儿科29到36章疾病试题374-479_在线真题试卷与模拟练习_儿科29到36章疾病试题374-479_考试宝

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A nurse is caring for a 2-year-old with a new diagnosis of strabismus. Which intervention should the nurse anticipate?

A nurse is planning to test the visual acuity of a 7-year-old. Which is the best way to test visual acuity in this child?

A 2-year-old is suspected of having retinoblastoma. The nurse recognizes which sign as being most characteristic of this disease?

A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which intervention is most important for the nurse to recommend to the parents in order to prevent recurrence?

The nurse is providing discharge instructions to the parent of a child with Kawasaki disease. The nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

An 8-month-old infant is scheduled for a femorally inserted balloon angioplasty of a congenital pulmonic stenosis in the cardiac catheterization laboratory. Which finding should the nurse report to the health care provider that could possibly delay the procedure?

A 3-month-old who weighs 8.8 lb (4 kg) has just returned to the intensive care unit after surgical repair of a congenital heart defect. Which finding by the nurse should be reported immediately to the health care provider?

Chest tubes may be placed during cardiac surgery to help drain fluid and air and to ensure room for lung expansion. The chest tube and chamber should be assessed every hour for color and quantity of drainage. Drainage >3 mL/kg/hr for 3 consecutive hours or >5-10 mL/kg in 1 hour should be reported immediately to the health care provider (Option 1). This could indicate postoperative hemorrhage and requires immediate intervention. Cardiac tamponade can develop rapidly in children and can be life-threatening. This child weighs 4 kg and an output of 50 mL in 1 hour is excessive.

The nurse is planning care for a child being admitted with Kawasaki disease and should give priority to which nursing intervention?

Kawasaki disease (KD) is a childhood condition that causes inflammation of arterial walls (vasculitis). The coronary arteries are affected in KD, and some children develop coronary aneurysms. The etiology of KD is unknown; there are no diagnostic tests to confirm the disease, and it is not contagious. KD has 3 phases: 1. Acute - sudden onset of high fever that does not respond to antibiotics or antipyretics. The child becomes very irritable and develops swollen red feet and hands. The lips become swollen and cracked, and the tongue can also become red (strawberry tongue). 2. Subacute - skin begins to peel from the hands and feet. The child remains very irritable. 3. Convalescent - symptoms disappear slowly. The child's temperament returns to normal. Initial treatment consists of IV gamma globulin (IVIG) and aspirin. IVIG creates high plasma oncotic pressure, and signs of fluid overload and pulmonary edema develop if it is given in large quantities. Therefore, the child should be monitored for symptoms of heart failure (eg, decreased urinary output, additional heart sounds, tachycardia, difficulty breathing).

The nurse has received report on 4 pediatric clients on a telemetry unit. Which client should the nurse assess first?

Ventricular septal defect (VSD) is a congenital abnormality in which a septal opening between ventricles causes left-to-right shunting, leading to excess blood flow to the lungs. This places the client at risk for congestive heart failure (CHF) and pulmonary hypertension. Clinical manifestations of VSD include a systolic murmur auscultated near the sternal border at the third or fourth intercostal spaces, and hallmark CHF signs (eg, diaphoresis, tachypnea, dyspnea). The client is currently showing signs of increased respiratory exertion (eg, grunting) and requires further assessment for CHF (Option 2).

Click on the area where the nurse should place the thumbs or fingers to provide chest compressions for an infant. Left-clicking the mouse will put an X to show the answer before submitting the question. (缺图)

The nurse is caring for a newborn with patent ductus arteriosus. Which assessment finding should the nurse expect?

The emergency nurse is admitting a 12-year-old client who reports palpitations. Which action should the nurse anticipate? Click the exhibit button for additional information.

The emergency nurse is admitting a 12-year-old client who reports palpitations. Which action should the nurse anticipate? Click the exhibit button for additional information.

Supraventricular tachycardia (SVT) is the most common tachyarrhythmia of childhood and refers to a rapid heart rate of 200-300/min with no variation in rate during activity. It can lead to life-threatening congestive heart failure if left untreated. Symptoms in children may include palpitations, dizziness, or chest pain. Once an ECG confirms SVT, the nurse should anticipate nonpharmacological interventions (ie, vagal maneuvers) to convert SVT to sinus rhythm if the client is stable. Placing an ice bag to the client's face and instructing the client to hold their breath while bearing down (Valsalva) are vagal maneuvers that can slow electrical conduction through the heart's atrioventricular node (Option 3). If these maneuvers are ineffective, or if the client becomes unstable, administration of adenosine or synchronized cardioversion is indicated. IV epinephrine is not an appropriate treatment for a stable client with tachycardia and would further increase the client's heart rate. Epinephrine is typically used for clients with pulseless arrhythmias (eg, asystole). The tripod position opens the airway and promotes airflow, particularly for clients with significant airway obstruction (eg, epiglottitis). The child with palpitations may assume any position of comfort. Asynchronous defibrillation is indicated for the treatment of lethal cardiac arrhythmias (eg, ventricular fibrillation, pulseless ventricular tachycardia). Educational objective: Supraventricular tachycardia refers to a rapid heart rate of 200-300/min with no variation in rate during activity. The nurse should anticipate instructing the client to perform vagal maneuvers (eg, Valsalva) first if the client is stable.

A nurse auscultates a loud cardiac murmur on a newborn with suspected trisomy 21 (Down syndrome). A genetic screen and an echocardiogram are scheduled that day. The neonate's vital signs are shown in the exhibit. What would be an appropriate action for the nurse to complete next? Click on the exhibit button for additional information.

A nurse auscultates a loud cardiac murmur on a newborn with suspected trisomy 21 (Down syndrome). A genetic screen and an echocardiogram are scheduled that day. The neonate's vital signs are shown in the exhibit. What would be an appropriate action for the nurse to complete next? Click on the exhibit button for additional information.

A nurse is assessing a 1-month-old infant with an atrial septal defect (ASD). Which assessment finding does the nurse expect?

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