Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is assessing an infant who has congestive heart failure. Which of the following findings should the nurse expect?
A. Increased urine output
Increased urine output. Infants with congestive heart failure (CHF) often have decreased urine output due to reduced kidney perfusion caused by poor cardiac function.
B. Bradycardia
Bradycardia. CHF is more likely to cause tachycardia as the heart compensates for poor circulation.
C. Increased blood pressure
Increased blood pressure. CHF in infants typically leads to hypotension or normal blood pressure rather than an increase.
D. Tachypnea
Tachypnea. Increased respiratory rate (tachypnea) is a common sign of CHF in infants because of fluid overload and pulmonary congestion, which make breathing difficult.
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Full Explanation
A. Increased urine output. Infants with congestive heart failure (CHF) often have decreased urine output due to reduced kidney perfusion caused by poor cardiac function.
B. Bradycardia. CHF is more likely to cause tachycardia as the heart compensates for poor circulation.
C. Increased blood pressure. CHF in infants typically leads to hypotension or normal blood pressure rather than an increase.
D. Tachypnea. Increased respiratory rate (tachypnea) is a common sign of CHF in infants because of fluid overload and pulmonary congestion, which make breathing difficult.
Similar Questions
A nurse is reinforcing the provider's explanation about treatment options to the parents of a 1-month-old who has coarctation of the aorta. Which of the following statements should the nurse include?
A. "The obstruction will be treated with a medication called indomethacin."
"The obstruction will be treated with a medication called indomethacin." Indomethacin is used to close a patent ductus arteriosus (PDA), not to treat coarctation of the aorta. Instead, prostaglandins may be used temporarily to keep the ductus arteriosus open and improve blood flow until surgery.
B. "Surgical repair is the recommended treatment for infants younger than 6 months old."
"Surgical repair is the recommended treatment for infants younger than 6 months old." Coarctation of the aorta does not resolve on its own and requires surgical intervention, typically within the first few months of life. Options include resection with end-to-end anastomosis or balloon angioplasty in some cases.
C. "The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant."
"The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant." Heart transplant is not the standard treatment for coarctation of the aorta; surgery or catheter-based intervention is the preferred approach.
D. "Most cases resolve spontaneously without treatment by 12 months of age."
"Most cases resolve spontaneously without treatment by 12 months of age." Coarctation of the aorta does not resolve on its own. If left untreated, it can lead to heart failure, hypertension, and other complications.
Full Explanation
A. "The obstruction will be treated with a medication called indomethacin." Indomethacin is used to close a patent ductus arteriosus (PDA), not to treat coarctation of the aorta. Instead, prostaglandins may be used temporarily to keep the ductus arteriosus open and improve blood flow until surgery.
B. "Surgical repair is the recommended treatment for infants younger than 6 months old." Coarctation of the aorta does not resolve on its own and requires surgical intervention, typically within the first few months of life. Options include resection with end-to-end anastomosis or balloon angioplasty in some cases.
C. "The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant." Heart transplant is not the standard treatment for coarctation of the aorta; surgery or catheter-based intervention is the preferred approach.
D. "Most cases resolve spontaneously without treatment by 12 months of age." Coarctation of the aorta does not resolve on its own. If left untreated, it can lead to heart failure, hypertension, and other complications.
A nurse is assessing a child who has rubeola. Which of the following findings should the nurse expect?
A. Lymphadenopathy
Lymphadenopathy. While some viral infections cause lymph node swelling, lymphadenopathy is not a hallmark sign of rubeola (measles).
B. Steatorrhea
Steatorrhea. Steatorrhea (fatty stools) is associated with conditions like cystic fibrosis and celiac disease, not rubeola.
C. Koplik spots
Koplik spots. Koplik spots are small, white lesions with a red base found on the buccal mucosa, and they are a classic early sign of measles (rubeola).
D. Paroxysmal coughing
Paroxysmal coughing. Paroxysmal coughing is characteristic of pertussis (whooping cough), not rubeola.
Full Explanation
A. Lymphadenopathy. While some viral infections cause lymph node swelling, lymphadenopathy is not a hallmark sign of rubeola (measles).
B. Steatorrhea. Steatorrhea (fatty stools) is associated with conditions like cystic fibrosis and celiac disease, not rubeola.
C. Koplik spots. Koplik spots are small, white lesions with a red base found on the buccal mucosa, and they are a classic early sign of measles (rubeola).
D. Paroxysmal coughing. Paroxysmal coughing is characteristic of pertussis (whooping cough), not rubeola.
A nurse is teaching the guardians of a school-age child who has cystic fibrosis about dietary needs. Which of the following statements should the nurse make?
A. "Offer your child foods that are low in calories."
"Offer your child foods that are low in calories." Children with cystic fibrosis (CF) require a high-calorie diet because their bodies have difficulty absorbing nutrients due to pancreatic insufficiency.
B. "Offer your child foods that are high in fat."
"Offer your child foods that are high in fat." A high-fat diet (35%-40% of total calories from fat) is recommended because fat malabsorption is common in CF, and they need additional fat to meet their energy needs.
C. "Offer your child foods that are high in vitamin C."
"Offer your child foods that are high in vitamin C." While vitamin C is important, fat-soluble vitamins (A, D, E, and K) are the primary concern since CF patients struggle to absorb them.
D. "Offer your child foods that are low in protein."
"Offer your child foods that are low in protein." Children with CF require adequate protein intake to support growth and maintain muscle mass, so protein restriction is not recommended.
Full Explanation
A. "Offer your child foods that are low in calories." Children with cystic fibrosis (CF) require a high-calorie diet because their bodies have difficulty absorbing nutrients due to pancreatic insufficiency.
B. "Offer your child foods that are high in fat." A high-fat diet (35%-40% of total calories from fat) is recommended because fat malabsorption is common in CF, and they need additional fat to meet their energy needs.
C. "Offer your child foods that are high in vitamin C." While vitamin C is important, fat-soluble vitamins (A, D, E, and K) are the primary concern since CF patients struggle to absorb them.
D. "Offer your child foods that are low in protein." Children with CF require adequate protein intake to support growth and maintain muscle mass, so protein restriction is not recommended.