1.
For what reason might a newborn infant with a cardiac defect, such as coarctation of the
aorta, that results in a right-to-left shunt receive prostaglandin E1?
a.To decrease inflammation
b.To control pain
c.To decrease respirations
d.To improve oxygenation
2.
After teaching a class about the hemodynamic characteristics of congenital heart disease,
the instructor determines that the teaching has been successful when the class identifies which
defect as an example of a disorder involving increased pulmonary blood flow?
a.
b.
c.
d.
Tetralogy of Fallot
Atrial septal defect
Hypoplastic left heart syndrome
Transposition of the great vessels
3.
The nurse is conducting a physical examination of a child with a ventricular septal defect.
Which finding would the nurse expect to assess?
a.
b.
c.
d.
right ventricular heave
Holosystolic harsh murmur along the left sternal border
Fixed split-second heart sound
Systolic ejection murmur
4.
The nurse is administering digoxin as ordered and the child vomits the dose. What should
the nurse do next?
a.
b.
c.
d.
Contact the physician.
Offer a snack and administer another dose.
Immediately administer another dose
Administer next dose as ordered in 12 hours.
5.
The nurse is caring for an infant with suspected patent ductus arteriosus. Which
assessment finding would the nurse identify as helping to confirm this suspicion?
a.
b.
c.
Thrill at the base of the heart
Harsh, continuous, machine-like murmur under the left clavicle
Faint pulses
d.
Systolic murmur best heard along the left sternal border
6.
The nurse is conducting a physical examination of a child with a suspected cardiovascular
disorder. Which finding would the nurse most likely expect to assess if the child had transposition
of the great vessels?
a.
Significant cyanosis without presence of a murmur
b.
Abrupt cessation of chest output with an increase in heart rate/filling pressure
c.
Soft systolic ejection
d.
Holosystolic murmur
7.
The nurse is assessing a child with suspected infective endocarditis. Which assessment
finding would the nurse interpret as a sign of extracardiac emboli?
a.
b.
c.
d.
Pruritus
Roth spots
Delayed capillary refill
Erythema marginatum
When conducting a physical examination of a child with suspected Kawasaki disease, which
finding would the nurse expect to assess?
a.
b.
c.
d.
Hirsutism or striae
strawberry tongue
Malar rash
Café au lait spots
8.
After teaching a group of students about acute rheumatic fever, the instructor determines
that the teaching was successful when the students identify which assessment finding?
a.
b.
c.
d.
Janeway lesions
Jerky movements of the face and upper extremities
Black lines
osler nodes
9.
A nurse is reviewing the medical record of a child and finds that the child has a grade III
murmur. After auscultating the child's heart sounds, how would the nurse document this murmur?
a.
b.
c.
d.
Loud without a thrill
Loud with a precordial thrill
Soft and easily heard
Loud, audible with a stethoscope
10.
The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart
failure. The nurse is providing teaching about nutrition. Which statement by the mother indicates a
need for further teaching?
a.
b.
c.
d.
"The baby may need as much as 150 calories/kg/day."
"Small, frequent feedings are best if tolerated."
"I need to feed him every hour to make sure he eats enough."
"Gavage feedings may be required for now."
11.
The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which
statement by the mother would warrant further investigation?
a.
b.
c.
d.
"My baby does not make any grunting noises."
"The baby seems more comfortable over my shoulder."
"The baby usually drinks all of her bottle."
"I don't notice any rapid breathing patterns."
12.
Auscultation of a child's heart reveals a loud murmur with a precordial thrill. The nurse
documents this as which grade?
a.
Grade II
b.
Grade III
c.
Grade IV
d.
Grade V
13.
After assessing a child's blood pressure, the nurse determines the pulse pressure and
finds that it is narrowed. What would the nurse identify as associated with this finding?
a.
b.
c.
d.
Aortic stenosis
Patent ductus arteriosus
Aortic insufficiency
Complete heart block
14.
A 9-year-old child has undergone a cardiac catheterization and is being prepared for
discharge. The nurse is instructing the parents and child about postprocedure care. Which
statement by the parents indicates that the teaching was successful?
a.
b.
c.
d.
"This pressure dressing needs to stay on for 5 days from now."
"He can't eat but he can drink fluids for the next 24 hours."
"He should avoid taking a bath for about 3 days but he can shower."
"It's normal if he says he feels like his heart skipped a beat."
15.
The nurse is preparing a teaching plan for the parents of a child who has been diagnosed
with a congenital heart defect. What would the nurse be least likely to include?
a.
b.
c.
d.
Daily weight assessment
Maintenance of strict bed rest
Prevention of infection
Signs of complications
16.
After teaching a class about the hemodynamic characteristics of congenital heart disease,
the instructor determines that the teaching has been successful when the class identifies which
defect as an example of a disorder involving increased pulmonary blood flow?
a.
b.
c.
d.
Tetralogy of Fallot
Atrial septal defect
Hypoplastic left heart syndrome
Transposition of the great vessels
17.
A 7-year-old child with a family history of cardiovascular disease is being screened for
hyperlipidemia. When reviewing the child's laboratory test results, which total cholesterol level
would be of significant concern?
a.
b.
c.
120 mg/dL
150 mg/dL
180 mg/Dl
d.
210 mg/dL
18.
A child with a suspected cardiovascular disorder is to undergo diagnostic testing and is
scheduled for an echocardiogram. When explaining this test to the child, what would the nurse
most likely include?
a.
"This test will check the pattern of how your heart is beating."
b.
"They'll take a picture of your chest to look at the heart's size."
c.
"A special wand that picks up sound is used to check your heart."
d.
"Small patches are attached to your chest to check the heart rhythm."
19.
The nurse is reviewing the medical record of a child with infective endocarditis. What
would the nurse expect to find? Select all that apply.
a.
White blood cell count revealing leukopenia
b.
Microscopic hematuria with urinalysis
c.
Electrocardiogram with prolonged PR interval
d.
Lungs clear on auscultation
e.
Petechiae on palpebral conjunctiva
20.
A child with heart failure is receiving supplemental oxygen. The nurse understands that in
addition to improving oxygen saturation, this intervention also has what effect?
a.
Cause vasodilation
b.
Increase pulmonary vascular resistance
c.
Promote diuresis
d.
Mobilize secretions
21.
The nurse is developing a plan of care for an infant with heart failure who is receiving
digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical
pulse rate was:
a.
140 beats per minute.
b.
120 beats per minute.
c.
100 beats per minute.
d.
80 beats per minute.
22.
A nurse is working with an adolescent who is slightly overweight and was recently
diagnosed with hypertension. They are discussing nutritional management. Which statement by
the adolescent demonstrates understanding of the information?
a.
"I have to make sure that I don't eat a lot of salty foods."
b.
"I can eat any amount at a meal as long as I don't eat between meals."
c.
"I should eat plenty of fresh fruits and vegetables."
d.
"If I skip breakfast, I can eat a much bigger lunch."
23.
A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder.
What would the nurse expect the physician to prescribe? Select all that apply.
a.
Intravenous immunoglobulin
b.
Ibuprofen
c.
Acetaminophen
d.
aspirin
e.
Alprostadile
24.
An infant with congenital heart disease is to undergo surgery to correct the defect. The
mother states, "I guess I'm going to have to stop breastfeeding her." Which response by the nurse
would be most appropriate?
a.
"That's true, but we'll make sure she gets the best intravenous nutrition."
b.
"Unfortunately, your baby needs more nutrients than what breast milk can provide."
c.
"Breast milk may help to boost her immune system, so you can continue to use it."
d.
"She won't be able to suck, so we have to give her fortified formula through a tube."
25.
During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital
heart disease tell the nurse, "We're just so tired and emotionally spent. All these tests and
examinations are overwhelming. We just want to have a normal life. We're so focused on the baby
that it seems like our 3-year-old is lost in the shuffle." Which nursing diagnosis would the nurse
identify as most appropriate?
a.
Risk for delayed growth and development related to necessary treatments
b.
Deficient knowledge related to the care of a child with congenital heart disease
c.
Interrupted family processes related to demands of caring for the ill child
d.
Fear related to infant's cardiac condition and need for ongoing care
26.
A nurse is caring for a newborn with congenital heart disease (CHD). Which finding would
the nurse interpret as indicating distress?
a.
Reduced respiratory rate during feeding
b.
Subcostal retraction at the time of feeding
c.
Perspiration on body after feeding
d.
Feeding lasting for 15-20 minutes
27.
Which defect results in increased pulmonary blood flow? a.Pulmonic stenosis
b.Tricuspid atresia c.Atrial septal defect
d.Transposition of the great arteries
28.
Which structural defects constitute tetralogy of Fallot?
a.Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
b.Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c.Aortic
stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy d.Pulmonic stenosis,
ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
29.
As part of the treatment for congestive heart failure, the child takes the diuretic furosemide.
As part of teaching home care, the nurse encourages the family to give the child foods such as
bananas, oranges, and leafy vegetables. These foods are recommended because they are high
in:
a.Chlorides. b.Potassium. c.Sodium d.Vitamins
30.
The nurse assessing a premature newborn infant auscultates a continuous machinery-like
murmur. Thisfinding is associated with which congenital heart defect?
a.Pulmonary stenosis b.Patent ductus arteriosus c.Ventricular septal defect d.Coarctation of the
aorta
31.
The nurse is developing a plan of care for an infant with heart failure who is receiving
digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical
pulse rate was:
a.
140 beats per minute.
b.
120 beats per minute.
c.
100 beats per minute.
d.
80 beats per minute.
32.
