Essentials of Pediatric Nursing Exam with Answers

Essentials of Pediatric Nursing Exam with Answers.
Item Bank:  Hockenberry Wong Essentials of Pediatric Nurs 9th Edition
Objective:    CH 25: The Child with Cardiovascular Dysfunction
 

Question Name: 0001 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?” The nurse’s response should be based on knowledge that the x-ray film will show:

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  bones of chest but not the heart.
  measurement of electrical potential generated from heart muscle.

*       C.  permanent record of heart size and configuration.

  computerized image of heart vessels and tissues.

 
Correct Answer:   C
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Explanation/Rationale:
ANS:  C
A chest radiograph will provide information on the heart size and pulmonary blood-flow patterns. It will provide a baseline for future comparisons. The heart will be visible, as well as the sternum and ribs. Electrocardiography (ECG) measures the electrical potential generated from heart muscle. Echocardiography will produce a computerized image of the heart vessels and tissues by using sound waves.
 
PTS:    1          DIF:    Cognitive Level: Understand REF:    835
TOP:    Integrated Process: Teaching/Learning
MSC:   Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0002 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

The nurse is assessing a child after a cardiac catheterization. Which complication should the nurse be assessing for?
*       A.  Cardiac arrhythmia

  Hypostatic pneumonia
  Heart failure
  Rapidly increasing blood pressure

 
Correct Answer:   A
 
Explanation/Rationale:
ANS:  A
Because a catheter is introduced into the heart, a risk exists of catheter-induced dysrhythmias occurring during the procedure. These are usually transient. Hypostatic pneumonia, heart failure, and rapidly increasing blood pressure are not risks usually associated with cardiac catheterization.
 
PTS:    1          DIF:    Cognitive Level: Apply          REF:    853
TOP:    Integrated Process: Nursing Process: Assessment
MSC:   Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0003 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

José is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:

  directed at his parents because he is too young to understand.
  detailed in regard to the actual procedures so he will know what to expect.
  done several days before the procedure so that he will be prepared. Essentials of Pediatric Nursing Exam with Answers

*       D.  adapted to his level of development so that he can understand.
 
Correct Answer:   D
 
Explanation/Rationale:
ANS:  D
Preoperative teaching should always be directed at the child’s stage of development. The caregivers also benefit from the same explanations. The parents may ask additional questions, which should be answered, but the child needs to receive the information based on developmental level. Preschoolers will not understand in-depth descriptions and should be prepared close to the time of the cardiac catheterization.
 
PTS:    1          DIF:    Cognitive Level: Apply          REF:    822
TOP:    Integrated Process: Teaching/Learning
MSC:   Area of Client Needs: Health Promotion and Maintenance
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0004 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

Which explanation regarding cardiac catheterization is appropriate for a preschool child?

  Postural drainage will be performed every 4 to 6 hours after the test.
  It is necessary to be completely “asleep” during the test.
  The test is short, usually taking less than 1 hour.

*       D.  When the procedure is done, you will have to keep your leg straight for at least 4 hours.
 
Correct Answer:   D
 
Explanation/Rationale:
ANS:  D
The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position. Postural drainage will not be performed unless the child has corresponding pulmonary problems. The child should be sedated to lie still, but being completely asleep is not necessary. The test will vary in length of time from start to finish.
 
PTS:    1          DIF:    Cognitive Level: Apply          REF:    823
TOP:    Integrated Process: Teaching/Learning
MSC:   Area of Client Needs: Health Promotion and Maintenance
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0005 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is “too wet.” The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to:

  notify physician.
  apply new bandage with more pressure.
  place the child in Trendelenburg position.

*       D.  apply direct pressure above catheterization site.
 
Correct Answer:   D
 
Explanation/Rationale:
ANS:  D
If bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the percutaneous skin site to localize pressure over the vessel puncture. Notifying a physician and applying a new bandage can be done after pressure is applied. The nurse can have someone else notify the physician while the pressure is being maintained. It is not a helpful intervention to place the girl in the Trendelenburg position. It would increase the drainage from the lower extremities.
 
PTS:    1          DIF:    Cognitive Level: Apply          REF:    823
TOP:    Integrated Process: Nursing Process: Implementation
MSC:   Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0006 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?

  “I should avoid tub baths but may shower.”

