NR 328 EXAM 2 PEDIATRIC NURSING PREP
WITH ACTUAL CORRECR QUESTIONS AND
VERIFIED DETAILED ANSWERS
|CURRENTLY TESTING QUESTIONS AND
SOLUTIONS|NEWEST |BRAND NEW
VERSION|JUST RELEASED!!
The nurse is caring for a 3 year old boy whose parents noticed that his eyes are reddened with
no discharge, and his palms and soles of the feet are red, swollen and peeling. Upon
examination, the nurse's assessment includes dry, cracked lips and a "strawberry tongue." the
nurse most likely suspects?
a. Varicella
b. Rheumatic Fever
c. Kawasaki Disease
d. Congenital Heart Defect
Answer: C
After cardiac catheterization of a child, which assessment finding is a cause of concern to the
nurse?
a. The pulse distal to the catheterization site is weak.
b. The affected extremity feels cool when touched.
c. The child is in bed with the affected extremity straight.
d. The child has resumed oral intake with clear liquids.
Answer: B
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,Rationale: If the affected extremity feels cool when touched, arterial obstruction may be
present. The health care provider must be notified immediately. A weak pulse distal to the
site for the first few hours after catheterization is not a cause for concern. However, the pulse
should gradually increase in strength. The child's usual diet can be resumed as soon as
tolerated, beginning with sips of clear liquids and advancing as the condition allows. The child
must take in enough fluids to ensure adequate hydration. Blood loss, nothing by mouth (NPO)
status, and diuretic actions of dyes used during the procedure increase the risk for
hypovolemia and dehydration. The child must be kept in bed, with the affected extremity
maintained straight for several hours, to promote healing of the cannulated vessel.
The nurse should explain to the parents that their child is receiving furosemide for severe
congestive heart failure because of which effect?
a. An ACE inhibitor
b. A diuretic
c. A form of digitalis
d. A β-blocker
Answer: B
Rationale: Furosemide is a diuretic used to eliminate excess water and salt to prevent the
accumulation of fluid associated with congestive heart failure. Furosemide is not a β-blocker.
Furosemide is not a form of digitalis. Furosemide is not an angiotensin-converting enzyme
(ACE) inhibitor.
Which term describes the thickening and flattening of the tips of the fingers and toes that is
thought to occur as a result of chronic tissue hypoxemia?
a. Raynaud phenomenon
b. Polycythemia
c. Clubbing
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,d. Hypercyanotic spells
Answer: C
Rationale: Clubbing is a thickening and flattening of the tips of the fingers and toes that is
thought to occur as a result of chronic tissue hypoxemia and polycythemia. Polycythemia is an
increased number of red blood cells. Hypercyanotic, or "blue," spells are often seen in infants
with tetralogy of Fallot; the affected infant becomes acutely cyanotic and hyperpneic.
Raynaud phenomenon is an autoimmune disease.
What does the nurse recognize as an early clinical sign of compensated shock in a child?
a. Apprehension
b. Hypotension
c. Sleepiness
d. Confusion
Answer: A
Rationale: Apprehension is a clinical manifestation of compensated shock in children.
Confusion is a sign of decompensated shock in children. Sleepiness is not an indication of
shock. Hypotension is a sign of irreversible shock in children.
What is an early sign of heart failure?
a. Inability to sweat
b. Bradycardia
c. Increased urine output
d. Resting tachypnea
Answer: D
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, Rationale: Tachypnea is one of the early signs of heart failure. Bradycardia is not an early
symptom of heart failure. The inability to sweat is not a sign of heart failure; in fact, many
affected children are diaphoretic. Urine output is usually decreased, not increased, in heart
failure.
A nurse is preparing to administer digoxin to a 2-year-old child. What is the most appropriate
action when the nurse is administering digoxin?
a. Checking the apical heart rate and holding the medication if the pulse is below 70 beats/min
b. Giving an extra dose if one is missed
c. Mixing the dose with juice to disguise the taste
d. Checking the apical heart rate and holding the medication if the pulse is below 90 to 110
beats/min
Answer: A
Rationale: The most appropriate nursing action when digoxin is being administered is
checking the apical heart rate and holding the medication if the pulse is below 70 beats/min.
Never give an extra dose if one is missed, and never mix digoxin with foods or other fluids.
Holding the drug if the apical pulse is below 90 to 110 beats/min is appropriate for an infant,
not a 2-year-old child.
