GI
A child undergoes rehydration therapy after having diarrhea and dehydration. A nurse is teaching the child’s parents about dietary management after rehydration. The nurse understands that the teaching plan has been successful when the parents tell the nurse they will follow which type of diet?
A. Regular
B. Clear liquid
C. Full liquid
D. Soft
A. Regular
A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The child's color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?
A. Obtain an order for sedation for the child
B. Assess for an irregular heart rate and rhythm
C. Explain to the child that it will only hurt for a short time
D. Place the child in the knees-to-chest position
D. Place the child in the knees-to-chest position
Ordered: 500 mL of Normal Saline over 4 hours. What would you set on your pump for rate and volume to be infused?
125 mL/hour
VTBI 499 mL
Ribbon like stools are associated with which of the following:
A. Intussusception
B. Crohns Disease
C. Biliary Atresia
D. Hirschprung's Disease
D. Hirschprung's Disease
What medication order would you question for an infant with a cardiac disorder?
A. Administer Furosemide for severe heart failure.
B. Administer Digoxin while infant's HR is 82.
C. Administer an ACE inhibitor while infant's BP is 80/40.
D. Administer Spironolactone while the infant is not on any Potassium supplements.
B. Administer Digoxin while infant's HR is 82.
The nurse admits an infant with pyloric stenosis to the hospital. Which aspect of the plan of care should the nurse implement first
A. Begin an IV infusion
B. Weigh the infant
C. Switch the infant to an oral electrolyte solution
D. Orient the parent to the hospital unit
B. Weigh the infant
Which of the following should the nurse consider when preparing a school-age child and the family for heart surgery?
A. Unfamiliar equipment should not be shown to the child.
B. Explain the procedure 10 minutes before the child is taken to the OR.
C. Let the child hear the sounds of a cardiac monitor, including alarms.
D. Explain to the parents that an endotracheal tube will not be needed if the surgery goes well.
C. Let the child hear the sounds of a cardiac monitor, including alarms.
A nurse is reinforcing discharge teaching about oral rehydration with the parent of a preschooler who has dehydration. Which of the following statements by the parent indicates an understanding of the teaching?
A. "I will offer my child a cup of oral rehydration fluid every time he has diarrhea."
B. "I will give my child apple juice in between meals to keep him hydrated."
C. "I will give my child a diet of bananas, rice, applesauce, and toast until his diarrhea subsides."
D. "I will give my child chicken broth three times each day."
A. "I will offer my child a cup of oral rehydration fluid every time he has diarrhea."
The nurse assesses an 8-month-old infant admitted with severe diarrhea. Which finding does the nurse recognize as being the most significant?
A. Bowel sounds every 5 minutes
B. Pale yellow urine
C. Normal skin elasticity
D. Depressed anterior fontanelle
D. Depressed anterior fontanelle
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:
A. Cyanosis
B. Congestive heart failure
C. Decreased pulmonary blood flow
D. Bounding pulses in upper extremities
B. Congestive heart failure
The nurses assesses an infant who has had surgery to correct an intussusception and is now at risk for the development of a paralytic ileus postoperatively. Which assessment should be the priority?
A. Measurement of urine specific gravity
B. Inspection of the first stool passed
C. Auscultation of bowel sounds
D. Measurement of gastric output
C. Auscultation of bowel sounds
For a child with CHD, what forms of education could you use to help parents begin to understand their child's diagnosis? Select all that apply.
A. Glossary of medical terms
B. Always use correct medical terminology
C. Provide a photo or diagram of the heart
D. Ask parents critical thinking questions related to the child's diagnosis
E. Adjust education to the developmental age of the child
A. Glossary of medical terms
C. Provide a photo of the heart
E. Adjust education to the developmental age of the child
A child weighs 18.6kg pre illness, now they weigh 17.8kg.
1. How many mL per kg have they lost?
2. What level of dehydration do they have?
24mL per kg
Mild
Which of the following is true regarding GER?
