Wongs Essentials of Pediatric Nursing 11th Edition Test Bank

Wongs Essentials of Pediatric Nursing 11th Edition Test Bank Related

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Coarctation of the aorta causes all of the following signs except:

  • A. higher B/P in the upper extremities
  • B. right ventricular hypertrophy
  • C. legs cooler than arms
  • D. nosebleeds
Correct Answer: D

Rationale: Coarctation of the aorta is a congenital heart defect characterized by a narrowing of the aorta, the main artery carrying blood from the heart to the body. The signs of coarctation of the aorta include higher blood pressure in the upper extremities (Choice A) due to the narrowing of the aorta causing increased pressure proximal to the constriction. Right ventricular hypertrophy (Choice B) occurs as the heart works harder to overcome the obstruction in the aorta. Legs being cooler than arms (Choice C) is a result of decreased blood flow to the lower body due to the aortic narrowing. Hemodilution (Choice E) can occur as a compensatory mechanism in response to the increased blood pressure in the upper body. Nosebleeds (Choice D) are not typically associated with coarctation of the aorta but may occur due to other factors unrelated to this condition.

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You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT

  • A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
  • B. AML is more common in children with Down syndrome as compared to ALL
  • C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
  • D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: D

Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.

The nurse is caring for a patient, age 68, who is receiving digoxin (Lanoxin) 0.125 mg qd for cardiac myopathy. Which of the following assessments of the patient would indicate that he is experiencing a side effect of digoxin that requires follow-up?

  • A. Skin flushing c.Hypertension
  • B. Anorexia
  • C. Constipation
Correct Answer: B

Rationale: Anorexia, or loss of appetite, is a common side effect of digoxin. It can lead to weight loss, weakness, and fatigue. Monitoring for anorexia is important because it may indicate digoxin toxicity, which can be serious and require intervention. Skin flushing is not a common side effect of digoxin. Hypertension is also not associated with digoxin use. Constipation is generally not a common side effect of digoxin. Therefore, anorexia is the assessment that indicates a potential side effect of digoxin that requires follow-up.

Which patient is most at risk for fluid volume overload?

  • A. The 40-year-old with meningitis
  • B. The 60-year-old with psoriasis
  • C. The 35-year-old with kidney failure
  • D. The 2-year-old with influenza
Correct Answer: C

Rationale: The patient with kidney failure is most at risk for fluid volume overload because the kidneys are responsible for regulating fluid balance in the body. In kidney failure, the kidneys are unable to effectively filter and excrete excess fluids, leading to an accumulation of fluid in the body. This can result in fluid volume overload, which can be dangerous and lead to complications such as pulmonary edema, congestive heart failure, and hypertension. It is important to monitor this patient closely for signs and symptoms of fluid overload and manage their fluid intake carefully.

A worried mother of a 4-year-old boy describes attacks of inconsolable crying and prefers to play alone. The MOST appropriate action is

  • A. reassures her that this is a normal phenomenon
  • B. seek more history regarding other skills and developmental domains
  • C. refer her to pediatric psychiatry
  • D. investigate social issues of the family
Correct Answer: B

Rationale: Further history is needed to rule out behavioral or psychological issues.

What is the care priority for a newborn with bladder exstrophy and a malformed pelvis?

  • A. Change the diaper frequently and assess for skin breakdown.
  • B. Keep the exposed bladder open in a warm, dry environment.
  • C. Offer formula for growth and fluid management.
  • D. Cluster care to allow the child uninterrupted sleep and strength for upcoming surgical repair.
Correct Answer: D

Rationale: Minimizing disturbances (clustering care) helps prevent infection and allows the infant to conserve energy before surgical repair.

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