ATI RN
Pediatric Cardiovascular Disorders Nursing Questions
Question 1 of 5
A client who took a camping vacation two weeks ago in a county with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse report to the healthcare provider?
Correct Answer: D
Rationale: The most important finding for the nurse to report to the healthcare provider in this scenario is option D) Jaundiced sclera. Jaundice is a serious sign of liver dysfunction, which could be indicative of a potential infection such as hepatitis, especially considering the recent travel to a tropical climate where infectious diseases may be more prevalent. Liver involvement can lead to serious complications, especially in pediatric patients. Option A) Weakness and fatigue are non-specific symptoms that can be associated with various conditions and may not provide a clear indication of the underlying issue. Option B) Intestinal cramping, while uncomfortable for the client, is a common symptom of diarrhea and may not necessarily point to a more serious condition. Option C) Weight loss, while significant, may be a consequence of the diarrhea and not necessarily the most critical finding requiring immediate attention. In an educational context, understanding the significance of specific symptoms and their implications in pediatric patients is crucial for nurses caring for children with potential health concerns. Recognizing the priority signs and symptoms to report to healthcare providers can lead to timely interventions and improved outcomes for pediatric patients.
Question 2 of 5
A client with urolithiasis is preparing for discharge after lithotripsy. Which intervention should the nurse include in the client's postoperative discharge instructions?
Correct Answer: D
Rationale: In the context of a client with urolithiasis post-lithotripsy, the correct intervention to include in postoperative discharge instructions is option D) Give IV dose of adenosine rapidly over 1-2 seconds. Adenosine is commonly used to treat supraventricular tachycardia, a condition that can occur as a complication of lithotripsy due to the stress and pain associated with the procedure. Rapid administration of adenosine can help restore normal sinus rhythm by temporarily blocking conduction through the atrioventricular node. Option A) Prepare for transcutaneous pacing is incorrect as it is not indicated in this situation. Transcutaneous pacing is used for bradycardia or heart blocks, not for supraventricular tachycardia. Option B) Deliver another defibrillator shock is also incorrect. Defibrillation is used for life-threatening arrhythmias like ventricular fibrillation or ventricular tachycardia, not for supraventricular tachycardia. Option C) Administer IV Epinephrine per ACLS protocol is not the correct choice either. Epinephrine is typically used in cardiac arrest situations to improve myocardial and cerebral perfusion, not for treating supraventricular tachycardia post-lithotripsy. Educationally, understanding the appropriate pharmacological interventions post-lithotripsy is crucial for nurses caring for patients with urolithiasis. It is important to differentiate between different types of arrhythmias and their respective treatments to provide safe and effective care to patients recovering from procedures like lithotripsy.
Question 3 of 5
During preoperative teaching for a male client scheduled for repair of an inguinal hernia, the client tells the nurse that he has had several surgeries and understands the need to perform coughing and deep breathing exercises after surgery. How should the nurse respond?
Correct Answer: A
Rationale: The correct answer is A) Ask for a demonstration of these exercises. This response is appropriate because it allows the nurse to assess the client's understanding of the coughing and deep breathing exercises. By asking for a demonstration, the nurse can ensure that the client is performing the exercises correctly, which is crucial for preventing postoperative complications such as atelectasis and pneumonia. Option B) Explain that coughing should be avoided is incorrect as coughing and deep breathing exercises are actually encouraged after surgery to promote lung expansion, improve oxygenation, and prevent respiratory complications. Option C) Review the client’s previous surgical history is not the most appropriate response in this situation as the client has already mentioned understanding the need for coughing and deep breathing exercises. Focusing on the current teaching and assessment of understanding is more relevant. Option D) Document the client's understanding of teaching is important but not sufficient on its own. While documentation is crucial, it does not actively assess the client's ability to perform the exercises correctly. In an educational context, this scenario highlights the importance of active assessment and validation of patient understanding in the teaching process. By asking for a demonstration, nurses can ensure that patients have the necessary skills and knowledge to care for themselves effectively postoperatively.
Question 4 of 5
A nurse assists a male client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to 'freeze' and then carefully lifts one leg and steps forward. He tells the nurse that he is pretending to step over a crack on the floor. How should the nurse respond?
Correct Answer: B
Rationale: In this scenario, option B is the correct response. The client with Parkinson's disease is exhibiting a phenomenon known as "freezing of gait," a common symptom in PD where individuals feel as though their feet are glued to the floor and have difficulty initiating movement. By pretending to step over a crack, the client is using a technique called "cued stepping," which can help overcome freezing episodes and facilitate ambulation. Option A is incorrect as re-orienting the client is not addressing the immediate issue of freezing of gait. Option C is also incorrect as simply changing the surface to carpeted area may not address the underlying problem and may not be practical in all settings. Option D is incorrect as assessing cognition is not the priority at this moment when the client is experiencing a physical symptom related to PD. Educationally, it is important for nurses to understand the various manifestations of Parkinson's disease, including freezing of gait, and how to effectively manage these symptoms to support the client in their activities of daily living. Understanding and recognizing cues like pretending to step over a crack can be crucial in providing holistic care for clients with PD.
Question 5 of 5
A client with unstable asthma had an emergent cardiac catheterization. Which complication should the nurse monitor for in the initial 24 hours after the procedure?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Thrombus formation. The nurse should monitor for this complication in the initial 24 hours after a client with unstable asthma undergoes an emergent cardiac catheterization. Rationale: - Thrombus formation is a critical concern post-cardiac catheterization due to the invasive nature of the procedure, which can lead to endothelial damage, platelet activation, and blood stasis—all potential triggers for thrombus development. - Infection (Option B) is a concern post-procedure but typically presents later than the initial 24 hours unless immediate signs are evident such as fever or local redness/swelling. - Bronchospasm (Option C) is more related to the client's asthma condition and may not be directly linked to the cardiac catheterization procedure. - Heart failure (Option D) is not typically an immediate complication post-cardiac catheterization unless pre-existing heart conditions worsen during or after the procedure. Educational context: Understanding post-procedural complications is crucial for nurses caring for pediatric clients with cardiovascular disorders. Monitoring for thrombus formation is essential to prevent life-threatening complications. Nurses must have a solid foundation in pharmacology to anticipate, recognize, and manage potential complications in these high-risk situations.