Peds Test Bank Questions Exam 1 - Cardiovascular/Genitourinary

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1. A chest radiograph film is ordered for a child with sus- Answer: C

pected cardiac problems. The childs parent asks the
nurse, What will the radiograph show about the heart?
The nurses response should be based on knowledge
that the x-ray film will show:
a. bones of chest but not the heart.
b. measurement of electrical potential generated from
heart muscle.
c. permanent record of heart size and configuration.
d. computerized image of heart vessels and tissues.

2. The nurse is assessing a child after a cardiac catheter- Answer: A

ization. Which complication should the nurse be as-
sessing for?
a. Cardiac arrhythmia
b. Hypostatic pneumonia
c. Heart failure
d. Rapidly increasing blood pressure

3. Jos is a 4-year-old child scheduled for a cardiac Answer: D

catheterization. Preoperative teaching should be:
a. directed at his parents because he is too young to
understand.
b. detailed in regard to the actual procedures so he
will know what to expect.
c. done several days before the procedure so that he
will be prepared.
d. adapted to his level of development so that he can
understand.

4. Which explanation regarding cardiac catheterization Answer: D

is appropriate for a preschool child?
a. Postural drainage will be performed every 4 to 6
hours after the test.
b. It is necessary to be completely asleep during the
test.
c. The test is short, usually taking less than 1 hour.
d. When the procedure is done, you will have to keep
your leg straight for at least 4 hours.
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5. The nurse is caring for a school-age child who has had Answer: D
a cardiac catheterization. The child tells the nurse that
the bandage is too wet. The nurse finds the bandage
and bed soaked with blood. The most appropriate ini-
tial nursing action is to:
a. notify physician.
b. apply new bandage with more pressure.
c. place the child in Trendelenburg position.
d. apply direct pressure above catheterization site.

6. The nurse is preparing an adolescent for discharge Answer: B

after a cardiac catheterization. Which statement by the
adolescent would indicate a need for further teach-
ing?
a. I should avoid tub baths but may shower.
b. I have to stay on strict bed rest for 3 days.
c. I should remove the pressure dressing the day after
the procedure.
d. I may attend school but should avoid exercise for
several days.

7. Surgical closure of the ductus arteriosus would: Answer: D

a. stop the loss of unoxygenated blood to the sys-
temic circulation.
b. decrease the edema in legs and feet.
c. increase the oxygenation of blood.
d. prevent the return of oxygenated blood to the lungs.

8. The nurse is conducting a staff in-service on congen- Answer: A

ital heart defects. Which structural defect constitutes
tetralogy of Fallot?
a. Pulmonic stenosis, ventricular septal defect, over-
riding aorta, right ventricular hypertrophy
b. Aortic stenosis, ventricular septal defect, overrid-
ing aorta, right ventricular hypertrophy
c. Aortic stenosis, atrial septal defect, overriding aor-
ta, left ventricular hypertrophy
d. Pulmonic stenosis, ventricular septal defect, aortic
hypertrophy, left ventricular hypertrophy
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9. A nurse is teaching nursing students the physiology Answer: B

of congenital heart defects. Which defect results in
decreased pulmonary blood flow?
a. Atrial septal defect
b. Tetralogy of Fallot
c. Ventricular septal defect
d. Patent ductus arteriosus

10. Which is best described as the inability of the heart to Answer: C

pump an adequate amount of blood to the systemic
circulation at normal filling pressures?
a. Pulmonary congestion
b. Congenital heart defect
c. Heart failure
d. Systemic venous congestion

11. Which is a clinical manifestation of the systemic ve- Answer: C

nous congestion that can occur with heart failure?
a. Tachypnea
b. Tachycardia
c. Peripheral edema
d. Pale, cool extremities

12. The nurse is preparing to administer a dose of digoxin Answer: A

(Lanoxin) to a child in heart failure (HF). Which is a
beneficial effect of administering digoxin (Lanoxin)?
a. It decreases edema.
b. It decreases cardiac output.
c. It increases heart size.
d. It increases venous pressure.

