The nurse is caring for a child diagnosed with ventricular septal defect (VSD) who is scheduled for a surgical repair tomorrow morning. When the nurse auscultates the child's lungs sounds, the nurse notes diffuse crackles and rales throughout the lung fields. The nurse interprets this assessment as which of the following?

Foreign body aspiration

Systemic congestion

Pneumonia

Pulmonary congestion

Answer and Explanation

The Correct Answer is D

A. Foreign body aspiration is characterized by sudden onset of coughing, choking, and wheezing, not crackles and rales.

B. Systemic congestion refers to peripheral edema and does not usually present with crackles in the lungs.

C. Pneumonia would present with localized crackles or rales over specific lung areas and often includes fever and cough, which are not mentioned here.

D. Pulmonary congestion is common in children with VSD, particularly when the left side of the heart cannot effectively pump blood, leading to fluid accumulation in the lungs. Crackles and rales indicate this type of fluid buildup.

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Correct Answer is D

Explanation

A. Kawasaki disease typically presents with fever, rash, and conjunctivitis, not a machine-like murmur or the other cardiovascular findings.

B. Tricuspid Atresia involves a defect in the tricuspid valve and presents with cyanosis and poor circulation, but not a machine-like murmur.

C. Tetralogy of Fallot involves a murmur due to pulmonary stenosis and VSD but would not produce a "machine-like" murmur, which is characteristic of PDA.

D. Patent Ductus Arteriosus (PDA) results in a continuous "machine-like" murmur due to abnormal blood flow between the aorta and pulmonary artery, along with findings of pulmonary congestion and right ventricular hypertrophy.

A. Itching and tenderness when manipulating the affected ear lobe B. Fullness in the ear and a clogged sensation without other systemic findings C. Edema and erythema of the external canal only D. Pulling on the affected ear, acute onset of fever and otalgia

Correct Answer is D

Explanation

A. Itching and tenderness when manipulating the affected ear lobe is more characteristic of an external ear infection (otitis externa) rather than acute otitis media.

B. Fullness in the ear and a clogged sensation might be experienced in acute otitis media, but it usually occurs with systemic signs of infection such as fever and pain.

C. Edema and erythema of the external canal only would indicate an external ear infection (otitis externa), not otitis media, which affects the middle ear.

D. Pulling on the affected ear, acute onset of fever, and otalgia (ear pain) are classic signs of acute otitis media. Children often pull or tug at the affected ear in response to pain.

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Naxlex Comprehensive Predictor Exams

While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a widened pulse pressure. pulmonary congestion and right ventricular hypertrophy. The nurse suspects that the newborn has:

Correct Answer is D

Explanation

A nurse is caring for a child who has acute otitis media. Which of the following classic assessment findings should the nurse expect?

Correct Answer is D

Explanation

The nurse is providing asthma education to a teen that has just been diagnosed with asthma. Which of the following statements by the client would indicate a need for further teaching? Select all that apply.

The nurse is assessing a child with epiglottitis. Which of the following would be an expected finding?

The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the neck extended. How would the nurse interpret this finding? -

The nurse is caring for a child diagnosed with Kawasaki disease. Keeping the pathophysiology in mind, the nurse carefully monitors the child for which complication?

The nurse is providing home care instructions to the parent of a 9-year-old child diagnosed with bacterial conjunctivitis. Topical antimicrobial therapy is prescribed for the child. Which statement by the parent indicates that the teaching has been effective?

The primary health care provider prescribes patching for a child with amblyopia of the right eye, and the nurse instructs the parent regarding this procedure. What would the nurse include in the instructions?

The nurse is assessing a client diagnosed with ventricular septal defect (VSD), the nurse is aware that many infants with these conditions also receive a diagnosis of which of the following?