Nokea
A 7-year-old child who has a history of a repaired congenital heart defect (CHD)has many dental caries along with gingival erythema and irritation and a temperature of 102.5°F. What will the primary care pediatric nurse practitioner do next?
- A. Admit to the hospital with a pediatric cardiology consult.
- B. Obtain blood cultures and a CBC and consult a pediatric cardiologist.
- C. Refer the child to a pediatric dental surgeon immediately.
- D. Start prophylactic antibiotics such as penicillin twice daily for 2 weeks.
Correct Answer: A
Rationale: Children who are suspected of having SBE should be admitted to the hospital and referred to pediatric cardiology.
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A male client with pernicious anemia takes supplemental folate and self-administers monthly Vitamin B12 injections. He reports feeling increasingly fatigued. Which laboratory value should the nurse review?
- A. Complete blood count
- B. Serum ferritin level
- C. Serum potassium level
- D. Liver function tests
Correct Answer: A
Rationale: Fatigue in pernicious anemia may indicate inadequate treatment. A complete blood count helps assess hemoglobin and red blood cell levels.
A nurse obtains the health history of a client who is newly admitted to the medical unit. Which statement by the client should alert the nurse to the presence of edema?
- A. I wake up to go to the bathroom at night.
- B. My shoes fit tighter by the end of the day.
- C. I seem to be feeling more anxious lately.
- D. I drink at least eight glasses of water a day.
Correct Answer: B
Rationale: Tight-fitting shoes by the end of the day suggest fluid retention (edema), a common sign of cardiovascular or renal issues.
An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity?
- A. Restlessness
- B. Decreased respiratory rate
- C. Increased urinary output
- D. Vomiting
Correct Answer: D
Rationale: Symptoms of digoxin toxicity include nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.
A feature of Turner syndrome is:
- A. Short stature
- B. Polydactyly
- C. Congenital heart defects
- D. Mental retardation
Correct Answer: A
Rationale: Short stature is a common feature of Turner syndrome, along with ovarian insufficiency and other physical abnormalities.
The nurse has provided home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement by the parents indicates a need for further instructions?
- A. “A balance of rest and exercise is important.â€
- B. “I can apply lotion or powder to the incision if it is itchy.â€
- C. “Activities in which my child could fall need to be avoided for 2-4 weeks.â€
- D. “We should avoid going to places like the mall or grocery stores for at least 2 weeks after surgery.â€
Correct Answer: B
Rationale: Applying lotion or powder to the incision can increase the risk of infection. Parents should be instructed to keep the incision clean and dry.