A child with hepatic failure received volume replacement. Following this therapy, laboratory tests reveal:
PT: 14 sec
PTT: 40 sec
Hct: 36%
Albumin: 3.5 g/dL
Before the patient undergoes a closed liver biopsy, further replacement should include:
Which of the following defines post-coarctectomy syndrome?
A nursing practice council is reviewing a protocol for flushing unused IV lines. A team member questions the use of saline vs. dextrose. What should the council do first?
A child’s ABG reveals pH 7.58, PaCO₂ 40, HCO₃ 30. What electrolyte change is expected?
In an infant with bronchopulmonary dysplasia (BPD), pathophysiologic consequences of chronic hypoxia include:
An adolescent’s sleep is disrupted by alarms and blood draws. What is the nurse’s best action?
A child ventilated with PEEP of 10 cm H₂O exhibits acute decreases in O₂ saturation, HR, BP, and systemic perfusion. A nurse should notify the physician and prepare for:
A patient with restrictive cardiomyopathy is ambulating and begins to complain of fatigue and chest pain. A nurse should expect initial treatment to be aimed at:
The plan of care for a child with possible epiglottitis should include:
Parent teaching for a child with encephalopathy should include which of the following?
An infant is 2 hours post median sternotomy closure after cardiac surgery. Assessment:
BP:82/56
HR:170
Temp:101.8°F (38.8°C)
CVP:3 mmHg
Cap refill:2 seconds
Skin color:Bright
Which type of shock is most likely developing?
A transgender adolescent requests to be addressed by preferred name/pronouns, different from medical record. What is the best response?
A 9-year-old patient with a history of tachycardia and syncope is connected to a monitor that shows a HR of 190, with regular P-P and R-R intervals. The patient is awake, crying, anxious, and has a BP of 94/60. Which of the following is the initial nursing intervention?
The treatment of choice for diabetes insipidus should be fluid:
The most beneficial nursing action to minimize avoidable patient safety incidents is:
A child is admitted following chest trauma, and a small pneumothorax (less than 10%) is noted. A nurse should anticipate which of the following?
An adolescent with recurrent leukemia expresses a desire to die peacefully. Weeks later, the patient is critically ill and the parents ask whether to escalate care. The nurse’s most appropriate response is:
For a 20-kg child experiencing abdominal hemorrhaging, a nurse should expect to administer a fluid bolus of:
CSF analysis shows: glucose 36 mg/dL, protein 110 mg/dL, and WBCs (PMNs) 1,000/microliters. These findings are indicative of:
During an exchange transfusion for sickle cell crisis, the patient becomes anxious and reports tingling and numbness around the mouth. The nurse should administer:
To evaluate effectiveness of transvenous ventricular pacing, the ECG should show a pacing spike followed by:
A school-aged patient who was admitted with an acute asthma exacerbation has improved and is now ready for transfer to the floor. In preparation for discharge, the nurse should evaluate:
Which of the following is a major indication for peritoneal dialysis?
After a disaster drill, several issues related to notification of personnel and their role in the disaster were revealed. Which action should be done first?
A 6-year-old with WPW syndrome and SVT episodes is admitted. What intervention is anticipated?
To lead a unit-based initiative to decrease central line-associated bloodstream infections, which of the following is the most appropriate approach?
A child with an aortic homograft with valve is at increased risk for:
An infant presents with poor feeding and a blood glucose level of 50 mg/dL. A nurse should assess for which of the following symptoms?
A child presents with new-onset right-sided weakness, slurred speech, and headache. Which chronic condition most likely predisposes the child to this presentation?
A patient asks the nurse to join in saying bedtime prayers. The nurse is not comfortable with this practice. Which of the following is the nurse’s most appropriate response?
When preparing a 2-month-old with hypoplastic left heart syndrome for a cardiac transplant, which of the following findings is most alarming?
Twenty-four hours after a severe burn and inhalation injury, a child develops increased tachypnea and desaturation. The most likely cause is:
A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?
A child with sickle cell anemia develops chest pain, SOB, and tachypnea. What is the most likely diagnosis?
A recently deceased patient's family begins arriving to the ICU, visibly distraught and wailing. What is the nurse's first action?
An irritable child has an acute fever, conjunctivitis, rash, and a strawberry tongue. A prolonged PR interval is observed on the ECG monitor. These findings are most likely due to:
Fifteen minutes after receiving PO pain medication, a patient reports dull pain in their lower abdomen without nausea. Which of the following interventions should a nurse consider next?
While ventilating with 100% FiO₂ via Ambu bag, an intubated child desaturates. Breath sounds are decreased in all fields. What is the best action?
A 6-year-old child with SIADH was initially treated with a full liquid diet high in sodium. The child is now complaining of headaches, nausea, and muscle cramps. Laboratory results indicate a low sodium level. The revised plan of care should be to:
A child with spinal muscular atrophy type I (SMA) is admitted with respiratory syncytial virus (RSV). The child is hypotonic and tachypneic with moderate subcostal retractions and nasal flaring. After suctioning, the child’s respiratory status does not improve. Arterial oxygen saturations are 93% with an FiO₂ of 50%. Which of the following interventions should the nurse anticipate next?
A stat abdominal x-ray reveals free air and a large loculated fluid collection presumed to be blood. The priority of care should be:
An infant is admitted with tonic-clonic movement of the lower extremities. The most likely etiology of the seizure is:
A child with RDS is on mechanical ventilation with PEEP 15 cm H₂O and FiO₂ 50%. What is the most likely initial complication?
A patient has visitors whose loud talking and laughing disrupts other patients and visitors in the ICU. Which of the following is the most effective way for a nurse to address this situation?
Early symptoms of carbon monoxide poisoning include: