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NUR113 Exam4 Practice

Total questions: 72

Worksheet time: 58mins

Name
Class
Date
1.

Where does stenosis occur in Tetrology of Fallot?

a)

Tricuspid stenosis

b)

Mitral stenosis

c)

Pulmonary stenosis

d)

Aortic stenosis

2.

Which is not a part of tetrology of fallot?

a)

Ventricular Septal Defect

b)

Overriding Aorta

c)

Right Ventricular Hypertrophy

d)

Left Ventricular Hypertrophy

3.

To detect a PDA, listen for leaking noise

a)

True

b)

False

4.

What issues could arise from Patent Ductus Arteriosus?

a)

Calcified Aorta

b)

Overworked heart and respiratory issues

c)

Pulmonary regortitation

d)

ASD

5.

____________ of _______ is where there's extra pressure on the left side of heart, thickens the muscle and overtime forces more blood to seep through ASD to right ventricle.

a)

Transposition of greater arteries

b)

Hypoplastic Left Heart Syndrum

c)

Coarctation of aorta

d)

Truncus arteriosus

6.

What are some signs of a "blue baby"?

a)

Blue eyes, lips and tip of tongue

b)

Blue earlobes and eyes

c)

Blue finger tips, eyes and nails

d)

Blue nose tip

7.

VSD occurs between ventricles

a)

True

b)

False

8.
A nurse is caring for an infant who has a congenital heart defect. Which of the following defects is associated with
increased pulmonary blood flow?
a)
Coarctation of the aorta
b)
Patent ductus arteriosus
c)
Tetralogy of Fallot
d)
Tricuspid atresia
9.
A nurse in a pediatric clinic is caring for a child who has iron deficiency anemia and a new prescription for ferrous sulfate
tablets. Which of the following instructions should the nurse provide the parents regarding administration of this
medication?
a)
Give with a 240 mL (8 oz) glass of milk.
b)
Administer at mealtimes.
c)
Give with orange juice.
d)
Administer at bedtime
10.
A nurse is caring for an infant who has a congenital heart defect. Which of the following defects is associated with
increased pulmonary blood flow?
a)
Coarctation of the aorta
b)
Patent ductus arteriosus
c)
Tetralogy of Fallot
d)
Tricuspid atresia
11.
A nurse is caring for a child who was admitted with suspected rheumatic fever. The provider prescribes an
anti-streptolysin O (ASO) titer. The parent asks the nurse the purpose of the test. Which of the following responses
should the nurse make?
a)
"This test will indicate if your child has rheumatic fever."
b)
"This test will confirm if your child had a recent streptococcal infection."
c)
"This test will indicate if your child has a therapeutic blood level of an aminoglycoside."
d)
"This test will confirm if your child has immunity to streptococcal bacteria."
12.
1.  A nurse is caring for a child with Kawasaki disease. Which of the following is the primary system involved with this diagnosis?
a)
Cardiovascular
b)
Gastrointestinal
c)
Integumentary
d)
Respiratory
13.
A nurse assessing a newborn finds an apical heart rate of 130/min. Which of the following is the appropriate nursing action?
a)
Ask another nurse to verify the heart rate.
b)
Document this as an expected finding.
c)
Call the neonatologist to assess the newborn.
d)
Prepare the newborn for transport to the NICU
14.
During the newborn assessment, a systolic blood pressure that is higher in the legs than in the arms is suggestive of which of the following findings?
a)
Cardiac arrhythmia
b)
Coarctation of the aorta
c)
Chromosome abnormality
d)
A normal finding for an infant
15.
The nurse has admitted a child with a cyanotic heart defect. The nurse would expect the initial lab result to show:
a)
A high hemoglobin.
b)
A low hematocrit.
c)
A low platelet count
d)
A high white blood cell count
16.
The nurse is teaching the parents of a group of cardiac patients. The nurse includes in the information that any child who has undergone cardiac surgery
a)
Should be restricted from most play activities.
b)
Should receive prophylactic antibiotics for any dental, oral, or upper respiratory tract procedures.
c)
Should not receive routine immunizations.
d)
Can be expected to have a fever for several weeks following the surgery.
17.
When educating the family of an infant with a small, asymptomatic atrial septal defect (ASD), which of the following would be included in the education?
a)
“Surgery is usually performed in the first two months of life for this defect.”
b)
“Most infants do not need surgical repair for this defect.”
c)
“The medication indomethacin is used to try to close this defect.”
d)
The medication prostaglandin E1 is used to try to close this defect.”
18.

In addition to assessing nutritional status, the patient's weight may be used to determine:

a)

activity levels.

b)

developmental stage.

c)

medication dosage.

d)

cardiac abnormalities.

e)

chronologic age.

19.

The most frequently obtained measurement in the pediatric office is:

a)

height

b)

weight

c)

temperature

d)

pulse

e)

respiration rate.

20.

from common physical features of down syndrome

a)

short neck

b)

small ears

c)

small hands

d)

strong muscle tone

21.

How many types of down syndrome are there..

a)

2 types

b)

3 types

c)

4 types

d)

non of the above

22.

Select 2 symptoms you would most likely see in a patient with a severe case of bronchiolitis.

a)

Barking or wheezing cough

b)

Loose bowels

c)

Swollen ankles

d)

Cyanosis

e)

Bradycardia

23.

What makes up the lower respiratory tract?

a)

Pharynx, trachea and Bronchi, bronchioles

b)

Nasal cavity, Pharynx, Larynx and trachea

c)

Trachea, bronchi, bronchioles and alveoli

d)

Pharynx, larynx, trachea and alveoli

24.

Respiratory syncytial virus (RSV) infection upper and sometimes lower respiratory tract infections. In which of the following ages groups is RSV a very common cause of respiratory tract infections?

a)

Adolescents ages 12 to 19 years

b)

Adults ages 40 to 60 years

c)

Infants and young children

d)

Adults ages 65 years and older

25.

Which of the following may be the first symptom in infants younger than 6 months old with RSV infection?

a)

Apnea (a period of not breathing)

b)

Bronchiolitis (an infection of the lower respiratory tract) 

c)

Pneumonia

d)

Runny nose

26.

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse plans to teach the parents about which anticipated treatment plan?

a)

Antihistamine use

b)

Cold washcloths on the face for comfort

c)

Antibiotic treatment with amoxicillin

d)

Referral for a sinuplasty

27.

For which potential problem should the child with chronic otitis media with effusion be evaluated?

a)

Brain abscess

b)

Meningitis

c)

Perforation of the tympanic membrane

d)

Hearing loss

28.

The nurse is assessing a child for epiglottitis. What findings are consistent with this condition? (Select all that apply)

a)

Drooling

b)

Dysphagia

c)

Dysphonia

d)

Distressed inspiratory efforts

e)

Decreased oxygenation

29.

The nurse should implement which interventions for an infant experiencing apnea? (Select all that apply.)

a)

Stimulate the infant by gently tapping the foot.

b)

Shake the infant vigorously.

c)

Have resuscitative equipment available.

d)

Suction the infant.

e)

Maintain a neutral thermal environment.

30.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following?

a)

Monitoring pulse oximetry

b)

Forcing fluids

c)

Instituting seizure precautions

d)

Encouraging a high-protein diet

31.

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.

32.

A nurse is caring for four infants. Which one should the nurse assess first?

a)

Nasal flaring

b)

Respiratory rate of 55 breaths/min

c)

Irregular respiratory pattern

d)

Abdominal breathing

33.

What information should the nurse teach workers at a daycare center about RSV?

a)

RSV is transmitted through airborne particles upon inhalation.

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 handwashing can decrease the spread of the virus.

34.

Which assessment finding after tonsillectomy should be reported to the surgeon?

a)

Vomiting bright red blood

b)

Pain at surgical site

c)

Pain on swallowing

d)

The ability to only take small sips of liquids

35.

Which of the following is part of the Pediatric Assessment Triangle?

a)

Blood Pressure

b)

Lung Sounds

c)

Work of Breathing

d)

BGL

36.

Which of the following is a sign of respiratory failure in a pediatric patient?

a)

Tachypnea

b)

Nasal Flaring

c)

ALOC

d)

Retractions

37.

What is the most common cause of pediatric cardiac arrest?

a)

Vascular Emergencies

b)

Long QT Syndrome

c)

Trauma

d)

Hypoxia

38.

Children have a ____________ metabolic demand then adults.

a)

higher

b)

lower

39.

Croup is a(n) __________ respiratory infection.

a)

Lower

b)

Upper

40.

Which of the following is NOT a sign of respiratory distress in the pediatric patient?

a)

Tachypnea

b)

Central Cyanosis

c)

Grunting

d)

Tachycardia

41.

