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 C

Explanation

A. Aortic stenosis (AS) typically causes a difference in blood flow across the aortic valve but does not usually require assessment of upper and lower extremity blood pressures.

B. Transposition of the Great Vessels (Arteries) results in cyanosis and abnormal circulatory flow but does not require upper and lower extremity blood pressure monitoring.

C. Coarctation of the Aorta (COA) is characterized by narrowing of the aorta, often resulting in higher blood pressure in the upper extremities compared to the lower extremities. Measuring both helps identify this condition.

D. Tetralogy of Fallot (TOF) involves right ventricular outflow obstruction, VSD, overriding aorta, and right ventricular hypertrophy, but upper and lower extremity blood pressures are not typically used for diagnosis.

A. Keep the child him and call for emergency airway equipment B. Assess the throat for a cherry red epiglottis C. Place the child on a knee to chest position D. Obtain IV access and start IV fluids

Correct Answer is A

Explanation

A. The child is showing signs of severe respiratory distress, likely due to epiglottitis. The priority is to keep the child calm to avoid further airway obstruction and to prepare for emergency airway management.

B. While assessing the throat for epiglottitis is important, direct visualization of the throat can cause spasm and worsen airway obstruction.

C. The knee-to-chest position is typically used in cases of respiratory distress in infants (e.g., with RSV), but not in this case.

D. While IV access and fluids may be necessary, the immediate priority is securing the airway.

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Naxlex Comprehensive Predictor Exams

In which congenital heart defect would the nurse need to take upper and lower extremity blood pressures?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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 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 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 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?

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 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.

Tetralogy of Fallot (TOF) involves which defects? Select all that apply.

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: