JeopardyGU Respiratory Cardiac Musculoskeletal Integumentary

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Final Jeopardy

$100 Question from H1What clinical finding warrants further intervention for the 10 year old child with acute poststreptococcal glomerulonephritis?a. Weight loss to within 1 lb of the preillness weightb. Urine output of 1 mL/kg/hrc. A positive ASO titerd. Inspiratory crackles

$100 Answer from H1

d. Inspiratory cracklesD Children with excess fluid volume may have pulmonary edema. Inspiratory crackles indicate fluid in the lungs. Pulmonary edema can be a life-threatening complication

$200 Question from H1

Which diagnostic finding is present when a child has primary nephrotic syndrome?a. Hyperalbuminemiab. Leukocytosisc. Positive ASO titerd. Proteinuria

$200 Answer from H1

d. Proteinuria

$300 Question from H1Which finding indicates that a child receiving prednisone for primary nephrotic syndrome is in remission?a. Urine is negative for casts for 5 days.b. Urine is 0 to trace for protein for 5 to 7 days.c. Urine is positive for glucose for 1 week.d. Urine is 0 to trace for blood for 1 week.

$300 Answer from H1

B The child receiving steroids for the treatment of primary nephrotic syndrome is considered in remission when the urine is 0 to trace for protein for 5 to 7 days

$400 Question from H1

Which intervention is appropriate when examining a male infant for cryptorchidism?a. Cooling the examiner's handsb. Eliciting the cremasteric reflexc. Taking a rectal temperatured. Warming the room

$400 Answer from H1

D For the infant's comfort, the infant should be examined in a warm room with the examiner's hands warmed. Testes can retract into the inguinal canal if the infant is upset or cold.

$500 Question from H1Which condition is characterized by a history of bloody diarrhea, fever, abdominal pain, and low hemoglobin and platelet counts?a. Acute viral gastroenteritisb. Hemolytic-uremic syndromec. Acute glomerulonephritisd.Acute nephrotic syndrome

$500 Answer from H1

b. Hemolytic-uremic syndrome

C Hemolytic-uremic syndrome is an acute disorder characterized by anemia, thrombocytopenia, and acute renal failure. Most affected children have a history of gastrointestinal symptoms, including bloody diarrhea.

$100 Question from H2A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition?a. Allergic rhinitisb. Asthmac. Bronchitisd. Sinusitis

$100 Answer from H2

d. Sinusitis

$200 Question from H2The father of an infant calls the nurse to his son’s room because he is “making a strange noise.” The child has been diagnosed with laryngomalacia. What does the nurse expect to find on assessment?a. Stridorb. Nasal congestionc. High-pitched cryd. Spasmodic cough

$200 Answer from H2

a. Stridor

$300 Question from H2Which intervention for treating croup at home should be taught to parents?a. Have a decongestant available to give the child when an attack occurs.b. Have the child sleep in a dry room.c. Sit with the child in the bathroom with the shower on when an attack occurs.d. Give the child an antibiotic at bedtime.

$300 Answer from H2

c. Sit with the child in the bathroom with the shower on when an attack occurs.

$400 Question from H2

The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding suggests that the child’s condition is worsening?a. Hypoventilationb. BradycardiaC. Thirstd. Clubbing

$400 Answer from H2

A) The nurse would assess the child for signs of hypoxia, including restlessness, fatigue, irritability, and increased heart and respiratory rate. As the child tires from increased work of breathing hypoventilation occurs, leading to increased carbon dioxide levels.

$500 Question from H2Which classification of drugs is used to relieve an acute asthma episode?a.Short-acting beta2-adrenergic agonistb. Leukotriene blockersc. Inhaled corticosteroidsd. Long-acting bronchodilators

$500 Answer from H2

A Short-acting beta2-adrenergic agonist is the first medication administered. Later, systemic corticosteroids decrease airway inflammation in an acute asthma attack. They are given for short burst courses of 5 to 7 days.

$100 Question from H3

$100 Answer from H3

Your Text Here

$200 Question from H3The nurse is admitting a child who has been diagnosed with Kawaski disease. What is the most serious complication of Kawasaki disease for which the nurse should assess?a. Cardiac valvular diseaseb. Coronary aneurysmc. Cardiomyopathyd. Rheumatic fever

$200 Answer from H3

b. Coronary aneurysmCoronary artery aneurysms are seen in 20% of children with untreated Kawaski disease.

