A nurse is assessing an infant who has Tetralogy of Fallot. Which of the following clinical manifestations should the nurse expect?

Select all that apply.

Bounding peripheral pulses

Cyanotic spells

Stridor

Anemia

heart murmur

Answer and Explanation

Correct Answer : B,E

A. "Bounding peripheral pulses." Bounding pulses are not characteristic of Tetralogy of Fallot. Instead, pulses may be normal or diminished, depending on the severity of the defect.
B. "Cyanotic spells." Tetralogy of Fallot causes decreased oxygenation, leading to periodic cyanotic episodes, particularly during crying or feeding ("tet spells").
C. "Stridor." Stridor is associated with upper airway obstructions, not cardiac defects like Tetralogy of Fallot.
D. "Anemia." Anemia is not a primary finding in Tetralogy of Fallot. Polycythemia (increased red blood cells) is more common due to chronic hypoxia.
E. "Heart murmur." A systolic murmur is common due to the pulmonary stenosis and ventricular septal defect associated with Tetralogy of Fallot.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

A. Applying heat to the affected areas: In vaso-occlusive crises associated with sickle cell disease,heat packs can be a helpful part of pain management, but they should be used with caution and not in all situations.
B. Administering prophylactic antibiotics: While prophylactic antibiotics are important in preventing infections in sickle cell anemia, this is not the immediate priority during a vaso-occlusive crisis.
C. Administering the pneumococcal vaccine: While vaccination is important, it is not a priority during a vaso-occlusive crisis.
D. Promoting bed rest: The nurse should assist the child to assume a comfortable position so that the child keeps the extremities extended to promote venous return; elevate the head of the bed no more than 30 degrees and avoid putting strain on painful joints.

A. Maintain aseptic technique during the child's dressing changes. B. Provide low-calorie snacks for the child several times each day. C. Apply continuous passive motion devices to the child's lower extremities during periods of rest. D. Administer pain medication to the child 30 min following physical therapy.

Correct Answer is A

Explanation

A. "Maintain aseptic technique during the child's dressing changes." Aseptic technique reduces the risk of infection, which is critical for children with burns as their immune response may be compromised.
B. "Provide low-calorie snacks for the child several times each day." Children with burns require a high-calorie, high-protein diet to promote healing and compensate for increased metabolic demands.
C. "Apply continuous passive motion devices to the child's lower extremities during periods of rest." Passive motion devices are not typically indicated for burn injuries unless there is joint involvement requiring physical therapy for mobility restoration.
D. "Administer pain medication to the child 30 min following physical therapy." Pain medication should be administered before physical therapy to improve tolerance and participation.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is assessing an infant who has Tetralogy of Fallot. Which of the following clinical manifestations should the nurse expect? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for an adolescent client who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is the nurse's priority?

Correct Answer is D

Explanation

A nurse is creating a plan of care for a school-age child who has moderate partial-thickness burns on both lower extremities. Which of the following interventions should the nurse include in the plan?

Correct Answer is A

Explanation

A nurse is providing discharge teaching to the parent of a school-age child who has juvenile idiopathic arthritis (JIA). The nurse should identify that which of the following responses by the parent indicates an understanding of the teaching?

A nurse is teaching a group of new parents about expected language development. The nurse should include that a child should begin to speak 10 or more words at about which of the following ages?

A nurse is teaching the parent of a school-age child who has cystic fibrosis about home care. Which of the following statements by the parent indicates an understanding of the teaching?

A nurse is admitting a child who has pertussis. Which of the following isolation precautions should the nurse initiate for the child?

A nurse is providing discharge teaching to the parent of a 5-year-old child who has leukemia and is receiving chemotherapy. Which of the following statements by the parent indicates an understanding of the teaching?

A nurse is providing discharge teaching to the parents of a school-age child who has epilepsy and a new prescription for phenytoin extended- release capsules. Which of the following instructions should the nurse include in the teaching?

A nurse is assessing an infant who has Tetralogy of Fallot. Which of the following clinical manifestations should the nurse expect?

Select all that apply.