A nurse is teaching nursing students the physiology of congenital heart defects. Which
defect results in decreased pulmonary blood flow?
a. Atrial septal defect b.Tetralogy of Fallot c.Ventricular septal defect d.Patent ductus arteriosus
33.
A common, serious complication of rheumatic fever is:
a. Seizures.
b.Cardiac arrhythmias. c.Pulmonary hypertension. d.Cardiac valve damage
34.
A major clinical manifestation of rheumatic fever is:
a.
Polyarthritis.
b.
Oslers nodes. c.Janeway spots.
d.Splinter hemorrhages of distal third of nail
35.
The nurse is admitting a child with rheumatic fever. Which therapeutic management should
the nurse expect to implement? a.Administering penicillin
b.
Avoiding salicylates (aspirin)
c.
Imposing strict bed rest for 4 to 6 weeks d.Administering corticosteroids if chorea develops
36.
Which action by the school nurse is important in the prevention of rheumatic fever?
a.Encourage routine cholesterol screenings.
b.Conduct routine blood pressure screenings. c.Refer children with sore throats for throat cultures.
d.Recommend salicylates instead of acetaminophen for minor discomforts.
37.
A common, serious complication of rheumatic fever is:
a.Seizures.
b.Cardiac arrhythmias c.Pulmonary hypertension.. d.Cardiac valve damage.
A common clinical manifestation of Hodgkins disease is: a.Petechiae.
b.Bone and joint pain.
c.Painful, enlarged lymph nodes. d.Enlarged, firm, nontender lymph nodes.
38.
What is an expected assessment finding in a child with coarctation of the aorta?
a.Orthostatic hypotension
b.Systolic hypertension in the lower extremities c.Blood pressure higher on the left side of the
body
d.
Disparity in blood pressure between the upper and lower extremities
A nurse is reviewing a patients chart and notes that the patient has a cancerous tumor that has
invaded other organs. Based on this information, at which stage is this patients cancer classified?
a.
Stage O
b.
Stage I
c.
Stage III
d.
Stage IV
39.
A nurse hears that a new admission to the hospital was recently diagnosed with the most
common kind of childhood cancer. Which collaborative care does the nurse prepare to provide to
this patient?
a.
Antibiotic administration
b.
Bone marrow transplant
c.
Chemotherapy
d.
Liver transplant
40.
Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM)
because it is usually characterized by:
a.Fever as high as 40 C (104 F). b.Severe pain in the ear. c.Nausea and vomiting.
d.A feeling of fullness in the ear.
41.
Which statement is characteristic of acute otitis media (AOM)? a.The etiology is unknown.
b.Permanent hearing loss often results.
c.It can be treated by intramuscular antibiotics.
d.It is treated with a broad range of antibiotics.
42.
An infants parents ask the nurse about preventing otitis media (OM). What should the
nurse recommend?
a.Avoid tobacco smoke. b.Use nasal decongestant. c.Avoid children with OM.
d.Bottle-feed or breastfeed in supine position.
43.
Which type of croup is always considered a medical emergency? a.Laryngitis
b.Epiglottitis c.Spasmodic croup
d.Laryngotracheobronchitis (LTB)
44.
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay
at the bedside as much as possible. The nurses rationale for this action is primarily that:
a.Mothers of hospitalized toddlers often experience guilt.
b.The mothers presence will reduce anxiety and ease the childs respiratory efforts. c.Separation
from the mother is a major developmental threat at this age.
d.The mother can provide constant observations of the childs respiratory effort
45.
A school-age child has had an upper respiratory tract infection for several days and then
began having a persistent dry, hacking cough that was worse at night. The cough has become
productive in the past 24 hours.This is most suggestive of:
a.Bronchitis. b.Bronchiolitis.
c.Viral-induced asthma. d.Acute spasmodic laryngitis.
46.
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated
with sepsis. Nursing actions should include:
a.Force fluids.
b.Monitor pulse oximetry. c.Institute seizure precautions. d.Encourage a high-protein diet.
47.
Asthma in infants is usually triggered by: a.Medications.
b.A viral infection c.Exposure to cold air.
d.Allergy to dust or dust mites.
48.
A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory
phase ofrespiration. This suggests:
a.Asthma. b.Pneumonia. c.Bronchiolitis.
d.Foreign body in the trachea.
49.
It is now recommended that children with asthma who are taking long-term inhaled
steroids should beassessed frequently because they may develop:
a.Cough. b.Osteoporosis. c.Slowed growth. d.Cushings syndrome.
50.
b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma
attack. What is their action?
a.
Liquefy secretions
b.
Dilate the bronchioles
c.Reduce inflammation of the lungs d.Reduce infection
51.
A parent whose two school-age children have asthma asks the nurse in what sports, if
any, they can participate. The nurse should recommend:
a.Soccer. b.Running. c.Swimming. d.Basketball.
52.
Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? a.If
it is present in a child, both parents are carriers of this defective gene.
b.It is inherited as an autosomal dominant trait.
c.It is a genetic defect found primarily in non-Caucasian population groups. d.There is a 50%
chance that siblings of an affected child also will be affected.
53.
The earliest recognizable clinical manifestation of cystic fibrosis (CF) is: a.Meconium ileus.
b.History of poor intestinal absorption. c.Foul-smelling, frothy, greasy stools. d.Recurrent
pneumonia and lung infections.
54.
Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this
diagnosis?
a.Bronchoscopy b.Serum calcium c.Urine creatinine d.Sweat chloride test A child with cystic
fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug:
a.May cause mucus to thicken. b.May cause voice alterations. c.Is given subcutaneously.
d.Is not indicated for children younger than 12 years.
55.
Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing
considerations should include:
a.Do not administer pancreatic enzymes if the child is receiving antibiotics. b.Decrease dose of
pancreatic enzymes if the child is having frequent, bulky stools. c.Administer pancreatic enzymes
between meals if at all possible.
d.Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at
thebeginning of a meal.
56.
In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse
keep in mind?
a.
Diet should be high in carbohydrates and protein.
b.
Diet should be high in easily digested carbohydrates and fats.
c.Most fruits and vegetables are not well tolerated. d.Fats and proteins must be greatly curtailed.
57.
Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated
because it is the mostcentral and accessible?
a.Radial b.Carotid c.Femoral d.Brachial
58.
An appropriate nursing intervention when caring for a child with pneumonia is to:
a.Encourage rest.
b.Encourage the child to lie on the unaffected side. c.Administer analgesics.
d.Place the child in the Trendelenburg position.
59.
The parent of a toddler calls the nurse, asking about croup. What is a distinguishing
manifestation of spasmodic croup?
a.Wheezing is heard audibly. b.It has a harsh, barky cough.
c.
It is bacterial in nature. d.The child has a high fever.
60.
Which intervention for treating croup at home should be taught to parents? a.Have a
decongestant available to give the child when an attack occurs. b.Have the child sleep in a dry
room.
c.Take the child outside.
d.
Give the child an antibiotic at bedtime.
61.
Which information should the nurse teach workers at a day care center about respiratory
syncytial virus (RSV)?
a.
RSV is transmitted through particles in the air.
b.
RSV can live on skin or paper for up to a few seconds after contact.
c.
RSV can survive on nonporous surfaces for about 60 minutes. d.Frequent hand washing
can decrease the spread of the virus.
62.
Which vitamin supplements are necessary for children with cystic fibrosis? a.Vitamin C
and calcium
b.Vitamins B6 and B12 c.Magnesium
d.Vitamins A, D, E, and K
Parents have understood teaching about prevention of childhood otitis media if they make which
statement?
a.We will only prop the bottle during the daytime feedings. b.Breastfeeding will be discontinued
after 4 months of age. c.We will place the child flat right after feedings.
d.We will be sure to keep immunizations up to date.
63.
Parents have understood teaching about prevention of childhood otitis media if they make
whichstatement?
a.We will only prop the bottle during the daytime feedings. b.Breastfeeding will be discontinued
after 4 months of age. c.We will place the child flat right after feedings.
d.We will be sure to keep immunizations up to date.
64.
An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole
(Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of
the instructions?
a.I should administer all the prescribed medication.
b.I should continue medication until the symptoms subside.
c.I will immediately stop giving medication if I notice a change in hearing.
d.I will stop giving medication if fever is still present in 24 hours.
65.
The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using
a tonguedepressor might precipitate which symptom or condition?
a.Inspiratory stridor b.Complete obstruction c.Sore throat
d.Respiratory tract infection
66.
A nurse is conducting an in-service on asthma. Which statement is the most descriptive of
bronchial asthma?
a.There is heightened airway reactivity. b.There is decreased resistance in the airway.
c.The single cause of asthma is an allergic hypersensitivity. d.It is inherited.
67.
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When
should this medication be administered?
a.Before chest physiotherapy (CPT) b.After CPT
c.Before receiving 100% oxygen d.After receiving 100% oxygen
68.
An infant has developed staphylococcal pneumonia. Nursing care of the child with
pneumonia includeswhich of the following? (Select all that apply)
.
a.Cluster care to conserve energy
b.Round-the-clock administration of antitussive agents c.Strict intake and output to avoid
congestive heart failure d.Administration of antibiotics
e.Placement in a mist tent
69.
Therapeutic management of most children with Hirschsprungs disease is primarily: a.Daily
enemas.
b.Low-fiber diet. c.Permanent colostomy.
d.Surgical removal of affected section of bowel.
70.
A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A temporary
colostomy will benecessary. The nurse should recognize that preparing this child psychologically
is:
a.Not necessary because of childs age.
b.Not necessary because the colostomy is temporary. c.Necessary because it will be an
adjustment.
d.Necessary because the child must deal with a negative body image.
71.
