Nokea
A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug?
- A. Calcium channel blocker
- B. Beta blocker
- C. ACE inhibitor
- D. ARB
Correct Answer: B
Rationale: Beta blockers affect the heart and also block beta receptors in the liver, reducing glycogen release and causing hypoglycemia. The low HR and BP support beta blocker ingestion.
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Examples of cyanotic heart disease include:
- A. Ebstein's anomaly
- B. Pulmonary stenosis
- C. Coarctation of aorta
- D. Hypoplastic left heart syndrome
Correct Answer: D
Rationale: Hypoplastic left heart syndrome is a form of cyanotic heart disease. Ebstein's anomaly and pulmonary stenosis can also cause cyanosis, but coarctation of the aorta typically does not.
Common causes of recurrent abdominal pain include:
- A. Gilbert syndrome
- B. Chronic constipation
- C. Functional cause
- D. Gastric ulcer
Correct Answer: C
Rationale: Functional abdominal pain is a common cause of recurrent abdominal pain in children, often without an identifiable organic cause.
A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?
- A. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
- B. The respiratory rate decreased from 25 breaths/min to 14 breaths/min
- C. Pulse decreased from 100 beats/min to 80 beats/min
- D. Oxygen saturation increased from 88% to 96%
Correct Answer: D
Rationale: Beta blockers reduce heart rate and blood pressure. A decrease in pulse rate from 100 beats/min to 80 beats/min is consistent with the expected pharmacological effect of a beta blocker.
Which is an important nursing consideration when chest tubes will be removed from a child?
- A. Explain that it is not painful.
- B. Explain that only a Band-Aid will be needed.
- C. Administer analgesics before the procedure.
- D. Expect bright red drainage for several hours after removal.
Correct Answer: C
Rationale: It is appropriate to prepare the child for the removal of chest tubes with analgesics. Short-acting medications can be used that are administered through an existing IV line. A sharp, momentary pain is felt. This should not be misrepresented to the child. A petroleum gauze, air-tight dressing will be needed, but it is not a pain-free procedure. Little or no drainage should be found on removal.
All are true about TAPSE (Tricuspid Annular Plane Systolic Excursion), except
- A. Normal TAPSE is >17 mm
- B. Reliable measure of RV systolic function
- C. Can be measured using either M-mode or 2D echo
- D. TAPSE is measured at septal aspect of tricuspid annulus
Correct Answer: D
Rationale: TAPSE is measured at the lateral aspect of the tricuspid annulus, not the septal aspect.