Chapter 21 Principles of Pediatric Nursing 6th Ed By Ball

Chapter 21 Principles of Pediatric Nursing 6th Ed By Ball

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

 

Question 1

Type: MCSA

The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result?

1. A high hemoglobin
2. A low hematocrit
3. A high white blood cell count
4. A low platelet count

Correct Answer: 1

Rationale 1: The child’s bone marrow responds to chronic hypoxemia by producing more red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues. This occurs in cases of cyanotic heart defects such as tricuspid atresia. Therefore, the hematocrit would not be low, the white blood cell count would not be high (unless an infection were present), and the platelets would be normal.

Rationale 2: The child’s bone marrow responds to chronic hypoxemia by producing more red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues. This occurs in cases of cyanotic heart defects such as tricuspid atresia. Therefore, the hematocrit would not be low, the white blood cell count would not be high (unless an infection were present), and the platelets would be normal.

Rationale 3: The child’s bone marrow responds to chronic hypoxemia by producing more red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues. This occurs in cases of cyanotic heart defects such as tricuspid atresia. Therefore, the hematocrit would not be low, the white blood cell count would not be high (unless an infection were present), and the platelets would be normal.

Rationale 4: The child’s bone marrow responds to chronic hypoxemia by producing more red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues. This occurs in cases of cyanotic heart defects such as tricuspid atresia. Therefore, the hematocrit would not be low, the white blood cell count would not be high (unless an infection were present), and the platelets would be normal.

Global Rationale: The child’s bone marrow responds to chronic hypoxemia by producing more red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues. This occurs in cases of cyanotic heart defects such as tricuspid atresia. Therefore, the hematocrit would not be low, the white blood cell count would not be high (unless an infection were present), and the platelets would be normal.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 21.2 Describe the pathophysiology associated with congenital heart defects with increased pulmonary circulation, decreased pulmonary circulation, mixed defects, and obstructed systemic blood flow.

 

Question 2

Type: MCSA

A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child?

1. Weight loss
2. Bradycardia
3. Tachycardia
4. Increased blood pressure

Correct Answer: 3

Rationale 1: Tachycardia is a sign of congestive heart failure because the heart attempts to improve cardiac output by beating faster. Bradycardia is a serious sign and can indicate impending cardiac arrest. Blood pressure does not increase in CHF, and the weight, instead of decreasing, increases because of retention of fluids.

Rationale 2: Tachycardia is a sign of congestive heart failure because the heart attempts to improve cardiac output by beating faster. Bradycardia is a serious sign and can indicate impending cardiac arrest. Blood pressure does not increase in CHF, and the weight, instead of decreasing, increases because of retention of fluids.

Rationale 3: Tachycardia is a sign of congestive heart failure because the heart attempts to improve cardiac output by beating faster. Bradycardia is a serious sign and can indicate impending cardiac arrest. Blood pressure does not increase in CHF, and the weight, instead of decreasing, increases because of retention of fluids.

Rationale 4: Tachycardia is a sign of congestive heart failure because the heart attempts to improve cardiac output by beating faster. Bradycardia is a serious sign and can indicate impending cardiac arrest. Blood pressure does not increase in CHF, and the weight, instead of decreasing, increases because of retention of fluids.

Global Rationale: Tachycardia is a sign of congestive heart failure because the heart attempts to improve cardiac output by beating faster. Bradycardia is a serious sign and can indicate impending cardiac arrest. Blood pressure does not increase in CHF, and the weight, instead of decreasing, increases because of retention of fluids.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 21.6 Develop a nursing care plan for a child with congestive heart failure.

 

Question 3

Type: MCSA

A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity?

1. Lowered blood pressure
2. Tinnitus
3. Ataxia
4. A change in heart rhythm

Correct Answer: 4

Rationale 1: An early sign of digoxin (Lanoxin) toxicity is a change in heart rhythm. Digoxin (Lanoxin) toxicity does not cause lowered blood pressure, tinnitus (ringing in the ears), or ataxia (unsteady gait).

Rationale 2: An early sign of digoxin (Lanoxin) toxicity is a change in heart rhythm. Digoxin (Lanoxin) toxicity does not cause lowered blood pressure, tinnitus (ringing in the ears), or ataxia (unsteady gait).