A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without
othercomplications. What should the nurse suggest to minimize reflux?
a.Place in Trendelenburg position after eating. b.Thicken formula with rice cereal.
c.Give continuous nasogastric tube feedings.
d.Give larger, less frequent feedings.
72.
What is used to treat moderate-to-severe inflammatory bowel disease? a.Antacids
b.Antibiotics c.Corticosteroids d.Antidiarrheal medications
73.
An infant with short bowel syndrome will be discharged home on total parenteral nutrition
(TPN) and gastrostomy feedings. Nursing care should include:
a.Preparing the family for impending death.
b.Teaching the family signs of central venous catheter infection. c.Teaching the family how to
calculate caloric needs.
d.Securing TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.
74.
What food choice by the parent of a 2-year-old child with celiac disease indicates a need
for further teaching?
a.Oatmeal b.Rice cake c.Corn muffin
d.Meat patty
75.
Which defect results in increased pulmonary blood flow? a.Pulmonic stenosis
b.Tricuspid atresia c.Atrial septal defect
d.Transposition of the great arteries
76.
Which structural defects constitute tetralogy of Fallot?
a.Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
b.Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c.Aortic
stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy d.Pulmonic stenosis,
ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
77.
What is best described as the inability of the heart to pump an adequate amount of blood
to the systemic circulation at normal filling pressures?
a.Pulmonary congestion b.Congenital heart defect c.Congestive heart failure d.Systemic venous
congestion
A clinical manifestation of the systemic venous congestion that can occur with congestive heart
failure is:
a.Tachypnea. b.Tachycardia. c.Peripheral edema. d.Pale, cool extremities.
78.
A beneficial effect of administering digoxin (Lanoxin) is that it:
a.Decreases edema. b.Decreases cardiac output. c.Increases heart size. d.Increases venous
pressure.
79.
Which drug is an angiotensin-converting enzyme (ACE) inhibitor? a.Captopril (Capoten)
c.Spironolactone (Aldactone) b.Furosemide (Lasix) d.Chlorothiazide (Diuril)
80.
The nurse is evaluating a child who is taking digoxin for her cardiac condition. The nurse is
cognizant that a common sign of digoxin toxicity is:
a.Seizures.
b.Vomiting. c.Bradypnea. d.Tachycardia.
81.
The parents of a young child with congestive heart failure tell the nurse that they are
nervous about giving digoxin. The nurses response should be based on knowing that:
a.
It is a safe, frequently used drug.
b.
It is difficult to either overmedicate or undermedicate with digoxin. c.Parents lack the
expertise necessary to administer digoxin.
d.Parents must learn specific, important guidelines for administration of digoxin.
82.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The
nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective
to decrease this risk is to:
a.Minimize seizures. b.Prevent dehydration. c.Promote cardiac output. d.Reduce energy
expenditure.
83.
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. The nurses reply should be based on
knowing that:
a.The child needs opportunities to play with peers.
b.The child needs to understand that peers activities are too strenuous.
c.Parents can meet all the childs needs.
d.Constant parental supervision is needed to avoid overexertion.
84.
When preparing a school-age child and the family for heart surgery, the nurse should
consider:
a.Not showing unfamiliar equipment.
b.Letting child hear the sounds of an electrocardiograph monitor. c.Avoiding mentioning
postoperative discomfort and interventions.
d.Explaining that an endotracheal tube will not be needed if the surgery goes well.
85.
Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7 C (101
F). The nurse should:
a.Keep the child warm with blankets. b.Apply a hypothermia blanket.
c.Record the temperature on nurses notes. d.Report findings to physician.
86.
An important nursing consideration when chest tubes will be removed from a child is to:
a.Explain that it is not painful.
b.Explain that only a Band-Aid will be needed. c.Administer analgesics before the procedure.
d.Expect bright red drainage for several hours after removal.
87.
The most common causative agent of bacterial endocarditis is: a.Staphylococcus albus..
b.Streptococcus hemolyticus. c.Staphylococcus albicans d.Streptococcus viridans.
88.
Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in
bacterialendocarditis?
a. Oslers nodes b.Janeway lesions c.Subcutaneous nodules d.Aschoffs nodules
89.
A common, serious complication of rheumatic fever is: a.Seizures.
b.Cardiac arrhythmias. c.Pulmonary hypertension. d.Cardiac valve damage.
90.
A major clinical manifestation of rheumatic fever is:
a.Polyarthritis. b.Oslers nodes. c.Janeway spots.
d.Splinter hemorrhages of distal third of nails.
The leading cause of death after heart transplantation is:
a.
Infection. b.Rejection. c.Cardiomyopathy.
d.Congestive heart failure.
91.
b.
Which clinical changes occur as a result of septic shock? a.Hypothermia
Increased cardiac output c.Vasoconstriction d.Angioneurotic edema
92.