What clinical manifestation should the nurse expect to find during the assessment of an infant
with coarctation of the aorta?
a. Cooler lower extremities
b. Low pressure in the arms
c. Bounding femoral pulses
d. Weak pulses in the arms
Answer: A
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WITH ACTUAL CORRECR QUESTIONS AND
VERIFIED DETAILED ANSWERS
|CURRENTLY TESTING QUESTIONS AND
SOLUTIONS|NEWEST |BRAND NEW
VERSION|JUST RELEASED!!
The nurse is caring for a 3 year old boy whose parents noticed that his eyes are reddened with
no discharge, and his palms and soles of the feet are red, swollen and peeling. Upon
examination, the nurse's assessment includes dry, cracked lips and a "strawberry tongue." the
nurse most likely suspects?
a. Varicella
b. Rheumatic Fever
c. Kawasaki Disease
d. Congenital Heart Defect
Answer: C
After cardiac catheterization of a child, which assessment finding is a cause of concern to the
nurse?
a. The pulse distal to the catheterization site is weak.
b. The affected extremity feels cool when touched.
c. The child is in bed with the affected extremity straight.
d. The child has resumed oral intake with clear liquids.
Answer: B
1|Page
,Rationale: If the affected extremity feels cool when touched, arterial obstruction may be
present. The health care provider must be notified immediately. A weak pulse distal to the
site for the first few hours after catheterization is not a cause for concern. However, the pulse
should gradually increase in strength. The child's usual diet can be resumed as soon as
tolerated, beginning with sips of clear liquids and advancing as the condition allows. The child
must take in enough fluids to ensure adequate hydration. Blood loss, nothing by mouth (NPO)
status, and diuretic actions of dyes used during the procedure increase the risk for
hypovolemia and dehydration. The child must be kept in bed, with the affected extremity
maintained straight for several hours, to promote healing of the cannulated vessel.
The nurse should explain to the parents that their child is receiving furosemide for severe
congestive heart failure because of which effect?
a. An ACE inhibitor
b. A diuretic
c. A form of digitalis
d. A β-blocker
Answer: B
Rationale: Furosemide is a diuretic used to eliminate excess water and salt to prevent the
accumulation of fluid associated with congestive heart failure. Furosemide is not a β-blocker.
Furosemide is not a form of digitalis. Furosemide is not an angiotensin-converting enzyme
(ACE) inhibitor.
Which term describes the thickening and flattening of the tips of the fingers and toes that is
thought to occur as a result of chronic tissue hypoxemia?
a. Raynaud phenomenon
b. Polycythemia
c. Clubbing
2|Page
,d. Hypercyanotic spells
Answer: C
Rationale: Clubbing is a thickening and flattening of the tips of the fingers and toes that is
thought to occur as a result of chronic tissue hypoxemia and polycythemia. Polycythemia is an
increased number of red blood cells. Hypercyanotic, or "blue," spells are often seen in infants
with tetralogy of Fallot; the affected infant becomes acutely cyanotic and hyperpneic.
Raynaud phenomenon is an autoimmune disease.
What does the nurse recognize as an early clinical sign of compensated shock in a child?
a. Apprehension
b. Hypotension
c. Sleepiness
d. Confusion
Answer: A
Rationale: Apprehension is a clinical manifestation of compensated shock in children.
Confusion is a sign of decompensated shock in children. Sleepiness is not an indication of
shock. Hypotension is a sign of irreversible shock in children.
What is an early sign of heart failure?
a. Inability to sweat
b. Bradycardia
c. Increased urine output
d. Resting tachypnea
Answer: D
3|Page
, Rationale: Tachypnea is one of the early signs of heart failure. Bradycardia is not an early
symptom of heart failure. The inability to sweat is not a sign of heart failure; in fact, many
affected children are diaphoretic. Urine output is usually decreased, not increased, in heart
failure.
A nurse is preparing to administer digoxin to a 2-year-old child. What is the most appropriate
action when the nurse is administering digoxin?
a. Checking the apical heart rate and holding the medication if the pulse is below 70 beats/min
b. Giving an extra dose if one is missed
c. Mixing the dose with juice to disguise the taste
d. Checking the apical heart rate and holding the medication if the pulse is below 90 to 110
beats/min
Answer: A
Rationale: The most appropriate nursing action when digoxin is being administered is
checking the apical heart rate and holding the medication if the pulse is below 70 beats/min.
Never give an extra dose if one is missed, and never mix digoxin with foods or other fluids.
Holding the drug if the apical pulse is below 90 to 110 beats/min is appropriate for an infant,
not a 2-year-old child.
What clinical manifestation should the nurse expect to find during the assessment of an infant
with coarctation of the aorta?
a. Cooler lower extremities
b. Low pressure in the arms
c. Bounding femoral pulses
d. Weak pulses in the arms
Answer: A
4|Page
