A nurse is providing care for an infant who has heart failure and is being discharged from the hospital. When providing discharge education. which of the following clinical manifestations should the nurse ensure caregivers are able to identify as signs of worsening heart failure?

Bradycardia, rapid weight gain. and irritability.

Cough. edema. and increased work of breathing.

Abdominal pain. poor appetite. and cough.

Tachypnea and diaphoresis with feeding. poor weight gain, and irritability.

Answer and Explanation

The Correct Answer is D

A. Bradycardia, rapid weight gain, and irritability. – Incorrect. Tachycardia (not bradycardia) is more concerning in worsening heart failure.

B. Cough, edema, and increased work of breathing. – Incorrect. These symptoms can occur but are less specific to worsening heart failure in infants.

C. Abdominal pain, poor appetite, and cough. – Incorrect. While appetite changes may occur, abdominal pain is not a classic sign of heart failure in infants.

D. Tachypnea and diaphoresis with feeding, poor weight gain, and irritability. – Correct. Infants with worsening heart failure experience increased respiratory effort, sweating with feeds (due to exertion), failure to thrive, and fussiness due to poor oxygenation.

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Correct Answer is D

Explanation

A. Low systolic blood pressure in the upper extremities and elevated systolic blood pressure in the lower extremities. – Incorrect. Coarctation of the aorta causes the opposite finding.

B. Elevated systolic blood pressure in the upper extremities and elevated systolic blood pressure in the lower extremities. – Incorrect. Blood pressure in the lower extremities is reduced due to decreased blood flow.

C. Low systolic blood pressure in the upper extremities and low systolic blood pressure in the lower extremities. – Incorrect. Coarctation of the aorta leads to hypertension in the upper body due to increased resistance.

D. Elevated systolic blood pressure in the upper extremities and low systolic blood pressure in the lower extremities. – Correct. Coarctation of the aorta causes high BP in the arms and low BP in the legs due to obstructed blood flow past the narrowing.

A. Administer benzodiazepine medication B. Perform neurological checks C. Reorient and calm the child D. Position the child in a side-lying position E. Restrict the child's movements during the seizure F. Document the duration and characteristics of the seizure

Correct Answer is ["A","B","C","D","E","F"]

Explanation

A. Administer benzodiazepine medication. – Correct. Benzodiazepines (e.g., lorazepam, diazepam) are first-line treatments for prolonged seizures.

B. Perform neurological checks. – Correct. Monitoring postictal status helps assess brain function.

C. Reorient and calm the child. – Correct. After the seizure, the child may be confused and require reassurance.

D. Position the child in a side-lying position. – Correct. This prevents aspiration and maintains a clear airway.

E. Restrict the child's movements during the seizure. – Incorrect. Restraining can cause injury. Instead, protect the child from harm by removing nearby objects.

F. Document the duration and characteristics of the seizure. – Correct. Recording seizure length, activity, and triggers is crucial for medical management.

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A nurse is providing care for an infant who has heart failure and is being discharged from the hospital. When providing discharge education. which of the following clinical manifestations should the nurse ensure caregivers are able to identify as signs of worsening heart failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is completing an assessment of a newborn, including obtaining blood pressure measurements at each extremity. Which of the following findings suggests coarctation of the aorta?

Correct Answer is D

Explanation

A nurse is caring for a child with a seizure in the hospital. Which nursing interventions are appropriate for this child? (Select All that Apply.)

Correct Answer is ["A","B","C","D","E","F"]

Explanation

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