NURS 3548 exam 2

Peds exam 2 Question 1 0 out of 2 points An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented? Answers : a. Increased platelet level b. Leukopenia c. Polycythemia d. Anemia Response Feedback: Persistent hypoxemia that occurs with tetralogy of Fallot stimulates erythropoiesis, which results in polycythemia, an increased number of red blood cells. Question 2 2 out of 2 points What is the most profound complication of prolonged middle ear disorders? Answers : a. Loss of hearing b. Failure to thrive c. Visual impairment d. Tympanic membrane rupture Question 3 2 out of 2 points A health care provider prescribes captopril (Capoten), 2.5 mg PO every 12 h for a child with heart failure. The medication label states: “Captopril 5 mg/5 ml.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place. ____________2.5____ Question 4 2 out of 2 points A 4-year-old girl is brought to the emergency department. She has a “froglike” croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner? Answers : a. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation. b. Make her lie down and rest quietly. c. Examine her oral pharynx and report to the physician. d. Auscultate her lungs and prepare for placement in a mist tent. Response Feedback: This child is exhibiting signs of respiratory distress and possible epiglottitis. Epiglottitis is always a medical emergency requiring antibiotics and airway support for treatment. Sitting up is the position that facilitates breathing in respiratory disease. The oral pharynx should not be visualized. If the epiglottis is inflamed, there is the potential for complete obstruction if it is irritated further. Although lung auscultation provides useful assessment information, a mist tent would not be beneficial for this child. Immediate medical evaluation and intervention are indicated. Question 5 2 out of 2 points What child has a congenital heart defect with decreased pulmonary blood flow? Answers : a. An infant with patent ductus arteriosus b. A 2-month-old infant with tetralogy of Fallot c. A 6-month-old infant with repaired ventricular septal defect d. A 1-year-old infant with atrial septal defect Response Feedback: Tetralogy of Fallot is a cyanotic congenital heart defect. Patent ductus arteriosus, atrial septal defect, and ventricular septal defect are acyanotic congenital heart defects. Question 6 2 out of 2 points An infant’s parents ask the nurse about preventing otitis media (OM). What information should be provided? Answers : a. Use nasal decongestants. b. Bottle- or breastfeed in a supine position. c. Avoid children with OM. d. Avoid tobacco smoke. Response Feedback: Eliminating tobacco smoke from the child’s environment is essential for preventing OM and other common childhood illnesses. Nasal decongestants are not useful in preventing OM. Children with uncomplicated OM are not contagious unless they show other symptoms of upper respiratory tract infection. Children should be fed in a semivertical position to prevent OM. Question 7 0 out of 2 points A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, “My throat hurts.” The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the child’s pain? Answers : a. Popsicle b. Ice chips c. Tylenol PR d. Tylenol PO Response Feedback: The throat is very sore after a tonsillectomy. Most children experience moderate pain after a tonsillectomy and need pain medication at regular intervals for at least the first 24 hours. Analgesics may need to be given rectally or intravenously to avoid the oral route. Question 8 2 out of 2 points A child post- tonsillectomy is being discharged from the hospital. What is the most appropriate suggestion made by the nurse for postoperative management of the child in the home setting? Answers : a. Ice cream should be avoided. b. Diluted citrus juice can be given. c. A straw can be used to help drink fluids. d. Fluids with a red or brown color should be avoided. Response Feedback: Following tonsillectomy surgery, the child’s secretions or vomit may contain fresh or old blood. Fluids with a red or brown color are generally avoided to distinguish any fresh or old blood from a hemorrhage. Ice cream leaves a milk coating in the mouth and throat. It may cause the child to clear the throat, which may irritate the operative site and cause bleeding. It can be given once clear fluids are retained by the child. Sour food is not well tolerated at this time, so citrus fruit juice should be avoided. A straw may hurt the operative site and it should not be used postoperatively. Question 9 2 out of 2 points What is a priority nursing diagnosis for the 4-year-old child newly diagnosed with leukemia? Answers : a. Ineffective Breathing Pattern related to mediastinal disease b. Risk for Infection related to immunosuppressed state c. Disturbed Body Image related to alopecia d. Impaired Skin Integrity related to radiation therapy Response Feedback: A. This nursing diagnosis applies to a child with non-Hodgkin lymphoma or any cancer involving the chest area. B. Leukemia is characterized by the proliferation of immature white blood cells, which lack the ability to fight infection. C. This is a nursing diagnosis related to chemotherapy, but it is not of the highest priority. Not all children have a body image disturbance as a result of alopecia, especially not preschoolers. This would be of more concern to an adolescent. D. Radiation therapy is not a treatment for leukemia. Question 10 2 out of 2 points Which is the most important laboratory test result that must be evaluated before administering digoxin to a child with congestive heart failure? Answers : a. Serum sodium level b. Serum chloride level c. Serum potassium