A 4-year-old child with a history of cystic fibrosis is hospitalized with an acute pulmonary exacerbation. His prescription includes chest physiotherapy four times a day, antibiotics via IV, and pancreatic enzymes. Which time is best for the nurse to plan for chest physiotherapy?

An hour before meals and at bedtime.

Every six hours around the clock.

Upon awakening and within an hour after meals.

Evenly spaced when the patient is awake.

Answer and Explanation

The Correct Answer is A

An hour before meals and at bedtime.

Choice A rationale:

Scheduling chest physiotherapy an hour before meals and at bedtime is optimal. This timing helps prevent aspiration during meals and aids in clearing secretions before sleep. It complements the patient's meal schedule and sleep routine.

Choice B rationale:

Every six hours around the clock could disrupt the patient's sleep and meal times. Chest physiotherapy might not align well with the patient's daily activities, potentially affecting treatment compliance and effectiveness.

Choice C rationale:

Performing chest physiotherapy upon awakening and after meals might increase the risk of aspiration during meals. Clearing airways before meals is safer, and performing it right after meals could cause discomfort.

Choice D rationale:

Evenly spaced physiotherapy when awake lacks synchronization with meal and sleep times. This approach might not optimize treatment effects and patient convenience.

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Correct Answer is ["B","C"]

Explanation

Choice A rationale:
Hypoplastic left heart syndrome involves inadequate development of the left side of the heart, leading to systemic hypoperfusion. It is characterized by decreased pulmonary blood flow due to underdeveloped left heart structures.
Choice B rationale:
Tetralogy of Fallot is characterized by obstruction to blood flow, specifically pulmonary stenosis, which obstructs blood flow from the right ventricle to the pulmonary artery.
Choice C rationale:
Atrial Septal Defect (ASD) is a left-to-right shunt, leading to increased pulmonary blood flow. This occurs because oxygenated blood from the left atrium flows back into the right atrium and then into the pulmonary circulation.
Choice D rationale:
Aortic Stenosis is not correctly matched with its hemodynamic classification. Aortic stenosis involves obstruction to blood flow from the left ventricle to the aorta.

A. "We will return to the hospital if my child spits up blood.". B. "I'll give my child cherry gelatin since that is her favorite.". C. "We will return to the hospital if my child develops difficulty breathing.". D. "I'll have my child rinse her mouth frequently with water to prevent a bad breath odor.".

Correct Answer is B

Explanation

Choice A rationale:

Returning to the hospital if the child spits up blood is a correct response as it indicates the recognition of potential postoperative bleeding.

Choice B rationale:

Giving the child cherry gelatin, even though it's the child's favorite, might not be appropriate after a tonsillectomy/adenoidectomy, as certain foods can irritate the healing throat.

Choice C rationale:

Returning to the hospital if the child develops difficulty breathing is a necessary step to address any respiratory distress.

Choice D rationale:

Having the child rinse her mouth frequently with water to prevent a bad breath odor is a suitable suggestion to maintain oral hygiene and comfort after surgery. In all three scenarios, the rationale for the correct answers revolves around patient safety, comfort, and appropriate post-operative care. The incorrect choices in each question either introduce potential complications, misunderstandings, or actions that might compromise the patient's well-being.

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A 4-year-old child with a history of cystic fibrosis is hospitalized with an acute pulmonary exacerbation. His prescription includes chest physiotherapy four times a day, antibiotics via IV, and pancreatic enzymes. Which time is best for the nurse to plan for chest physiotherapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is working on a pediatric cardiology unit and has four patients, each with a different congenital heart defect. Match the congenital heart defect with the correct hemodynamic classification.

Correct Answer is ["B","C"]

Explanation

The nurse is providing discharge instructions to the parent of a patient who had a tonsillectomy/adenoidectomy. Which statement would indicate that the parent needs further teaching?

Correct Answer is B

Explanation

What information should a nurse plan to give the parents of a child newly diagnosed with cognitive impairment (mental retardation)?

The nurse is to record the intake and output of a 2-year-old patient. The patient is not toilet trained. Which measure would be most appropriate to include in the patient's plan of care?

When administering zidovudine to a patient with human immunodeficiency virus (HIV), which action should be the first priority for the nurse?

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A 4-year-old patient is newly diagnosed with acute lymphocytic leukemia (ALL). The patient's mother says to the nurse, "I feel numb. I just can't believe this is happening.”. The nurse recognizes that this statement is consistent with which emotional reaction?

An 8-year-old patient suspected of having seizures is admitted to the hospital for a diagnostic workup. Which psychological concern is the patient most likely to have during diagnostic testing?

A school-aged child is recently diagnosed with attention deficit hyperactive disorder (ADHD). What information about the newly prescribed stimulant medication should a nurse plan to give the family?