Rationale 3: An early sign of digoxin (Lanoxin) toxicity is a change in heart rhythm. Digoxin (Lanoxin) toxicity does not cause lowered blood pressure, tinnitus (ringing in the ears), or ataxia (unsteady gait).

Rationale 4: An early sign of digoxin (Lanoxin) toxicity is a change in heart rhythm. Digoxin (Lanoxin) toxicity does not cause lowered blood pressure, tinnitus (ringing in the ears), or ataxia (unsteady gait).

Global Rationale: An early sign of digoxin (Lanoxin) toxicity is a change in heart rhythm. Digoxin (Lanoxin) toxicity does not cause lowered blood pressure, tinnitus (ringing in the ears), or ataxia (unsteady gait).

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 21.5 Recognize the signs and symptoms of congestive heart failure in an infant and child.

 

Question 4

Type: MCSA

The nurse is checking peripheral perfusion to a child’s extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity?

1. A capillary refill of greater than three seconds
2. A palpable dorsalis pedis pulse but a weak posterior tibial pulse
3. A decrease in sensation with a weakened dorsalis pedis pulse
4. A capillary refill of less than three seconds with palpable warmth

Correct Answer: 4

Rationale 1: The nurse checks the extremity to determine adequacy of circulation following a cardiac catheterization. An extremity that is warm with capillary refill of less than three seconds has adequate circulation. Other indicators of adequate circulation include palpable pedal (dorsalis and posterior tibial) pulses, adequate sensation, and pinkness of skin color. If the capillary refill is over three seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation may not be adequate.

Rationale 2: The nurse checks the extremity to determine adequacy of circulation following a cardiac catheterization. An extremity that is warm with capillary refill of less than three seconds has adequate circulation. Other indicators of adequate circulation include palpable pedal (dorsalis and posterior tibial) pulses, adequate sensation, and pinkness of skin color. If the capillary refill is over three seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation may not be adequate.

Rationale 3: The nurse checks the extremity to determine adequacy of circulation following a cardiac catheterization. An extremity that is warm with capillary refill of less than three seconds has adequate circulation. Other indicators of adequate circulation include palpable pedal (dorsalis and posterior tibial) pulses, adequate sensation, and pinkness of skin color. If the capillary refill is over three seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation may not be adequate.

Rationale 4: The nurse checks the extremity to determine adequacy of circulation following a cardiac catheterization. An extremity that is warm with capillary refill of less than three seconds has adequate circulation. Other indicators of adequate circulation include palpable pedal (dorsalis and posterior tibial) pulses, adequate sensation, and pinkness of skin color. If the capillary refill is over three seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation may not be adequate.

Global Rationale: The nurse checks the extremity to determine adequacy of circulation following a cardiac catheterization. An extremity that is warm with capillary refill of less than three seconds has adequate circulation. Other indicators of adequate circulation include palpable pedal (dorsalis and posterior tibial) pulses, adequate sensation, and pinkness of skin color. If the capillary refill is over three seconds; if any of the pedal pulses are absent and/or weakened; or if the extremity is cool, cyanotic, or lacking sensation, circulation may not be adequate.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 21.1 Describe the anatomy and physiology of the cardiovascular system, focusing on the flow of blood and the action of heart valves.

 

Question 5

Type: MCSA

The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate?

1. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow
2. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect
3. Acute Pain Related to the Effects of a Congenital Heart Defect
4. Hypothermia Related to Decreased Metabolic State

Correct Answer: 1

Rationale 1: Because of the increased pulmonary congestion, Impaired Gas Exchange would be an appropriate nursing diagnosis. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

Rationale 2: Because of the increased pulmonary congestion, Impaired Gas Exchange would be an appropriate nursing diagnosis. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

Rationale 3: Because of the increased pulmonary congestion, Impaired Gas Exchange would be an appropriate nursing diagnosis. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

Rationale 4: Because of the increased pulmonary congestion, Impaired Gas Exchange would be an appropriate nursing diagnosis. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

Global Rationale: Because of the increased pulmonary congestion, Impaired Gas Exchange would be an appropriate nursing diagnosis. Ventricular septal defects do not cause pain, fever, or deficient fluid volume.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Basic Care and Comfort

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 21.2 De