Deck 25: The Child With a Respiratory or Cardiovascular Disorder

Question 1

The nurse caring for a child experiencing an acute asthma attack would include:

A) Offering plenty of fluids, particularly carbonated beverages
B) Placing the child in a humidified cool mist tent with oxygen
C) Administering sedatives as ordered to decrease anxiety
D) Positioning the child with arms resting on the overbed table

Answer 1

Positioning the child with arms resting on the overbed table

Question 2

The nurse offers a variety of fluids to compensate for the fluid loss through dyspnea. Appropriate fluids would be:

A) Room temperature water
B) Carbonated beverages
C) Iced fruit juice
D) Cold milk

Answer 2

Room temperature water

Question 3

The nurse explains that a ventricular septal defect will:

A) Allow blood to shunt left to right, causing increased pulmonary flow and no cyanosis
B) Allow right-to-left shunt, causing decreased pulmonary flow and cyanosis
C) Allow no shunting because of high pressure in the left ventricle
D) Allow increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume

Answer 3

Allow blood to shunt left to right, causing increased pulmonary flow and no cyanosis

Question 4

The nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, would expect to find:

A) Fine crackles
B) Coarse rhonchi
C) Expiratory wheezing
D) Decreased breath sounds at lung bases

Question 5

An infant is hospitalized with RSV bronchiolitis. The priority nursing diagnosis is:

A) Fatigue related to increased work of breathing
B) Ineffective breathing pattern related to airway inflammation and increased secretions
C) Risk for fluid volume deficit related to tachypnea and decreased oral intake
D) Fear/anxiety related to dyspnea and hospitalization

Question 6

The nurse would advise a mother to clear the nostrils when her infant has a cold by:

A) Clearing the nasal passages after the infant has a feeding
B) Using over-the-counter nose drops to clear passages
C) Removing nasal secretions with a bulb syringe
D) Instilling saline nose drops after clearing away secretions

Question 7

The assessment that would lead the nurse to suspect that a newborn infant has a ventricular septal defect, is:

A) A loud, harsh murmur with a systolic tremor
B) Cyanosis when crying
C) Blood pressure higher in the arms than in the legs
D) A machinery-like murmur

Question 8

The nurse would observe a child for frequent swallowing following a tonsillectomy and adenoidectomy (T & A) because this is indicative of:

A) Bleeding from the surgical site
B) Pain at the incision area
C) Sore throat from postnasal drip
D) Potential vomiting

Question 9

The best choice for fluid replacement that the nurse can offer a child who has just had a tonsillectomy is:

A) Popsicle
B) Chocolate milk
C) Orange juice
D) Cola drink

Question 10

The statement indicating that the child's parents understand how to perform respiratory therapy is:

A) "We do her postural drainage before the aerosol therapy."
B) "We give her respiratory treatments when she is coughing a lot."
C) "We give the aerosol followed by postural drainage before meals."
D) "She needs respiratory therapy everyday when she has an infection."

Question 11

The 4-month-old child in the emergency department shows extreme dyspnea, a croaking inspiration, and excessive drooling. Based on these observations alone, the nurse's initial intervention would be to:

A) Sit the child upright and notify the physician.
B) Start oxygen by mask and keep the child flat.
C) Apply a cold compress to the throat.
D) Assess the back of the throat for obstruction.

Question 12

The nurse is planning to teach parents about preventing sudden infant death syndrome (SIDS). Significant information would be to:

A) Wrap the infant snugly for rest periods.
B) Position the infant prone for sleep.
C) Sit the baby up in an infant seat.
D) Place infants on their back or side for sleep.

Question 13

To facilitate digestion and absorption of nutrients, the nurse teaches the child with cystic fibrosis that she needs to take:

A) Pancreatic enzymes
B) Water-soluble minerals
C) Fat-soluble vitamins
D) Salt supplements

Question 14

The initial intervention that the nurse would suggest to the parents of a child experiencing laryngeal spasm is to:

A) Take the child outside in the cool air.
B) Bring the child directly to the emergency department.
C) Put the child in the bathroom with a hot shower running.
D) Have the child drink plenty of fluids.

Question 15

The nurse explains to the parent of a child with exercise-induced asthma that Cromolyn, an antiinflammatory drug, should be inhaled:

A) Before exercise to prevent attacks
B) At the initial onset of the attack
C) During the attack to relieve symptoms
D) As often as 4 times a day

Question 16

The nurse is caring for a toddler with acute laryngotracheobronchitis. The assessment finding that would indicate the child is experiencing increased respiratory obstruction is:

A) Restlessness
B) Tachycardia
C) Brassy cough
D) Expiratory wheezing

Question 17

The finding the nurse would expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta is:

A) Blood pressure is higher on the right side.
B) Blood pressure is higher on the left side.
C) Blood pressure is lower in the arms than in the legs.
D) Blood pressure is lower in the legs than in the arms.

