Nokea
Paroxysmal hypercyanotic attacks (hypoxic, blue, or tet spells) are a particular problem during the lst 2 yr of life. They are characterized by
- A. early evening occurrence
- B. an increase in intensity of the systolic murmur
- C. unpredictable onset
- D. metabolic alkalosis
Correct Answer: A
Rationale: Unpredictable onset and metabolic alkalosis are common features of tet spells.
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A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals: HR: 220 beats per minute (regular) Respiratory rate: 30 per minute BP: 84/52 Capillary refill: 3 seconds Which dysrhythmia does the nurse suspect in this child?
- A. Rapid pulmonary flutter
- B. Sinus bradycardia
- C. Rapid atrial fibrillation
- D. Supraventricular tachycardia (SVT)
Correct Answer: D
Rationale: SVT is typically above 200 beats per minute and can result from dehydration; the rapid rate causes low cardiac output (CO), resulting in low BP and prolonged capillary refill.
Which statement by the mother of a child with rheumatic fever (RF) shows she has a good understanding of the care of her child?
- A. I will apply heat to his swollen joints to promote circulation.
- B. I will have him do gentle stretching exercises to prevent contractures.
- C. I will give him the aspirin that is ordered for pain and inflammation.
- D. I will apply cold packs to his swollen joints to reduce pain.
Correct Answer: C
Rationale: Aspirin is the drug of choice for treating RF due to its anti-inflammatory and analgesic properties.
An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant?
- A. Encouraging the infant to hold a bottle
- B. Keeping the infant on bed rest to conserve energy
- C. Rotating caregivers to provide more stimulation
- D. Maintaining a consistent, structured environment
Correct Answer: D
Rationale: A consistent, structured environment helps build trust and security, which is essential for an infant with nonorganic failure to thrive.
Nurse Betina should begin screening for lead poisoning when a child reaches which age?
- A. 6 months
- B. 12 months
- C. 18 months
- D. 24 months
Correct Answer: B
Rationale: Screening for lead poisoning typically begins at 12 months, as children at this age are more likely to be exposed to lead through crawling and hand-to-mouth activities.
When planning care for a 8-year-old boy with Down syndrome, the nurse should:
- A. Plan interventions according to the developmental level of a 7-year-old child because that’s the child’s age
- B. Plan interventions according to the developmental levels of a 5-year-old because the child will have developmental delays
- C. Assess the child’s current developmental level and plan care accordingly
- D. Direct all teaching to the parents because the child can’t understand
Correct Answer: C
Rationale: Care should be individualized based on the child’s current developmental level, not just their chronological age or assumptions about delays.