*       B.  “I have to stay on strict bed rest for 3 days.”

  “I should remove the pressure dressing the day after the procedure.”
  “I may attend school but should avoid exercise for several days.”

 
Correct Answer:   B
 
Explanation/Rationale:
ANS:  B
The child does not need to be on strict bed rest for 3 days. Showers are recommended; children should avoid a tub bath. The pressure dressing is removed the day after the catheterization and replaced by an adhesive bandage to keep the area clean. Strenuous activity must be avoided for several days, but the child can return to school.
 
PTS:    1          DIF:    Cognitive Level: Analyze       REF:    823
TOP:    Integrated Process: Teaching/Learning
MSC:   Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0007 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

Surgical closure of the ductus arteriosus would:

  stop the loss of unoxygenated blood to the systemic circulation.
  decrease the edema in legs and feet.
  increase the oxygenation of blood.

*       D.  prevent the return of oxygenated blood to the lungs.
 
Correct Answer:   D
 
Explanation/Rationale:
ANS:  D
The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a right-to-left shunt. If this is surgically closed, no additional oxygenated blood (from the aorta) will return to the lungs through the pulmonary artery. The aorta carries oxygenated blood to the systemic circulation. Because of the higher pressure in the aorta, blood is shunted into the pulmonary artery and the pulmonary circulation. Edema in the legs and feet is usually a sign of heart failure. This repair would not directly affect the edema. Increasing the oxygenation of blood would not interfere with the return of oxygenated blood to the lungs.
 
PTS:    1          DIF:    Cognitive Level: Analyze       REF:    825
TOP:    Integrated Process: Nursing Process: Planning
MSC:   Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0008 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

Which defect results in increased pulmonary blood flow?

  Pulmonic stenosis
  Tricuspid atresia

*       C.  Atrial septal defect

  Transposition of the great arteries

 
Correct Answer:   C
 
Explanation/Rationale:
ANS:  C
Atrial septal defect results in increased pulmonary blood flow. Blood flows from the left atrium (higher pressure) into the right atrium (lower pressure) and then to the lungs via the pulmonary artery. Pulmonic stenosis is an obstruction to blood flowing from the ventricles. Tricuspid atresia results in decreased pulmonary blood flow. Transposition of the great arteries results in mixed blood flow.
 
PTS:    1          DIF:    Cognitive Level: Understand REF:    825
TOP:    Integrated Process: Nursing Process: Assessment
MSC:   Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00                                        Total Group:                               0.00
Upper 27% of Group:             0.00                                        Upper 27% of Group:               0.00
Lower 27% of Group:             0.00                                        Lower 27% of Group:               0.00
Point Biserial:                               0.00                                    Point Biserial:                                 0.00
Response Frequencies (%)
A               B               C               D
Last:                       0.00          0.00          0.00          0.00
Cumulative:         0.00          0.00          0.00          0.00
 
___________________________________________________________________________________________________
 

Question Name: 0009 Type: MC Objective: CH 25: The Child with Cardiovascular Dysfunction      Item Bank: Hockenberry Wong Essentials of Pediatric Nurs 9th Edition

The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
*       A.  Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

  Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
  Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
  Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

 
Correct Answer:   A
 
Explanation/Rationale:
ANS:  A
Tetralogy of Fallot has these four characteristics: pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not atrial stenosis in tetralogy of Fallot. Right ventricular hypertrophy, not left ventricular hypertrophy, is present in tetralogy of Fallot. Tetralogy of Fallot has right ventricular hypertrophy, not left ventricular hypertrophy, and an atrial septal defect, not aortic hypertrophy.
 
PTS:    1          DIF:    Cognitive Level: Understand REF:    830
TOP:    Integrated Process: Nursing Process: Assessment
MSC:   Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
Reference/Notes:
 
Keywords:
Points:                 1.00                              Penalty:                 0.00                              Score Mode:   Active
Date Created:    03/18/13 16:03:57    Date Modified:    03/18/13 16:03:57    Date Used:
Difficulty:           Easy                                                             Discrimination:          Low
Item Analysis: Last                                                                 Item Analysis: Cumulative
No. of Students Responded:     0                                          No. of Students Responded:       0
Correct Responses (%):                                                          Correct Responses (%):
Total Group:                             0.00      Â