Question 18

The parents of a 3-month-old infant with cystic fibrosis (CF) want to know how their child got this disease, because no one in their families has CF. The nurse's response is based on the understanding that with CF:

A) Only one parent carries the CF gene.
B) Both parents are carriers of the CF gene.
C) The inheritance pattern is multifactorial.
D) The result is probably a genetic mutation.

Question 19

The asthmatic child who has been taking theophylline complains of stomach ache and tachycardia and is sweating profusely. The nurse recognizes these symptoms as:

A) Severe asthma attack
B) Allergic response to theophylline
C) Onset of bronchitis
D) Drug toxicity

Question 20

The nurse tells the parents of a child who has a positive throat culture for group A hemolytic streptococcus that the treatment most likely will be:

A) Acetaminophen and plenty of fluids
B) Oral penicillin for 10 days
C) Penicillin until his sore throat is gone
D) Streptococcus immunization

Question 21

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" The nurse bases a response on the understanding that clubbing occurs as a result of:

A) Untreated congestive heart failure
B) A left-to-right shunting of blood
C) Decreased cardiac output
D) Chronic hypoxia

Question 22

The nurse describes the "allergic salute" as a cluster of signs related to chronic allergy, which are: Select all that apply.

A) Mouth breathing
B) Transverse nasal crease
C) Dark circles under the eyes
D) Productive cough
E) Reddened conjunctiva

Question 23

An infant with congestive heart failure is receiving Lanoxin. The nurse recognizes signs of digoxin toxicity, which are:

A) Restlessness
B) Decreased respiratory rate
C) Increased urinary output
D) Vomiting

Question 24

The nurse explains that the ____________________ can sense the oxygen concentration in the blood and can signal the brainstem to increase respiration.

Question 25

A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?

A) Subcutaneous nodules and fever
B) Painful, tender joints and carditis
C) Erythema marginatum and arthralgia
D) Chorea and elevated sedimentation rate

Question 26

The nurse would suggest to the parents of an asthmatic child to encourage participation in such activities as: Select all that apply.

A) Swimming
B) Gymnastics
C) Baseball
D) Basketball
E) Tennis

Question 27

The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. The nurse can determine the parent understood the instructions when he states:

A) "If the baby turns blue, I will hold him over my shoulder with his knees bent up toward his chest."
B) "If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest of his body."
C) "If the baby turns blue, I will immediately put the baby upright in an infant seat."
D) "If the baby turns blue, I will put the baby in a squatting position."

Question 28

When a father asks why his child with tetralogy of Fallot seems to favor a squatting position, the nurse would explain that squatting:

A) Increases the return of venous blood back to the heart
B) Decreases arterial blood flow away from the heart
C) Is a common resting position when a child is tachycardic
D) Increases the workload of the heart

Question 29

The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" The nurse's response is based on the understanding that:

A) Inflammation weakens blood vessels, leading to aneurism.
B) Increased lipid levels lead to the development of atherosclerosis.
C) Untreated disease causes mitral valve stenosis.
D) Altered blood flow increases cardiac workload with resulting heart failure.

Question 30

After the 3-month-old child with respiratory syncytial virus is given a protocol of antiviral medications, the nurse explains that routine immunizations will need to be delayed for ____________________ months.

Question 31

A child develops carditis from rheumatic fever. The nurse knows that the areas of the heart affected by carditis are:

A) The coronary arteries
B) The heart muscle and the mitral valve
C) The aortic and pulmonic valves
D) The contractility of the ventricles

Question 32

An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because:

A) Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
B) Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
C) Blood is shunted past cardiac arteries, causing myocardial hypoxia.
D) Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

Question 33

The nurse reviews for the client drugs such Accolate and Zyflo, which are _______________ _______________; they are capable of blocking the inflammatory response as well as providing bronchodilation.

Question 34

The comment made by a parent of a 1-month-old that would alert the nurse about the presence of a congenital heart defect is:

A) "He is always hungry."
B) "He tires out during feedings."
C) "He is fussy for several hours every day."
D) "He sleeps all the time."

Question 35

An appropriate nursing action related to the administration of Lanoxin to an infant would be:

A) Counting the apical rate for 30 seconds before administering the medication
B) Withholding a dose if the apical heart rate is less than 100 beats/min
C) Repeating a dose if the child vomits within 30 minutes of the previous dose
D) Checking respiratory rate and blood pressure before each dose