A nurse is assessing a toddler who has heart failure. Which of the following findings should the nurse expect?
Orthopnea
Bradycardia
Weight loss
Increased urine output
The Correct Answer is A
A. Orthopnea
Explanation:
Orthopnea refers to difficulty breathing that occurs when lying flat. In heart failure, fluid may accumulate in the lungs, leading to respiratory distress when the child is in a supine position. Orthopnea is a common symptom of heart failure in both adults and children.
B. Bradycardia
Explanation: Bradycardia (slow heart rate) is not a typical finding in heart failure. Heart failure often leads to compensatory mechanisms, including an increased heart rate (tachycardia), to maintain cardiac output.
C. Weight loss
Explanation: Weight loss is not a typical finding in heart failure. In fact, heart failure in children may lead to fluid retention and weight gain rather than weight loss.
D. Increased urine output
Explanation: Heart failure in toddlers is more likely to be associated with decreased urine output rather than increased urine output. Reduced cardiac output can result in decreased blood flow to the kidneys, leading to decreased urine production and potential fluid retention. Increased urine output is not a characteristic finding in heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Coughing spells may be triggered by dust or smoke:
Incorrect: This is a correct statement. Irritants like dust or smoke can trigger coughing spells in a child recovering from pertussis.
B. We need to maintain droplet precautions and a quiet environment for at least 2 weeks.
Correct Answer: Pertussis is highly contagious during the catarrhal and paroxysmal stages, but once the child has reached the convalescent stage (usually after 2-4 weeks of illness), the risk of spreading the infection decreases significantly. Continuing strict droplet precautions and a quiet environment for two weeks after the convalescent stage is not necessary.
C. "We need to encourage our child to drink fluids":
Incorrect: This is a correct statement. Encouraging fluid intake is important to prevent dehydration, especially during coughing spells.
D. Vomiting may occur when our child has coughing episodes:
Incorrect: This is a correct statement. Vomiting can be a common occurrence during coughing episodes in pertussis due to the forceful nature of the cough. Parents should be aware of this symptom.
Correct Answer is C
Explanation
A. A highly pruritic profuse macule to papule rash on the trunk
Explanation: This description does not fit the typical characteristics of erythema infectiosum. Fifth disease is not typically associated with a highly pruritic rash.
B. A discrete pinkish red maculopapular rash that is spreading to the trunk
Explanation: While erythema infectiosum does involve a rash that can spread to the trunk, the distinctive "slapped face" appearance is a key characteristic that is not captured in this option.
C. An erythema on the face that has a "slapped face" appearance.
Explanation:
Erythema infectiosum, commonly known as fifth disease or slapped cheek syndrome, is characterized by a distinctive facial rash that gives the appearance of a "slapped face." The rash typically starts on the face and then spreads to the trunk and extremities. It often begins with erythema on the cheeks, giving the child a flushed or slapped appearance, followed by a discrete rose-pink maculopapular rash on the trunk.
D. A discrete rose-pink maculopapular rash on the trunk
Explanation: This description fits the typical characteristics of the rash seen in erythema infectiosum, but the key identifier is the "slapped face" appearance on the face.
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