As the pediatric patient progresses from respiratory distress to respiratory failure, which of the following occurs?

a)

Increased arterial carbon dioxide tension

b)

Peripheral cyanosis

c)

Muscular rigidity

d)

Hyperactivity

42.

Interpret the following ABG: pH 7.48, Pa02 56, PaC02 30, HC03 25, Fi02 45

a)

uncompensated respiratory alkalosis

b)

uncompensated metabolic acidosis

c)

uncompensated respiratory acidosis

d)

compensated respiratory acidosis

43.

What is the primary goal for a patient with ARDS?

a)

increase respiratory rate

b)

achieve adequate oxygenation

c)

volume control

d)

keep C02 within normal range

44.

Interpret the following ABG: pH 7.34, Pa02 90, PaC02 70, HC03 36, Fi02 45

a)

compensated respiratory alkalosis

b)

uncompensated respiratory alkalosis

c)

compensated respiratory acidosis

d)

uncompensated respiratory acidosis

45.

A client with acute respiratory distress syndrome (ARDS) is showing signs of increased dyspnea. The nurse notes the following ABGs: pH 7.35, PaCO2 25, HCO3 22, PaO2 95. Which finding is abnormal?

a)

pH

b)

PaCO2

c)

HCO3

d)

PaO2

46.
Why are retractions so prominent in neonates in comparison to large children and adults?
a)
Because they aren't strong yet
b)
Neonates have fast respiratory rates
c)
Neonates have thin and weak musculature and a less rigid thorax
d)
Neonates have small airways
47.

Which condition manifest with hypoventilation?

a)

Respiratory acidosis

b)

respiratory alkalosis

c)

metabolic acidosis

d)

metabolic alkalosis

48.

What is the normal range value for PaCO2

a)

30 to 40 mmHg

b)

22-26 mmHg

c)

35-45 mmHg

d)

33-43 mmHg

49.

An unconscious baby is receiving mechanical ventilation.

Which nursing diagnosis takes priority?

a)

Self-care deficit related to unconsciousness.

b)

Risk for impaired skin integrity related to immobility.

c)

Ineffective airway clearance related to the inability to expectorate.

d)

Imbalanced nutrition: less than body requirements related to inability to swallow.

50.
Which of the following may be a reason to order an ABG on a patient?
a)
The patient suddenly develops shortness of breath
b)
An asthmatic is starting to show signs of tiring
c)
A diabetic has developed Kussmaul respirations
d)
All of the above
51.
You are reviewing the results of an ABG. When the pH and the PaCO2 values are moving in opposite directions, the primary problem is: 
a)
Respiratory
b)
Renal
c)
Metabolic
d)
Compensation
52.

Indications for assisting ventilations in a child include:

a)

a respiratory rate of less than 12 breaths/min

b)

respiratory rate of greater than 60 breaths/min

c)

inadequate tidal volume

d)

all of the above

53.

Death caused by shaken baby syndrome is usually the result of:

a)

multiple open fx

b)

bleeding in the brain

c)

fx of the cervical spine

d)

intra-abdominal hemorrhage

54.

True statement regarding postextubation stridor in pediatric patients:

a)

It is less common in children with recent URTIs and Down syndrome.

b)

Heliox has not been shown to be effective in reducing the work of breathing.

c)

Usually results from swelling of the tongue after the endotracheal tube has been removed

d)

Treatment includes humidified oxygen, intravenous dexamethasone and nebulized racemic epinephrine.

55.

Otitis media (OM)

•It refers to any ................... of the middle ear, without reference to etiology or parthenogenesis

a)

infection

b)

pain

c)

inflammation

d)

disease

56.

the most important Acute otitis media-Causing Pathogen is...........

a)

Staphylococcusaureus

b)

Streptococcus pneumoniae

c)

Moraxella catarrhalis

d)

Haemophilusinfluenzae

57.

Acute otitis media symptoms are .............

a)

ear pain

b)

hear weakness

c)

vomiting

d)

all answers are right

58.

What is/are the complication/s of acute otitis media?

a)

acute mastoiditis

b)

facial nerve palsy

c)

meningitis

d)

Labyrinthitis

59.

A 23 year old man presents to you with two days history of left ear pain which associated with pruritus, scanty discharge, and has mild hearing loss.

On physical examination, there is tenderness with tragal pressure.

What is the possible diagnosis?

