The nurse is collecting data on a 2 month-old-child with left-sided congestive heart failure. Which clinical manifestation would support this diagnosis of left-sided congestive heart failure?

Edema in the lower extremities

Ascites

Shortness of breath

Hepatomegaly

Answer and Explanation

The Correct Answer is C

A. Edema in the lower extremities:
Incorrect: Edema in the lower extremities is more characteristic of right-sided heart failure. In left-sided failure, pulmonary congestion is more prominent.
B. Ascites:
Incorrect: Ascites, or fluid accumulation in the abdominal cavity, is also more commonly associated with right-sided heart failure.
C. Shortness of breath:
Correct Answer: Left-sided congestive heart failure can lead to pulmonary congestion, resulting in difficulty breathing or shortness of breath. This is often observed as increased work of breathing, rapid breathing, or other signs of respiratory distress in infants.
D. Hepatomegaly:
Incorrect: Hepatomegaly, or enlargement of the liver, is another manifestation more commonly associated with right-sided heart failure.

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Correct Answer is B

Explanation

A. "I will have my child wear soft fabric clothing under the brace."
Explanation: Wearing soft fabric clothing under the brace can enhance comfort and reduce the risk of irritation. This is a suitable practice.
B. "I need to apply lotion under the brace to prevent skin breakdown."
Explanation:
Applying lotion under the brace may lead to moisture accumulation and skin breakdown. It is generally recommended to keep the skin clean and dry under the brace to prevent irritation and pressure sores. Lotions or creams can contribute to moisture, potentially causing skin problems.
C. "I need to avoid the use of powder because it will cake under the brace."
Explanation: Powder can accumulate and cake under the brace, leading to skin issues. This statement is correct, emphasizing the importance of avoiding the use of powder.
D. "I will encourage my child to perform prescribed exercises."
Explanation: Encouraging the child to perform prescribed exercises is essential for maintaining flexibility and strength. This statement reflects a positive and supportive approach to managing scoliosis.

A. Ribbon-like stools B. Profuse projectile vomiting C. Bright red blood and mucus in the stools D. Watery diarrhea

Correct Answer is C

Explanation

A. Ribbon-like stools
Explanation: Ribbon-like or pencil-thin stools are associated with conditions affecting the rectum, such as colorectal cancer, but they are not a typical sign of intussusception.
B. Profuse projectile vomiting
Explanation: Profuse projectile vomiting is not a typical sign of intussusception. Vomiting may occur, but it is not the primary characteristic feature.
C. Bright red blood and mucus in the stools
Explanation:
Intussusception is a condition in which one part of the intestine slides into another, causing a blockage. One of the classic signs of intussusception is the presence of "currant jelly" stools, which are characterized by a mixture of bright red blood and mucus in the stools. This occurs due to the compression of the blood vessels in the intestine, leading to bleeding and mucosal discharge.
D. Watery diarrhea
Explanation: Watery diarrhea is not a typical sign of intussusception. The condition is more commonly associated with abdominal pain, vomiting, and the characteristic "currant jelly" stools.

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The nurse is collecting data on a 2 month-old-child with left-sided congestive heart failure. Which clinical manifestation would support this diagnosis of left-sided congestive heart failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction?

Correct Answer is B

Explanation

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented?

Correct Answer is C

Explanation

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