A nurse is assessing a child who has heart failure.
Which of the following findings is a clinical manifestation associated with this diagnosis?

Tachypnea

Increased appetite

Tremors

Bradycardia

Answer and Explanation

The Correct Answer is A

Choice A rationale

Tachypnea, or rapid breathing, is a common clinical manifestation of heart failure in children. This occurs because the heart is unable to pump enough blood to meet the body’s needs, causing fluid to back up into the

lungs and leading to shortness of breath and rapid breathing.

Choice B rationale

Contrary to increased appetite, children with heart failure often experience a decrease in appetite or difficulty feeding. This is due to increased energy expenditure and early satiety caused by abdominal distension from hepatomegaly or ascites.

Choice C rationale

Tremors are not typically associated with heart failure. They could be a sign of other neurological conditions, side effects of certain medications, or anxiety.

Choice D rationale

Bradycardia, or a slower than normal heart rate, is not typically a symptom of heart failure. In fact, tachycardia, or a faster than normal heart rate, is more commonly seen in heart failure as the heart tries to compensate for its reduced ability to pump blood.

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Correct Answer is ["A","C","E"]

Explanation

Choice A rationale

Providing a high-calorie diet is a recommended action for a child who has received partial-thickness burns to

over 50% of his body. After a burn injury, the body needs extra calories and protein to heal, fight infection, and maintain its functions. A high-calorie diet can help meet these increased nutritional needs.

Choice B rationale

Administering analgesics intramuscularly (IM) is not a recommended action for a child with partial- thickness burns. Pain management is crucial in burn care, but analgesics should be given orally or intravenously, not IM, to avoid additional pain and tissue damage.

Choice C rationale

Monitoring intake and output is a recommended action for a child who has received partial-thickness burns to over 50% of his body. This can help assess the child’s hydration status, kidney function, and response to fluid replacement therapy.

Choice D rationale

Removing splints during sleep is not a recommended action for a child with partial-thickness burns. Splints are used to prevent contractures by keeping the joints in a functional position. They should be worn as prescribed by the healthcare provider, which often includes during sleep.

Choice E rationale

Changing dressings using aseptic technique is a recommended action for a child who has received partial- thickness burns to over 50% of his body. This can help prevent infection, promote healing, and assess the burn’s progress.

A. Keep the child away from others until the skin is clear of scabs B. Dress the child in warm clothing to promote healing of vesicles C. Apply calamine lotion to vesicles on the child’s skin D. Avoid giving the child a bath while vesicles are prese .

Correct Answer is ["A","C"]

Explanation

he correct answer is Choice A, Choice C.

Choice A rationale: Keeping the child away from others until all vesicles have crusted over is essential to prevent the spread of varicella. The child is no longer contagious once the vesicles have crusted, reducing the risk of transmission.

Choice B rationale: Dressing the child in warm clothing is not recommended as it can cause discomfort and aggravate itching. Loose, comfortable clothing should be used to prevent irritation of vesicles and promote healing.

Choice C rationale: Applying calamine lotion to vesicles on the child’s skin can soothe itching and provide relief. It is a safe and effective topical treatment to manage symptoms associated with varicella, ensuring the child remains comfortable.

Choice D rationale: Bathing the child is recommended to maintain hygiene and prevent secondary infections. Using mild soap and lukewarm water can help keep the skin clean and reduce itching, contrary to avoiding baths.

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A nurse is assessing a child who has heart failure.Which of the following findings is a clinical manifestation associated with this diagnosis?

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Explanation

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A nurse is assessing a child who has heart failure.
Which of the following findings is a clinical manifestation associated with this diagnosis?