The nurse assesses a child with coarctation of the aorta. Which common clinical manifestation is the nurse likely to observe?
Upper body blood pressure is higher than the lower body
Clubbing of the digits and shortness of breath
Cyanosis
Pedal edema
The Correct Answer is A
A. Coarctation of the aorta is a congenital narrowing of the aorta, typically after the branches that supply the upper body. This results in increased blood pressure in the upper extremities and decreased perfusion (and lower blood pressure) in the lower extremities.
B. Clubbing and shortness of breath are more characteristic of chronic hypoxemia, often seen in cyanotic congenital heart defects such as Tetralogy of Fallot, not coarctation of the aorta.
C. Cyanosis is typically associated with defects that cause mixing of oxygenated and deoxygenated blood, such as transposition of the great arteries or tetralogy of Fallot, not coarctation.
D. Pedal edema is more commonly associated with right-sided heart failure and is not a hallmark sign of coarctation in pediatric clients.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Frequent swallowing is a classic sign of post-tonsillectomy hemorrhage, as the child may be swallowing blood that is draining down the throat. This can be a subtle but early indicator of bleeding and requires immediate evaluation.
B. Increased pain is expected in the immediate postoperative period and not specific to hemorrhage.
C. Drooling may be due to throat pain or refusal to swallow but is not a key indicator of bleeding.
D. Poor fluid intake is common after tonsillectomy due to pain and discomfort, but not specific to hemorrhage.
Correct Answer is C
Explanation
A. Fatigue is a common symptom in terminally ill children, but it is not the one identified in research as receiving the least relief.
B. Respiratory distress is also common, especially in the final days, but symptom relief is typically addressed through oxygen therapy or medications like opioids or benzodiazepines.
C. Pain is one of the most commonly reported and under-relieved symptoms in dying children. Studies have shown that despite available pain management strategies, only about 27% of children receive adequate pain relief in their final weeks. This highlights the need for better pediatric palliative care practices.
D. Poor appetite is expected and typically accepted as part of the dying process, and while distressing to families, it is not the most inadequately managed symptom.
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