13. A nurse is preparing to administer an an- Answer: A

giotensin-converting enzyme (ACE) inhibitor. Which
drug should the nurse be administering?
a. Captopril (Capoten)
b. Furosemide (Lasix)
c. Spironolactone (Aldactone)
d. Chlorothiazide (Diuril)

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14. An 8-year-old child is receiving digoxin (Lanoxin). Answer: B
The nurse should notify the practitioner and withhold
the medication if the apical pulse is less than _____
beats/min.
a. 60
b. 70
c. 90
d. 100

15. A 6-month-old infant is receiving digoxin (Lanoxin). Answer: C

The nurse should notify the practitioner and withhold
the medication if the apical pulse is less than _____
beats/min.
a. 60
b. 70
c. 90 to 110
d. 110 to 120

16. The nurse is teaching parents about signs of digoxin Answer: B

(Lanoxin) toxicity. Which is a common sign of digoxin
toxicity?
a. Seizures
b. Vomiting
c. Bradypnea
d. Tachycardia

17. The parents of a young child with heart failure tell Answer: D
the nurse that they are nervous about giving digoxin
(Lanoxin). The nurses response should be based on
which statement?
a. It is a safe, frequently used drug.
b. It is difficult to either overmedicate or undermed-
icate with digoxin.
c. Parents lack the expertise necessary to administer
digoxin.
d. Parents must learn specific, important guidelines
for administration of digoxin.

18. 19. The nurse is talking to a parent of an infant with Answer: A

heart failure about feeding the infant. Which statement
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about feeding the child is correct?
a. You may need to increase the caloric density of your
infants formula.
b. You should feed your baby every 2 hours.
c. You may need to increase the amount of formula
your infant eats with each feeding.
d. You should place a nasal oxygen cannula on your
infant during and after each feeding.

19. As part of the treatment for heart failure, the child Answer: B
takes the diuretic furosemide (Lasix). As part of teach-
ing home care, the nurse encourages the family to
give the child foods such as bananas, oranges, and
leafy vegetables. These foods are recommended be-
cause they are high in:
a. chlorides.
b. potassium.
c. sodium.
d. vitamins.

20. An 8-month-old infant has a hypercyanotic spell while Answer: B

blood is being drawn. The nurses first action should
be to:
a. assess for neurologic defects.
b. place the child in the knee-chest position.
c. begin cardiopulmonary resuscitation.
d. prepare family for imminent death.

21. The nurse is caring for a child with persistent hypox- Answer: B
ia secondary to a cardiac defect. The nurse recog-
nizes that a risk exists of cerebrovascular accidents
(strokes). Which is an important objective to decrease
this risk?
a. Minimize seizures.
b. Prevent dehydration.
c. Promote cardiac output.
d. Reduce energy expenditure.

22. Parents of a 3-year-old child with congenital heart Answer: A

disease are afraid to let their child play with other
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children because of possible overexertion. The nurses
reply should be based on which statement?a. Child
needs opportunities to play with peers.
b. Child needs to understand that peers activities are
too strenuous.
c. Parents can meet all of the childs needs.
d. Constant parental supervision is needed to avoid
overexertion.

23. Which should the nurse consider when preparing a Answer: B

school-age child and the family for heart surgery?
a. Unfamiliar equipment should not be shown.
b. Let child hear the sounds of an ECG monitor.
c. Avoid mentioning postoperative discomfort and in-
terventions.
d. Explain that an endotracheal tube will not be need-
ed if the surgery goes well.

24. 72 hours after cardiac surgery, a young child has a Answer: D

temperature of 101 F. Which action should the nurse
take?
a. Keep child warm with blankets.
b. Apply a hypothermia blanket.
c. Record temperature on nurses notes.
d. Report findings to physician.

25. Which is an important nursing consideration when Answer: C

suctioning a young child who has had heart surgery?
a. Perform suctioning at least every hour.
b. Suction for no longer than 30 seconds at a time.
c. Administer supplemental oxygen before and after
suctioning.
d. Expect symptoms of respiratory distress when suc-
tioning.

26. The nurse is caring for a child after heart surgery. Answer: C
Which should the nurse do if evidence is found of
cardiac tamponade?
a. Increase analgesia.
b. Apply warming blankets.
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c. Immediately report this to physician.
d. Encourage child to cough, turn, and breathe deeply.

27. Which is an important nursing consideration when Answer: C

chest tubes will be removed from a child?
a. Explain that it is not painful.
b. Explain that only a Band-Aid will be needed.
c. Administer analgesics before procedure.
d. Expect bright red drainage for several hours after
removal.

28. Which is the most common causative agent of bacte- Answer: D

rial endocarditis?
a. Staphylococcus albus
b. Streptococcus hemolyticus
c. Staphylococcus albicans
d. Streptococcus viridans

29. Which painful, tender, pea-sized nodules may appear Answer: A

on the pads of the fingers or toes in bacterial endo-
carditis?
a. Osler nodes
b. Janeway lesions
c. Subcutaneous nodules
d. Aschoff nodes

30. The primary nursing intervention to prevent bacterial Answer: B

endocarditis is to:
a. institute measures to prevent dental procedures.
b. counsel parents of high-risk children about prophy-
lactic antibiotics.
c. observe children for complications, such as em-
bolism and heart failure.
d. encourage restricted mobility in susceptible chil-
dren.

31. Which is a common, serious complication of rheumat- Answer: D

ic fever?
a. Seizures
b. Cardiac arrhythmias
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c. Pulmonary hypertension
d. Cardiac valve damage

32. The nurse is conducting a staff in-service on child- Answer: A

hood-acquired heart diseases. Which is a major clini-
cal manifestation of rheumatic fever?
a. Polyarthritis
b. Osler nodes
c. Janeway spots
d. Splinter hemorrhages of distal third of nails

33. The nurse is admitting a child with rheumatic fever. Answer: A

Which therapeutic management should the nurse ex-
pect to implement?
a. Administering penicillin
b. Avoiding salicylates (aspirin)
c. Imposing strict bed rest for 4 to 6 weeks
d. Administering corticosteroids if chorea develops

34. Which action by the school nurse is important in the Answer: C

prevention of rheumatic fever?
a. Encourage routine cholesterol screenings.
b. Conduct routine blood pressure screenings.
c. Refer children with sore throats for throat cultures.
d. Recommend salicylates instead of acetaminophen
for minor discomforts.

35. When discussing hyperlipidemia with a group of ado- Answer: D

lescents, the nurse should explain that cardiovascular
disease can be prevented by high levels of:
a. cholesterol.
b. triglycerides.
c. low-density lipoproteins (LDLs).
d. high-density lipoproteins (HDLs).

36. Which is the leading cause of death after heart trans- Answer: B
plantation?
a. Infection
b. Rejection

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c. Cardiomyopathy
d. Heart failure

37. When caring for the child with Kawasaki disease, the Answer: D
nurse should know which information?
a. A childs fever is usually responsive to antibiotics
within 48 hours.
b. The principal area of involvement is the joints.
c. Aspirin is contraindicated.
d. Therapeutic management includes administration
of gamma globulin and aspirin.

38. The nurse is teaching nursing students about shock Answer: B

that occurs in children. One of the most frequent caus-
es of hypovolemic shock in children is:
a. sepsis.
b. blood loss.
c. anaphylaxis.
d. congenital heart disease.

39. Which type of shock is characterized by a hyper- Answer: D

sensitivity reaction causing massive vasodilation and
capillary leaks, which may occur with drug or latex
allergy?
a. Neurogenic
b. Cardiogenic
c. Hypovolemic
d. Anaphylactic

40. Which clinical manifestation should the nurse expect Answer: D

to see as shock progresses in a child and becomes
decompensated shock?
a. Thirst
b. Irritability
c. Apprehension
d. Confusion and somnolence

41. Which occurs in septic shock? Answer: B

a. Hypothermia
b. Increased cardiac output
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c. Vasoconstriction
d. Angioneurotic edema

42. A child is brought to the emergency department expe- Answer: C

riencing an anaphylactic reaction to a bee sting. While
an airway is being established, the nurse should pre-
pare which medication for immediate administration?
a. Diphenhydramine (Benadryl)
b. Dobutamine (Dobutarex)
c. Epinephrine (Adrenalin)
d. Calcium chloride (calcium chloride)

43. Clinical manifestations of toxic shock syndrome in- Answer: C

clude:
a. severe hypertension.
b. subnormal temperature.
c. erythematous macular rash.
d. papular rash over extremities.