In which situation is there the greatest risk that a newborn infant will have a congenital
heart defect (CHD)?
a.Trisomy 21 detected on amniocentesis b.Family history of myocardial infarction c.Father has
type 1 diabetes mellitus d.Older sibling born with Turners syndrome
93.
When assessing a child for possible congenital heart defects (CHDs), where should the
nurse measure blood pressure?
a.The right arm b.The left arm
c.All four extremities
d.Both arms while the child is crying
94.
What is the nurses first action when planning to teach the parents of an infant with a
congenital heart defect (CHD)?
a.Assess the parents anxiety level and readiness to learn. b.Gather literature for the parents.
c.Secure a quiet place for teaching. d.Discuss the plan with the nursing team.
95.
What is the appropriate priority nursing action for the infant with a CHD who has an
increased respiratory rate, is sweating, and is not feeding well?
a.R
echeck the infants blood pressure. b.Alert the physician.
c.
Withhold oral feeding.
d.
Increase the oxygen rate.
Surgical closure of the ductus arteriosus would:
a.S
top the loss of unoxygenated blood to the systemic circulation. b.Decrease the edema in
legs and feet.
c.Increase the oxygenation of blood.
d.Prevent the return of oxygenated blood to the lungs.
96.
A nurse is teaching nursing students the physiology of congenital heart defects. Which
defect results in decreased pulmonary blood flow?
a.Atrial septal defect b.Tetralogy of Fallot c.Ventricular septal defect d.Patent ductus arteriosus
97.
The nurse is caring for an infant with congestive heart disease (CHD). The nurse should
plan whichintervention to decrease cardiac demands?
a.Organize nursing activities to allow for uninterrupted sleep. b.Allow the infant to sleep through
feedings during the night. c.Wait for the infant to cry to show definite signs of hunger.
d.Discourage parents from rocking the infant
98.
The nurse is conducting discharge teaching about signs and symptoms of heart failure to
parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the
nurse include (Select all that apply)?
a.Warm flushed extremities
b.Weight loss
c.Decreased urinary output d.Sweating (inappropriate) e.Fatigue
99.
What is most descriptive of the pathophysiology of leukemia? a.Increased blood viscosity
occurs.
b.Thrombocytopenia (excessive destruction of platelets) occurs.
c.Unrestricted proliferation of immature white blood cells (WBCs) occurs. d.The first stage of the
coagulation process is abnormally stimulated.
100. A boy with leukemia screams whenever he needs to be turned or moved. The most
probable cause of this pain is:
a.Edema.
b.Bone involvement. c.Petechial hemorrhages. d.Changes within the muscles.
101. A child with leukemia is receiving triple intrathecal chemotherapy consisting of
methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent: a.Infection.
b.Brain tumor. c.Drug side effects.
d.Central nervous system (CNS) disease.
102. A school-age child with leukemia experienced severe nausea and vomiting when receiving
chemotherapyfor the first time. The most appropriate nursing action to prevent or minimize these
reactions with subsequent treatments is to:
a.Encourage drinking large amounts of favorite fluids.
b.Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside.
c.Administer an antiemetic before chemotherapy begins.
d.Administer an antiemetic as soon as child has nausea.
103. Which immunization should not be given to a child receiving chemotherapy for cancer?
a.Tetanus vaccine
b.Inactivated poliovirus vacci c.Diphtheria, pertussis, tetanus (DPT) d.Measles, rubella, mumps
104. An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that
the bone marrow will be administered by which route?
a. Bone grafting
b.Bone marrow injection c.Intravenous infusion d.Intraabdominal infusion
105. A nursing faculty member explains to the class that which item is the most important for
tumor cell growth?
a.
Age of transforming cells
b.
Programmed cell death
c.
Proximity to a capillary
d.
Rapidity of cell growth
106. A nurse is reviewing a patients chart and notes that the patient has a cancerous tumor that
has invaded other organs. Based on this information, at which stage is this patients cancer
classified?
a.
Stage O
b.
Stage I
c.
Stage III
d.
Stage IV
107. A nurse hears that a new admission to the hospital was recently diagnosed with the most
common kind of childhood cancer. Which collaborative care does the nurse prepare to provide to
this patient?
a.
Antibiotic administration
b.
Bone marrow transplant
c.
Chemotherapy
d.
Liver transplant
108. A parent brings a child to the clinic and reports that the child is reluctant to walk and has a
new limp. The parent also reports that the child seems lethargic and tired all the time. The nurse
notes that the child appears pale. Which other finding would warrant immediate notification of the
health-care provider?
a.
Difficulty staying asleep at night
b.
c.
d.
Left-sided abdominal enlargement
Polyphagia and polydipsia
Swelling of the legs and feet
109. A child is admitted and is scheduled to receive intravenous asparginase (Elspar). Which
action by the nurse is most important when administering this medication?
a.
Arranging an outpatient hearing test
b.
Having emergency drugs on hand
c.
Monitoring the childs intake and output
d.
