel parents of high-risk children.
✔✔What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? -
✔✔Polyarthritis
✔✔What action by the school nurse is important in the prevention of rheumatic fever
(RF)? - ✔✔Refer children with sore throats for throat cultures.
SET A+
✔✔The nurse is preparing to admit a 7-year-old child with hepatitis B. What clinical
features of hepatitis B should the nurse recognize? - ✔✔Rash is common.
Jaundice is present
The mode of transmission is principally by the parenteral route.
✔✔The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical
manifestations should the nurse expect to observe? - ✔✔Pain is common.
Weight loss is severe.
Diarrhea is moderate to severe.
✔✔What term is defined as the volume of blood ejected by the heart in 1 minute? -
✔✔Cardiac output
✔✔A chest radiography examination is ordered for a child with suspected cardiac
problems. The childs parent asks the nurse, What will the x-ray show about the heart?
The nurses response should be based on knowledge that the radiograph provides
which information? - ✔✔Supplies information on heart size and pulmonary blood flow
patterns
✔✔A 6-year-old child is scheduled for a cardiac catheterization. What consideration is
most important in planning preoperative teaching? - ✔✔Preoperative teaching should
be adapted to his level of development so that he can understand.
✔✔After returning from cardiac catheterization, the nurse monitors the childs vital signs.
The heart rate should be counted for how many seconds? - ✔✔60
✔✔The nurse is caring for a school-age girl who has had a cardiac catheterization. The
child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed
soaked with blood. What nursing action is most appropriate to institute initially -
✔✔Apply direct pressure above the catheterization site.
,✔✔What statement best identifies the cause of heart failure (HF)? - ✔✔Consequence of
an underlying cardiac defect
✔✔The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min
during sleep. What nursing intervention is most appropriate at this time? - ✔✔Report
data to the practitioner.
✔✔What drug is an angiotensin-converting enzyme (ACE) inhibitor? - ✔✔Captopril
(Capoten)
✔✔A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the
practitioner and withhold the medication if the apical pulse is less than which rate? -
✔✔90 beats/min
✔✔What clinical manifestation is a common sign of digoxin toxicity? - ✔✔Vomiting
✔✔The parents of a young child with heart failure (HF) tell the nurse that they are
nervous about giving digoxin. The nurses response should be based on which
knowledge? - ✔✔Parents need to learn specific, important guidelines for administration
of digoxin.
✔✔What nutritional component should be altered in the infant with heart failure (HF)? -
✔✔Increase in calories
✔✔Decreasing the demands on the heart is a priority in care for the infant with heart
failure (HF). In evaluating the infants status, which finding is indicative of achieving this
goal? - ✔✔Appropriate weight gain for age
✔✔The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect.
The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What
strategy is an important objective to decrease this risk? - ✔✔Prevent dehydration.
✔✔A 3-month-old infant has a hypercyanotic spell. What should be the nurses first
action? - ✔✔Place the child in the kneechest position.
✔✔A cardiac defect that allows blood to shunt from the (high pressure) left side of the
heart to the (lower pressure) right side can result in which condition? - ✔✔Heart failure
✔✔What blood flow pattern occurs in a ventricular septal defect? - ✔✔Increased
pulmonary blood flow
, ✔✔The physician suggests that surgery be performed for patent ductus arteriosus
(PDA) to prevent which complication? - ✔✔Pulmonary vascular congestion
✔✔What cardiovascular defect results in obstruction to blood flow? - ✔✔Aortic stenosis
✔✔. What structural defects constitute tetralogy of Fallot? - ✔✔Pulmonary stenosis,
ventricular septal defect, overriding aorta, right ventricular hypertrophy
✔✔The 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. How should the nurse
reply to this concern? - ✔✔The child needs opportunities to play with peers.
✔✔What preparation should the nurse consider when educating a school-age child and
the family for heart surgery? - ✔✔Let the child hear the sounds of a cardiac monitor,
including alarms.
✔✔Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4 C
(101.1 F). What action should the nurse perform? - ✔✔Report findings to the
practitioner.
✔✔What nursing consideration is important when suctioning a young child who has had
heart surgery? - ✔✔Administer supplemental oxygen before and after suctioning.
✔✔The nurse notices that a child is increasingly apprehensive and has tachycardia
after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the
nurses initial intervention? - ✔✔Notify the practitioner of these findings.
✔✔A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the
cardiology clinic and reports that the child is just not herself. Her appetite is decreased,
she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints
ache. Based on this information, how should the nurse advise the mother? -
✔✔Immediately bring the child to the clinic for evaluation.
✔✔What primary nursing intervention should be implemented to prevent bacterial
endocarditis? - ✔✔Counsel parents of high-risk children.
✔✔What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? -
✔✔Polyarthritis
✔✔What action by the school nurse is important in the prevention of rheumatic fever
(RF)? - ✔✔Refer children with sore throats for throat cultures.