44. A preschool child is scheduled for an echocardio- Answer: C

gram. Parents ask the nurse whether they can hold the
child during the procedure. The nurse should answer
with which response?
a. You will be able to hold your child during the proce-
dure.
b. Your child can be active during the procedure, but
cant sit in your lap.
c. Your child must lie quietly; sometimes a mild seda-
tive is administered before the procedure.
d. The procedure is invasive so your child will be re-
strained during the echocardiogram.

45. The nurse is caring for an infant with congestive heart Answer: A
disease (CHD). The nurse should plan which interven-
tion to decrease cardiac demands?
a. Organize nursing activities to allow for uninterrupt-
ed sleep.
b. Allow the infant to sleep through feedings during
the night.
c. Wait for the infant to cry to show definite signs of
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hunger.
d. Discourage parents from rocking the infant

46. The nurse is conducting a staff in-service on renal ul- Answer: A

trasounds. Which statement describes this diagnostic
test?
a. Computed tomography uses external radiation to
visualize the renal system.
b. Visualization of the renal system is accomplished
without exposure to radiation or radioactive isotopes.
c. Contrast medium and x-rays allow for visualization
of the renal system.
d. External radiation for x-ray films is used to visualize
the renal system, before, during, and after voiding.

47. The nurse is admitting a school-age child in acute Answer: C

renal failure with reduced glomerular filtration rate.
Which urine test is the most useful clinical indication
of glomerular filtration rate?
a. pH
b. Osmolality
c. Creatinine
d. Protein level

48. The nurse is conducting an assessment on a Answer: A

school-age child with urosepsis. Which assessment
finding should the nurse expect?
a. Fever with a positive blood culture
b. Proteinuria and edema
c. Oliguria and hypertension
d. Anemia and thrombocytopenia

49. The nurse is teaching parents about prevention of Answer: B

urinary tract infections in children. Which factor pre-
disposes the urinary tract to infection?
a. Increased fluid intake
b. Short urethra in young girls
c. Prostatic secretions in males
d. Frequent emptying of the bladder

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50. Which should the nurse recommend to prevent uri- Answer: A
nary tract infections in young girls?
a. Wear cotton underpants.
b. Limit bathing as much as possible.
c. Increase fluids; decrease salt intake.
d. Cleanse perineum with water after voiding.

51. The nurse is admitting a newborn with hypospadias to Answer: D

the nursery. The nurse expects which finding in this
newborn?
a. Absence of a urethral opening is noted.
b. Penis appears shorter than usual for age.
c. The urethral opening is along the dorsal surface of
the penis.
d. The urethral opening is along the ventral surface of
the penis.

52. The nurse is conducting a staff in-service on newborn Answer: B

defects of the genitourinary system. Which describes
the narrowing of the preputial opening of the fore-
skin?
a. Chordee
b. Phimosis
c. Epispadias
d. Hypospadias

53. Which is an objective of care for a 10-year-old child Answer: B

with minimal change nephrotic syndrome?
a. Reduce blood pressure.
b. Reduce excretion of urinary protein.
c. Increase excretion of urinary protein.
d. Increase ability of tissues to retain fluid.

54. Which is instituted for the therapeutic management of Answer: A

minimal change nephrotic syndrome?
a. Corticosteroids
b. Antihypertensive agents
c. Long-term diuretics
d. Increased fluids to promote diuresis

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55. Which is a common side effect of short-term corticos- Answer: D
teroid therapy?a. Fever
b. Hypertension
c. Weight loss
d. Increased appetite

56. The nurse closely monitors the temperature of a child Answer: A

with minimal change nephrotic syndrome. The pur-
pose of this assessment is to detect an early sign of
which possible complication?
a. Infection
b. Hypertension
c. Encephalopathy
d. Edema

57. A hospitalized child with minimal change nephrot- Answer: A

ic syndrome is receiving high doses of prednisone.
Which is an appropriate nursing goal related to this?
a. Prevent infection.
b. Stimulate appetite.
c. Detect evidence of edema.
d. Ensure compliance with prophylactic antibiotic
therapy.