A. It is a regurgitation of gastric contents into the lung
B. Children who are born post-maturely have a higher incidence
C. Repeated reflux of gastric contents can damage delicate esophageal mucosa
D. Surgery is the usual treatment
C. Repeated reflux of gastric contents can damage delicate esophageal mucosa
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 38o C (100.4 F), and now her muscles and joints ache. Based on this information you advise the mother to:
A. treat the symptoms with acetaminophen and fluids, since it is most likely a viral illness
B. Come to the clinic next week on a scheduled appointment
C. Recognize that the child is trying to get out of school for the day by complaining of vague symptoms
D. Immediately bring the child to clinic for evaluation
D. Immediately bring the child to clinic for evaluation
Eight hours ago, an infant with Hirschsprung's disease had surgery to create a colostomy. Which finding should alert the nurse to notify the provider immediately?
A. 3 cm increase of abdominal circumference
B. Periods of occasional fussiness
C. Absence of bowel sounds since surgery
D. Appearance of bright red stoma
A. 3 cm increase of abdominal circumference
What medication can be administered to try and close a patent ductus arteriosus (PDA)?
A. Indomethacin
B. Digoxin
C. Metoprolol
D. Prostaglandin E1
A. Indomethacin
An infant weighing 7.34kg has the following wet diapers during your 12 hour shift:
33mL, 45mL, 43mL, 58mL.
Is this sufficient?
Yes
Which statement by the parents would indicate the need for further education regarding caring for their child post cleft lip surgery?
A. “I will prop my child up while they are laying down”
B. “I will give my child Tylenol for the pain when we are at home”
C. “I will feed my child applesauce with a spoon for the first two weeks”
D. “I will wash the sutures with soap and water”
C. “I will feed my child applesauce with a spoon for the first two weeks”
The nurse assesses a child after heart surgery to correct tetralogy of Fallot. Which finding would the nurse report to the health care provider as an indication that the client has low cardiac output?
A. Bounding pulses and mottled skin
B. Altered level of consciousness and thready pulse
C. Capillary refill of 2 seconds and blood pressure of 96/67
D. Extremities warm to the touch and pale skin
B. Altered level of consciousness and thready pulse
The infant you are caring for begins to have excessive frothy salvia, unexplained episodes of apnea, O2 desaturations, and episodes of cyanosis, what would your FIRST action be?
A. This is an expected finding, no further action needed.
B. Call the provider.
C. Obtain a set of vital signs.
D. Observe the infant during a feed.
B. Call the provider.
A 10-year-old presents to the ED with sudden aimless irregular movements of the extremities, speech disturbances, and a pink rash on the trunk and extremities. The nurse notes a recent history of pharyngitis. Which diagnosis does the nurse anticipate being made?
A. Kawasaki’s Disease
B. Bacterial Endocarditis
C. Rheumatic Fever
D. Fifth’s Disease
C. Rheumatic Fever
A child is brought to the ED with recurrent vomiting and diarrhea. Their parent states that they have tried to maintain hydration with chicken broth, but their child is not improving. The nurse anticipates the child has what type of dehydration?
A. Hypotonic
B. Isotonic
C. Hypertonic
D. Idktonic
C. Hypertonic
Your 4-year-old patient presents to the hospital with the following symptoms: Sudden abdominal pain, abdominal distention, lethargy, and jelly-like stools. What diagnosis do you expect the patient to receive?
A. Biliary atresia
B. Appendicitis
C. GER
D. Intussusception
D. Intussusception
A child admitted to the hospital with an unknown illness manifesting with a high fever. While in the hospital the nurse notes inflammation of the oropharynx and periungual desquamation. What treatment does the nurse anticipate being ordered?
A. Penicillin G
B. IVIG & aspirin
C. Spironolactone
D. Digoxin
B. IVIG & aspirin