‫جامعة بورسعيد‬
‫كلية التمريض‬
‫م‬2014-2013:‫ العام الجامعي‬Critical Pediatric Nursing ‫ تمريض حاالت حرجة أطفال‬:‫المادة‬
‫ األول‬:‫الفصل الدراسي‬
‫ الثالثة‬: ‫الفرقة‬
‫درجة‬40 :‫الدرجة‬
‫ أمل أحمد خليل‬.‫د‬.‫ ا‬:‫أستاذ المادة‬
‫نجوى رزق محمد‬.‫د‬
:‫التاريخ‬
‫ ساعات‬3 : ‫الزمن‬
QI: Chose the correct answer: Only one choice (15 marks each point
1\2)
1. The following respiratory disorders are considering respiratory emergency
except:
a. Croup
b. Epiglotitis
c. Bronchitis
d. Asthma
2. The following is the obvious sign of epiglotitis:
a. The child sits up, leans forward, extends neck slightly
b. Veins may become visible on the chest
c. Tachycardia and dyspneic
d. decreased blood flow to extremities
3. Which is the following manifestation would cause the nurse to suspect renal
failure:
a. Pyelonephritis
b. An upper respiratory tract infection
c. Followed to skin infection
d. Antigen-antibody reaction secondary to an infection
4. The manifestations of foreign body airway obstruction all the following
except:
a. Respiratory distress
b. Choking
c. Congenital obstruction
d. Coughing
5. All of the following are true about renal failure except:a. Provide diet low in protein ,sodium ,and potassium
b. Shave abdomen in peritoneal dialysis
c. Instruct about the need for medical evaluation & tissue culture of sore
throats
d. Wash the site of shunt with sterile water
6. Which of the following instructions would the nurse include in a teaching
plan that focuses on initial prevention of leukemia:
a. Avoid certain preservatives in pickled, salted foods; fried foods;
high-fat
b. Problem solving skills training for the children
c. Provide support for parents and the child
d. Nurse should provide peaceful and comfortable environment
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7. Peak onset of leukemia between ages:
a. 1-2 years.
b. 2-4 years.
c. 2-8 years.
d. 3-5 years
8. The primary cause of heart failure in the first 3 years of life is
a. Congenital H.D
b. Poor feeding.
c. Anorexia.
d. Meningitis.
9. The following are the types of Seizure except:
a. Tonic
b. Clonic
c. Autonomic
d. Myoclonic
10. Which of the following instructions would the nurse include in a care plan
that focuses on the management of congestive heart failure:
a. Avoid restraints in abdomen or chest
b. Observe cyanosis,dyspnea,Orthopnea
c. Position and humidified O2
d. All of the above
11. Common Signs of Digoxin Toxicity are the following except:
a. Anorexia
b. Bradycardia
c. Choking
d. Dysrhythmia
12. When the nurse assess the neonate with congenital heart disease; Which of
the following disorders leads to cyanosis from deoxygenated blood entering
the systemic arterial circulation?
a. Patent duct arteriosus.
b. Tetralogy of Fallot.
c. Coarctation of aorta.
d. Aortic Stenosis.
13. While assessing a child with Coarctation of the aorta, the nurse would expect
to find which of the following
a. Absent or diminished femoral pulse
b. Cyanosis at birth.
c. Squatting posture.
d. Cyanotic episodes.
14. In prepare incubator for safe use the nurse must:
a. Turn the temperature control dial between 28- 32 °c.
b. Keep incubator in sunlight or warm radiant.
c. Adjust humidity knob between 80- 95%.
d. Turn the temperature control dial between 30- 32 °c.
15. In the intensive care unit (in incubator).
a. Live plants and flowers are not allowed beside the incubator.
b. Supplies should be shared between babies.
c. Employees with infectious skin touch baby without precautions.
d. Food and drink are allowed beside the incubator.
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16. Which of the following instructions would the nurse focuses on for the child
epispadias and hypospadias:
a. The child should not be circumcised before repair of the defect
b. Avoid restraints in abdomen or chest
c. Do nothing because this is a normal finding for this child
d. Perform an intensive neurological examination.