58. Which is included in the diet of a child with minimal Answer: B

change nephrotic syndrome?
a. High protein
b. Salt restriction
c. Low fat
d. High carbohydrate

59. Which best describes acute glomerulonephritis? Answer: B

a. Occurs after a urinary tract infection
b. Occurs after a streptococcal infection
c. Associated with renal vascular disorders
d. Associated with structural anomalies of genitouri-
nary tract

60. A child is admitted with acute glomerulonephritis. The Answer: B

nurse should expect the urinalysis during this acute
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phase to show:
a. bacteriuria, hematuria.
b. hematuria, proteinuria.
c. bacteriuria, increased specific gravity.
d. proteinuria, decreased specific gravity.

61. A mother asks the nurse what would be the first indi- Answer: D
cation that acute glomerulonephritis is improving. The
nurses best response should be that the:
a. blood pressure will stabilize.
b. the child will have more energy.
c. urine will be free of protein.
d. urinary output will increase.

62. The nurse notes that a child has lost 8 pounds after 4 Answer: C
days of hospitalization for acute glomerulonephritis.
This is most likely the result of:
a. poor appetite.
b. increased potassium intake.
c. reduction of edema.
d. restriction to bed rest.

63. The nurse is teaching the parent about the diet of Answer: C
a child experiencing severe edema associated with
acute glomerulonephritis. Which information should
the nurse include in the teaching?
a. You will need to decrease the number of calories in
your childs diet.
b. Your childs diet will need an increased amount of
protein.
c. You will need to avoid adding salt to your childs
food.
d. Your childs diet will consist of low-fat, low-carbohy-
drate foods.

64. Which is the most appropriate nursing diagnosis for Answer: C

the child with acute glomerulonephritis?
a. Risk for Injury related to malignant process and
treatment
b. Fluid Volume Deficit related to excessive losses
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c. Fluid Volume Excess related to decreased plasma
filtration
d. Fluid Volume Excess related to fluid accumulation
in tissues and third spaces

65. The nurse is admitting a child with a Wilms tumor. Answer: A

Which is the initial assessment finding associated
with this tumor?
a. Abdominal swelling
b. Weight gain
c. Hypotension
d. Increased urinary output

66. Which is the most common cause of acute renal fail- Answer: D
ure in children?
a. Pyelonephritis
b. Tubular destruction
c. Urinary tract obstruction
d. Severe dehydration

67. The nurse is conducting an admission assessment on Answer: A

a school-age child with acute renal failure. Which are
the primary clinical manifestations the nurse expects
to find with this condition?
a. Oliguria and hypertension
b. Hematuria and pallor
c. Proteinuria and muscle cramps
d. Bacteriuria and facial edema

68. The nurse is caring for a child with acute renal failure. Answer: D
Which clinical manifestation should the nurse recog-
nize as a sign of hyperkalemia?a. Dyspnea
b. Seizure
c. Oliguria
d. Cardiac arrhythmia

69. When a child has chronic renal failure, the progressive Answer: A
deterioration produces a variety of clinical and bio-
chemical disturbances that eventually are manifested
in the clinical syndrome known as:
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a. uremia.
b. oliguria.
c. proteinuria.
d. pyelonephritis.

70. Which is a major complication in a child with chronic Answer: C

renal failure?
a. Hypokalemia
b. Metabolic alkalosis
c. Water and sodium retention
d. Excessive excretion of blood urea nitrogen

71. Which clinical manifestation would be seen in a child Answer: D

with chronic renal failure?
a. Hypotension
b. Massive hematuria
c. Hypokalemia
d. Unpleasant uremic breath odor

72. One of the clinical manifestations of chronic renal fail- Answer: B

ure is uremic frost. Which best describes this term?
a. Deposits of urea crystals in urine
b. Deposits of urea crystals on skin
c. Overexcretion of blood urea nitrogen
d. Inability of body to tolerate cold temperatures

73. Calcium carbonate is given with meals to a child with Answer: B

chronic renal disease. The purpose of this is to:
a. prevent vomiting.
b. bind phosphorus.
c. stimulate appetite.
d. increase absorption of fat-soluble vitamins.