Providing anti-emetic drugs as needed ANS: B
110. A child has been diagnosed with chronic myelogenous leukemia (CML). Which statement
by the nurse to the parents is most appropriate?
a.
Radiation therapy is the standard treatment.
b.
The prognosis for this disease is extremely poor.
c.
There are lots of good medications for nausea.
d.
We need to test siblings for a bone marrow match.
111. A nurse is caring for a child who has acute lymphocytic leukemia and has been treated
with doxorubicin (Adriamycin). Which assessment finding would the nurse report immediately?
a.
Loss of appetite
b.
Low WBC count
c.
Peripheral edema
d.
Temperature of 100.6F (38.1C), once
112. A nursing student is caring for a child diagnosed with Wilms tumor. Which action by the
student causes the faculty member to intervene?
a.
Assesses urinary output per protocol
b.
Involves the parents in the childs care
c.
Palpates the abdomen in all four quadrants
d.
Provides frequent nutritious snacks
113. A nurse sees the term proptosis in a childs medical record. Which physical assessment
does the nurse plan to incorporate into the childs exam based on this finding?
a.
Balance testing
b.
Hearing screen
c.
Visual acuity
d.
Strength testing
A parent confides to the nurse that a friend, who is 32, has been diagnosed with Hodgkins
disease. The parent says I thought only children get that! What response by the nurse is the most
appropriate?
a.
No, there are both young adult and older adult forms.
b.
Usually people over the age of 50 do not get this.
c.
Yes, only children under the age of 10 are affected.
d.
You are right; your friend must have misspoken.
114. A nurse is caring for four patients who have Hodgkins lymphoma. Which child should the
nurse see first?
a.
Anorexia for a week
b.
Enlarged cervical lymph nodes
c.
Fever of 102.1F (38.9C)
d.
Mediastinal mass
115.
a.
b.
c.
d.
Prior to administering IV chemotherapy, which action by the nurse is most important?
Ensure the IV has a good blood return.
Provide diversionary activities.
Take and record a set of vital signs.
Weigh the child.
116. A child is receiving chemotherapy. The nurse assesses the childs oral cavity and notes the
following: raspy voice, thick saliva, and debris on the teeth. Which action by the nurse is the most
appropriate?
a.
Have the child use commercial mouthwash.
b.
Hold the next dose of chemotherapy.
c.
Increase the frequency of oral care.
d.
Place the child on NPO status.
117. The nurse is assisting the pediatric provider with a newborn examination. The provider
notes that the infant has hypospadias. The nurse understands that hypospadias refers to:
a.
Absence of a urethral opening.
b.
Penis shorter than usual for age.
c.
Urethral opening along dorsal surface of penis.
d.
Urethral opening along ventral surface of penis.
118.
a.
b.
An objective of care for the child with nephrosis is to:
Reduce blood pressure.
Reduce excretion of urinary protein.
c.
d.
Increase excretion of urinary protein.
Increase ability of tissues to retain fluid.
119.
a.
b.
c.
Therapeutic management of nephrosis includes:
Corticosteroids.
Antihypertensive agents
Long-term diuretics. .
d.
Increased fluids to promote diuresis.
120. The nurse closely monitors the temperature of a child with nephrosis. The purpose of this
is to detect an early sign of:
a.
Infection.
b.
Hypertension.
c.
Encephalopathy.
d.
Edema.
121. Which drug would be used to treat a child who has increased intracranial pressure (ICP)
resulting from
cerebral edema? a.Mannitol
b.Epinephrine hydrochloride c.Atropine sulfate
d.Sodium bicarbonate
131.A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis
during this acute phase to show:
a.
Bacteriuria and hematuria.
b.
Hematuria and proteinuria.
c.
Bacteriuria and increased specific gravity.
d.
Proteinuria and decreased specific gravity.
132.
a.
b.
c.
d.
The most appropriate nursing diagnosis for the child with acute glomerulonephritis is:
Risk for Injury related to malignant process and treatment.
Deficient Fluid Volume related to excessive losses.
Excess Fluid Volume related to decreased plasma filtration.
Excess Fluid Volume related to fluid accumulation in tissues and third spaces.
A child is brought to the emergency department after experiencing a seizure at school. There is no
previoushistory of seizures. The father tells the nurse that he cannot believe the child has
epilepsy. The nurses best response is:
a.Epilepsy is easily treated.
b.Very few children have actual epilepsy.
c.The seizure may or may not mean that your child has epilepsy.
d.Your child has had only one convulsion; it probably wont happen again.
133. Which type of seizure involves both hemispheres of the brain?
a. Focal b.Partial c.Generalized d.Acquired
134. The nurse is teaching the parent about the diet of a child experiencing severe edema
associated with acute glomerulonephritis. Which information should the nurse include in the
teaching?
a.
You will need to decrease the number of calories in your childs diet.
b.
