A nurse is teaching an adolescent how to use a peak expiratory flow meter (PEFM). The nurse should identify that which of the following statements by the child indicates an understanding of the teaching?

"I will breathe in through the mouthpiece, hold my breath for 5 seconds, and then exhale."

"If I get a reading in the green zone, I will tell my parents right away so they can call the doctor."

"I will slowly exhale through the mouthpiece over a 10-second interval."

"I will record the highest reading of the three attempts."

Answer and Explanation

The Correct Answer is D

A. "I will breathe in through the mouthpiece, hold my breath for 5 seconds, and then exhale.": Incorrect because the child should exhale forcefully and quickly into the device, not inhale or hold their breath.
B. "If I get a reading in the green zone, I will tell my parents right away so they can call the doctor.": Incorrect because a green zone reading indicates controlled asthma, and no immediate action is required.
C. "I will slowly exhale through the mouthpiece over a 10-second interval.": Incorrect because the exhalation should be rapid and forceful to measure peak flow effectively.
D. "I will record the highest reading of the three attempts." Recording the highest reading ensures accurate monitoring of airway status and helps the child track their progress over time.

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

Explanation

A. "Bounding peripheral pulses." Bounding pulses are not characteristic of Tetralogy of Fallot. Instead, pulses may be normal or diminished, depending on the severity of the defect.
B. "Cyanotic spells." Tetralogy of Fallot causes decreased oxygenation, leading to periodic cyanotic episodes, particularly during crying or feeding ("tet spells").
C. "Stridor." Stridor is associated with upper airway obstructions, not cardiac defects like Tetralogy of Fallot.
D. "Anemia." Anemia is not a primary finding in Tetralogy of Fallot. Polycythemia (increased red blood cells) is more common due to chronic hypoxia.
E. "Heart murmur." A systolic murmur is common due to the pulmonary stenosis and ventricular septal defect associated with Tetralogy of Fallot.

A. Temperature 36.9°C (98.4° F) B. Heart rate 162/min C. Respiratory rate 28/min D. Also spits up after every feeding, sometimes forcefully E. Small, soft, midline bulge observed on abdomen between xyphoid process and umbilicus F. Weight 5,925 g (13 lb 1 oz). Parents report birth weight was 4,196 g (9 lb 4 oz)

Correct Answer is ["B","D","E"]

Explanation

Heart rate 162/min: Elevated for a 4-month-old at rest; tachycardia can indicate dehydration, fever, or stress.

Spits up forcefully after feedings: Forceful vomiting can suggest gastroesophageal reflux disease (GERD) or pyloric stenosis.

Small, soft midline bulge: Likely an umbilical hernia; may need monitoring or intervention if persistent or large.

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A nurse is teaching an adolescent how to use a peak expiratory flow meter (PEFM). The nurse should identify that which of the following statements by the child indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing an infant who has Tetralogy of Fallot. Which of the following clinical manifestations should the nurse expect? Select all that apply.

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

Explanation

Correct Answer is ["B","D","E"]

Explanation

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