The primary care pediatric nurse practitioner is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend?
- A. Avoidance of all sports to prevent sudden death
- B. Clearance for any sports since this is mild
- C. Evaluation by a cardiologist prior to participation
- D. Low-intensity sports
Correct Answer: C
Rationale: Children with mild AS may participate in any sport but must have annual cardiac evaluations.
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The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention takes top priority?
- A. Changing the linens on the clients’ beds
- B. Restocking the bedside supplies needed for a dressing change on the upcoming shift
- C. Documenting the care provided during her shift
- D. Emptying the trash cans in the assigned client room
Correct Answer: C
Rationale: Documenting care is a legal and professional responsibility that ensures continuity of care and accurate communication between shifts.
Indomethacin is being given to an infant with a patent ductus arteriosus in an attempt to promote closure of the PDA. The nurse caring for this infant becomes concerned about adverse side effects when noticing:
- A. decreased urine output, decreased platelets, and abdominal distention.
- B. increased blood pressure, tachycardia, and decreased oxygen requirements.
- C. increased urine output, increased white blood cell count, and increased reticulocyte count.
- D. Jaundice, pallor, and a petechial rash
Correct Answer: A
Rationale: Indomethacin can cause renal side effects, including decreased urine output, as well as hematologic effects such as decreased platelets, and gastrointestinal effects like abdominal distention, which are concerning adverse effects in an infant.
The following cranial nerves carry pre-ganglionic parasympathetic nerves:
- A. Oculomotor nerve
- B. Trigeminal nerve
- C. Facial nerve
- D. Vagus nerve
Correct Answer: D
Rationale: The vagus nerve carries parasympathetic fibers. The oculomotor, trigeminal, and facial nerves do not.
A female client enters the clinic and insists on being seen. She is weak, nervous, and reports a racing heart beat and recent weight loss of 15 pounds. After ruling out substance withdrawal, the healthcare provider suspects hyperthyroidism and admits her for further testing. Which action should the nurse implement?
- A. Begin preparing client for thyroidectomy procedure
- B. Space the client's care to provide periods of rest
- C. Assess the client for hyperactive bowel sounds
- D. Provide warm blankets to prevent heat loss
Correct Answer: B
Rationale: Rest is important for managing symptoms of hyperthyroidism, which can be exacerbated by stress and activity.
Regarding ECG in infancy
- A. T Wave inversion present
- B. PR interval is < 0.16 s
- C. P wave is < 3mm tall
- D. QRS represent ventricular depolarization
Correct Answer: B
Rationale: In infants, the PR interval is shorter than in adults (< 0.16 seconds).
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