You may choose more than one answer.

a)

acute otitis media

b)

acute otitis external

c)

furunculosis

d)

foreign body

60.
A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?
a)
Obtain a throat culture.
b)
Place the child in an upright position.
c)
Transport the child to radiology for a throat x-ray.
d)
Place the child in an upright position.
61.
A nurse is monitoring an infant who is 3 months old and has sneezing, coughing, nasal congestion, intermittent fever, and apneic spells. These nurse should recognize these findings are associated with which of the following diagnoses?
a)
Influenza
b)
Bronchiolitis
c)
Croup
d)
Epiglottitis
62.

A nurse in a PACU is admitting a client who is postoperative following a tonsillectomy. Which of the following actions should the nurse plan to take to prevent aspiration?

a)

Place a bedside humidifier at the head of the client's bed.

b)

Suction the nasopharynx as needed.

c)

Withhold fluids until the client demonstrates a gag reflex.

d)

Perform chest physiotherapy.

63.

A nurse is providing discharge instructions to the parent of a 10-year-old child following a cardiac catheterization. Which of the following instructions should the nurse include?

a)

Keep the child home for 1 week.

b)

Give the child acetaminophen for discomfort.

c)

Offer the child clear liquids for the first 24 hr.

d)

Assist the child to take a tub bath for the first 3 days.

64.

Which of the following is the heart rate range of children 1 to 3 years old?

a)

120–150 bpm

b)

98-140 bpm

c)

70–110 bpm

d)

60–100 bpm

65.

How many seconds are counted when assessing an older child’s respirations?

a)

15 seconds

b)

30 seconds

c)

60 seconds

d)

120 seconds

66.

Which of the following statement concerning the anatomy of the infant airway compared with the adult airway is true?

a)

The glottic opening is more anterior in infants than in adults

b)

The epiglottis is relatively small in infants compared with adult

c)

The larynx is at the C5-C6 level in infants and C6-C7 level in adults

d)

The vocal cords are in a more horizontal position within the larynx in infants than in adults

e)

The vocal cords are the narrowest part of the larynx in infants, whereas the cricoid cartilage is the narrowest part in adults

67.

The nurse has identified a problem of anxiety for a 4-year-old preparing for a tonsillectomy. The nurse should tell the child:

a)

"You will not have so many sore throats after your tonsils are removed.”

b)

"The doctor will put you to sleep so you do not feel anything.”

c)

"Show me how to give the doll an IV.”

d)

"When it is done, you will get to see your mommy and get an ice pop.”

68.

An 11-year-old is admitted for treatment of an asthma attack. Which finding indicates immediate intervention is needed?

a)

thin, copious mucous secretions

b)

productive cough

c)

intercostal retractions

d)

respiratory rate of 20 breaths/min

69.

A nurse is teaching the parents of a preschooler about the possibility of postoperative hemorrhage after a tonsillectomy and adenoidectomy. When should the nurse explain that the risk of bleeding is the greatest?

a)

1 to 3 days after surgery

b)

4 to 6 days after surgery

c)

7 to 10 days after surgery

d)

11 to 14 days after surgery

70.

The triage nurse in the emergency department must prioritize the children waiting to be seen. Which child is in the greatest need of emergency medical treatment?

a)

a 6-year-old with a fever of 104°F (40°C), a muffled voice, no spontaneous cough, and drooling

b)

a 3-year-old with a fever of 100°F (37.8°C), a barky cough, and mild intercostal retractions

c)

a 4-year-old with a fever of 101°F (38.3°C), a hoarse cough, inspiratory stridor, and restlessness

d)

a 13-year-old with a fever of 104°F (40°C), chills, and a cough with thick yellow secretions

71.

A charge nurse is making assignments for a group of children on a pediatric unit. The nurse should most avoid assigning the same nurse to care for a 2-year-old with respiratory syncytial virus (RSV) and:

a)

an 18-month-old with RSV.

b)

a 9-year-old 8 hours postappendectomy.

c)

a 1-year-old with a heart defect.

d)

a 6-year-old with sickle cell crisis.

72.

A toddler who has been treated for a foreign body aspiration begins to fuss and cry when the parents attempt to leave the hospital for an hour. As the nurse tries to take the child out of the crib, the child pushes the nurse away. The nurse interprets this behavior as indicating which stage of separation anxiety?

a)

protest

b)

despair

c)

regression

d)

Detachment