74. Which should the nurse recommend for the diet of a Answer: C
child with chronic renal failure?
a. High in protein
b. Low in vitamin D
c. Low in phosphorus
d. Supplemented with vitamins A, E, and K

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75. The nurse is caring for an adolescent who has just Answer: D
started dialysis. The child seems always angry, hos-
tile, or depressed. The nurse should recognize that
this is most likely related to:
a. neurologic manifestations that occur with dialysis.
b. physiologic manifestations of renal disease.
c. adolescents having few coping mechanisms.
d. adolescents often resenting the control and en-
forced dependence imposed by dialysis.

76. Which is an advantage of peritoneal dialysis? Answer: D

a. Treatments are done in hospitals.
b. Protein loss is less extensive.
c. Dietary limitations are not necessary.
d. Parents and older children can perform treatments.

77. A preschool child is being admitted to the hospital Answer: D

with dehydration and a urinary tract infection (UTI).
Which urinalysis result should the nurse expect with
these conditions?
a. WBC <1; specific gravity 1.008
b. WBC <2; specific gravity 1.025
c. WBC >2; specific gravity 1.016
d. WBC >2; specific gravity 1.030

78. The nurse is conducting teaching for an adolescent Answer: B

being discharged to home after a renal transplant. The
adolescent needs further teaching if which statement
is made?
a. I will report any fever to my primary health care
provider.
b. I am glad I only have to take the immunosuppres-
sant medication for two weeks.
c. I will observe my incision for any redness or
swelling.
d. I wont miss doing kidney dialysis every week.

79. The nurse is teaching parents of a child with chron- Answer: C

ic renal failure (CRF) about the use of recombinant
human erythropoietin (rHuEPO) subcutaneous injec-
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tions. Which statement indicates the parents have un-
derstood the teaching?
a. These injections will help with the hypertension.
b. Were glad the injections only need to be given once
a month.
c. The red blood cell count should begin to improve
with these injections.
d. Urine output should begin to improve with these
injections.

80. A school-age child with chronic renal failure is admit- Answer: B

ted to the hospital with a serum potassium level of
5.2 mEq/L. Which prescribed medication should the
nurse plan to administer?
a. Spironolactone (Aldactone)
b. Sodium polystyrene sulfonate (Kayexalate)
c. Lactulose (Cephulac)
d. Calcium carbonate (Calcitab)

81. The nurse is caring for an infant with a suspected Answers: A, C, F

urinary tract infection. Which clinical manifestations
should be expected? (Select all that apply.)
a. Vomiting
b. Jaundice
c. Failure to gain weight
d. Swelling of the face
e. Back pain
f. Persistent diaper rash

82. A school-age child is admitted to the hospital with Answers: A, D, E

acute glomerulonephritis and oliguria. Which dietary
menu items should be allowed for this child? (Select
all that apply.)
a. Apples
b. Bananas
c. Cheese
d. Carrot sticks
e. Strawberries

83. Answers: B, D, E
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A school-age child has been admitted to the hospital
with an exacerbation of nephrotic syndrome. Which
clinical manifestations should the nurse expect to as-
sess? (Select all that apply.)
a. Weight loss
b. Facial edema
c. Cloudy smoky brown-colored urine
d. Fatigue
e. Frothy-appearing urine

84. A 6-year-old child is scheduled for an IV urography Answers: B, C, E

(IVP) in the morning. Which preparatory interventions
should the nurse plan to implement? (Select all that
apply.)
a. Clear liquids in the morning before the procedure
b. Cathartic in the evening before the procedure
c. Soap suds enema the morning of the procedure
d. Insertion of a Foley catheter before the procedure
e. Teaching with regard to insertion of an intravenous
catheter before the procedure

85. The nurse is performing a pH dipstick test on a urine 6

specimen. Which is the average pH expected for this
test?

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