Your childs diet will need an increased amount of protein.
c.
You will need to avoid adding salt to your childs food.
d.
Your childs diet will consist of low-fat, low-carbohydrate foods.
135. The nurse is caring for a child with severe head trauma after a car accident. Which is an
ominous sign that often precedes death?
a.Papilledema b.Delirium
c.Dolls head maneuver d.Periodic and irregular breathing
136. A school-age child is admitted to the hospital with acute glomerulonephritis and oliguria.
Which dietary menu items should be allowed for this child (Select all that apply)?
a.
Apples
b.
c.
d.
e.
Bananas
Cheese
Carrot sticks
Strawberries
A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome.
Which clinical manifestations should the nurse expect to assess (Select all that apply)?
a.
Weight loss
b.
Facial edema
c.
Cloudy, smoky browncolored urine
d.
Fatigue
e.
Frothy-appearing urine
137. Clinical manifestations of increased intracranial pressure (ICP) in infants are (Select all
that apply):
a.Low-pitched cry. b.Sunken fontanel.
c.Diplopia and blurred vision. d.Irritability.
e.Distended scalp veins. f.Increased blood pressure.
138. The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which
are late signs of
increased ICP in an infant (Select all that apply)? a.Tachycardia
b.Alteration in pupil size and reactivity c.Increased motor response d.Extension or flexion
posturing e.Cheyne-Stokes respirations
139. What effect does immobilization have on the cardiovascular system? a.Venous stasis
b.Increased vasopressor mechanism c.Normal distribution of blood volume
d.Increased efficiency of orthostatic neurovascular reflexes
140.
a.
b.
c.
d.
What is characteristic of the immune-mediated type 1 diabetes mellitus?
Ketoacidosis is infrequent.
Onset is gradual.
Age at onset is usually younger than 18 years.
Oral agents are often effective for treatment.
141.
Which symptom is considered a cardinal sign of diabetes mellitus?
a.
Nausea
b.
Seizures
c.
Impaired vision
142. Frequent urination Type 1 diabetes mellitus is suspected in an adolescent. Which clinical
manifestation may be present?
a.
Moist skin
b.
Weight gain
c.
Fluid overload
143. Poor wound healing When does idiopathic scoliosis become most noticeable? a.Newborn
period
b.When child starts to walk
c.During preadolescent growth spurt d.Adolescence
144. The parents of a child who has just been diagnosed with type 1 diabetes ask about
exercise. The nurse should explain that:
a.
Exercise will increase blood glucose.
b.
Exercise should be restricted.
c.
Extra snacks are needed before exercise.
d.
Extra insulin is required during exercise.
145. Osteosarcoma is the most common bone cancer in children. Where are most of the
primary tumor sites?
a.Femur c.Pelvis
b.Humerus d.Tibia
146. What is most descriptive of the therapeutic management of osteosarcoma? a.Treatment
usually consists of surgery and chemotherapy.
b.Amputation of the affected extremity is rarely necessary. c.Intensive irradiation is the primary
treatment.
d.Bone marrow transplantation offers the best chance of long-term survival.
147. Which medication is usually tried first when a child is diagnosed with juvenile idiopathic
arthritis (JIA)?
a.Aspirin b.Corticosteroids
c.Cytotoxic drugs such as methotrexate d.Nonsteroidal antiinflammatory drugs (NSAIDs)
148. An important nursing consideration when caring for a child with juvenile idiopathic arthritis
(JIA) is to:
a.Apply ice packs to relieve stiffness and pain. b.Administer acetaminophen to reduce
inflammation.
c.Teach child and family the correct administration of medications. d.Encourage range-of-motion
exercises during periods of inflammation.
149. Discharge planning for the child with juvenile arthritis includes the need for: a.Routine
ophthalmologic examinations to assess for visual problems.
b.A low-calorie diet to decrease or control weight in the less mobile child. c.Avoiding the use of
aspirin to decrease gastric irritation.
d.Immobilizing the painful joints, which are the result of the inflammatory process.
150. What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not
eating as a result of a minor illness?
a.
Give the child half his regular morning dose of insulin.
b.
Substitute simple carbohydrates or calorie-containing liquids for solid foods.
c.
Give the child plenty of unsweetened, clear liquids to prevent dehydration.
d.
Take the child directly to the emergency department.
151. The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal
instrumentation
procedure. Which consideration should the nurse include?
a.Nasogastric intubation and urinary catheter may be required. b.Ambulation will not be allowed
for up to 3 months.
c.Surgery eliminates the need for casting and bracing. d.Discomfort can be controlled with
nonpharmacologic methods.
152. The parent of a child with diabetes mellitus asks the nurse when urine testing will be
necessary. The nurse should explain that urine testing is necessary for which?
a.
Glucose is needed before administration of insulin.
b.
Glucose is needed four times a day.
c.
Glycosylated hemoglobin is required.
d.
Ketonuria is suspected.