17. Anomalies of the stomach and duodenum are the following:
a. Pyloric stenosis
b. Duodenal obstruction
c. Hiatus hernia
d. All the above
18. The following are the most nursing general considerations upon surgery for
children with congenital anomalies except:
a. The child usually needs proportionately less analgesic
b. Abnormal fluid loss is more serious in the infant and young child
c. The body tissues of the child heal quickly
d. Lie on the abdomen
19. Which is the following manifestation would cause the nurse to suspect cleft
lip:
a. Fissure in the upper lip appears at birth
b. Respiratory distress
c. Midline fissure of the palate
d. None of the above
20. When the nurse perform incubator care after the baby leave it out of the
unit, the type of the incubator care is:
a. Daily care
b. Terminal care
c. Safe use care
d. None of the above
21. The nurse prepares the humidity of the incubator during daily care:
a. Between 55-65%
b. Between 20%- 40%
c. Between 50%- 40%
d. Between 10%-15%
22. When the nurse assess the neonate for Physiological jaundice:a. In full term appears 2-3 days and disappears at 7days.
b. In full term appears 3-4 days and disappears at 9-10 days.
c. Appears within the first day after birth.
d. Disappears within the first day after birth
23. Before neonatal resuscitation the nurse must prepare the needed equipment
for it as the following:
a. Bag ventilation mask (BVM) with heated & humidified O2
b. Suction source and tubing
c. Laryngoscope with proper sized blades
d. All of the above
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24. Steps that the nurse performs in neonatal resuscitation are the following
except:
a. Warmth and stimulation and assessment for the 1st 30 seconds
b. Clear airway if required
c. Position the neonate in Sniffing Position
d. Initiate breast feeding immediately
25. AS the respiratory distress syndrome (RDS) progress the nurse would expect
to find the following except:a. Flaccidity.
b. Unresponsiveness
c. Frequent apneic episodes
d. Fever
26. The nurse must be alert to the side effects of photo therapy which are the
following:
a. Erythema .
b. Hypocalcemia.
c. Retinal damage
d. All of the above
27. Sufficient nursing personnel are required to provide appropriate care for the
neonates in level-II is:
a. 1 nurse per 6-8 neonate
b. 1 nurse per 2-3 neonate
c. 1 nurse per 1-2 neonate
d. None of the above
28. Chest electrodes in incubator should be changed every
a. 3 days.
b. 4 days.
c. 5 days
d. 6 days
29. From the nursing responsibilities in blood exchange transfusion:
a.
b.
c.
d.
Keep the newborn NPO for 2-4 hours before exchange
Check donor blood carts compatibility.
Keep resuscitation equipment at bedside.
All of the above
30. The deformity can be identified by placing the nurse`s fingers directly on the
palate:
a.
b.
c.
d.
Cleft lip.
Cleft palate
Cleft lip & palate
None is correct
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QII: read the following sentences and write true or false in front of
each sentence (5 marks each point 1\2):
Item
T
F
1. Hand Washing is recognized as the single most important infection control
measure in the all neonatal units.
2. When the nurse notice the baby cold moist pale or cyanotic skin postoperatively, she expect the child complaining of hypothermia
3. Longer-term side effects of chemotherapy can include infertility
4. Atrial septum defect is the opening in the septum between the two
ventricles
5. If the nurse noticed that higher pressures in the upper extremities than in
the lower extremities she must expect this child have ventricular septal
defect
6. Hyperacute rejection after heart transplantation may begin at about 7 days
7. Meningitis is an inflammation of the meninges which may leads to neck
stiffness
8. Post term is any baby born before 32 weeks of gestational age
9. Leukemia is a destruction of the RBCs of the fetus and newborn by
antibodies produced by the mother
10. Imperforated anus is a defective closure of the vertebral column usually
occurs in the lumbosacral area.
QIII: answer the following questions (12 marks):
1. Discuss 3 nursing diagnoses with the needed intervention for the newborn with
hyperbilirubinemia (2 marks).
2. Explain Nursing care of the Shunt during dialysis (2 marks).
3. Design nursing care plan for the child with meningitis (2 marks).
4. Illustrate classification of congenital heart disease (2 marks).
5. Put appropriate nursing care plan for the child with leukemia (2 marks).
6. Discuss nursing interventions to reduce the workload of the heart (2 marks).
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QIV: read the following situation and answer the questions (8 marks):
Ahlam coming to emergency unit accompanying with her sister`s male newborn
in el naser hospital suffering from excessive amount of frothy saliva in the mouth and
difficulty with secretions and unexplained episodes of cyanosis. After complete
physical examination both physician and nurse detect that this neonate have
congenital anomaly and they dealing with the neonate in this emergency situation as
well as refers to the pediatric surgical department to receive the appropriate treatment
and nursing management.
Answer the following questions:
1. Determine the diagnosis of the problem that the neonate have during this
emergency situation and define it (1 mark).
2. List its clinical manifestations (1 mark).
3. Explain the assessment of this neonate in this situation (2 marks).
4. State the possible nursing diagnosis for this neonate in this situation (2 marks).
5. Explain the nursing management of the neonate during this emergency situation
(2 marks).
With beast wishes
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