$300 Question from H3What is an expected assessment finding in a child with coarctation of the aorta?a. Orthostatic hypotensionb. Systolic hypertension in the lower extremitiesc. Blood pressure higher on the left side of the bodyd. Disparity in blood pressure between the upper and lower extremities

$300 Answer from H3

d. Disparity in blood pressure between the upper and lower extremities

The classic finding in children with coarctation of the aorta is a disparity in pulses and blood pressures between the upper and lower extremities

$400 Question from H3An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. Provide answer using lowercase letters separated by commas (e.g., a, b, c, d). a. Administer 100% oxygen by blow-by.b. Place infant in knee-chest position.c. Remain calm.d. Give morphine subcutaneously or by an existing intravenous line

$400 Answer from H3This is the correct response:b, a, d, cHypercyanotic spells, also referred to as blue spells or tet spells because they are often seen in infants with tetralogy of Fallot, may occur in any child whose heart defect includes obstruction to pulmonary blood flow and communication between the ventricles. The infant becomes acutely cyanotic and hyperpneic because sudden infundibular spasm decreases pulmonary blood flow and increases right-to-left shunting. Because profound hypoxemia causes cerebral hypoxia, hypercyanotic spells require prompt assessment and treatment to prevent brain damage or possibly death. The infant should first be placed in the knee-chest position to reduce blood returning to the heart. Next 100% oxygen is given to alleviate the hypoxemia. Morphine is next administered to reduce infundibular spasms. Last, the nurse should remain calm.

$500 Question from H3The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?

A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy B. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy C. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy D. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

$500 Answer from H3

A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

$100 Question from H4

The nurse is taking care of an adolescent diagnosed with kyphosis. Which describes this condition?

A. Lateral curvature of the spine B. Immobility of the shoulder joint C. Exaggerated concave lumbar curvature of the spine D. Increased convex angulation in the curve of the thoracic spine

$100 Answer from H4

D. Increased convex angulation in the curve of the thoracic spine

$200 Question from H4

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

A. Aspirin B. Corticosteroids C. Cytotoxic drugs such as methotrexate D. Nonsteroidal anti-inflammatory drugs (NSAIDs)

$200 Answer from H4

D. Nonsteroidal anti-inflammatory drugs (NSAIDs)

$300 Question from H4

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.)A. Palpable distal pulseB. Capillary refill to extremity less than 3 secondsC. Severe pain not relieved by analgesicsD. Tingling of extremityE. Inability to move extremity

$300 Answer from H4C. Correct Severe pain not relieved by analgesicsD. Correct Tingling of extremityE. Correct Inability to move extremity

$400 Question from H4A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

A. “We will be very careful handling the baby.” B. “We will lift the baby by the buttocks when diapering.” C. “We’re glad there is a cure for this disorder.” D. “We will schedule follow-up appointments as instructed

$400 Answer from H4

C. “We’re glad there is a cure for this disorder.”

$500 Question from H4A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action?

A. Encouraging normal activity for as long as is possible B. Explaining the cause of the disease to the child and family C. Preparing the child and family for long-term, permanent disabilities D. Teaching the family the care and management of the corrective appliance

$500 Answer from H4

D. Teaching the family the care and management of the corrective appliance

$100 Question from H5

What should be included in teaching a parent about the management of small red macules and vesicles that become pustules around the child's mouth and cheek?a. Keep the child home from school for 24 hours after initiation of antibiotic treatment.b. Clean the rash vigorously with Betadine three times a day.c. Notify the physician for any itching.d. Keep the child home from school until the lesions are healed.

$100 Answer from H5a. Keep the child home from school for 24

hours after initiation of antibiotic treatment.

To prevent the spread of impetigo to others, the child should be kept home from school for 24 hours after treatment is initiated. Good handwashing is imperative in preventing the spread of impetigo

$200 Question from H5What nursing assessment and care holds the highest priority in the initial care of a child with a major burn injury?a. Establishing and maintaining the child’s airwayb. Establishing and maintaining intravenous accessc. Insertion of a catheter to monitor hourly urine outputd.Insertion of a nasogastric tube into the stomach to supply adequate nutrition

$200 Answer from H5

a. Establishing and maintaining the child’s airway

$300 Question from H5The nurse is planning an educational in-service on burn

injuries in children. In teaching nursing care for burned children, the nurse will stress that children with more severe injuries will require a higher level of care. Prioritize the following types of burns and level of nursing care required. Use the numbers 1, 2, 3, and 4. Prioritize from highest level of nursing care required (number 1) to lowest level of nursing care required (number 4).___ Destruction of epidermis and some dermis. Thin-walled, fluid filled blisters present.___ Epidermis effected. Redness. No blisters.___ Flat, dehydrated, tissue-paper–like appearance. Mottled, waxy white, dry surface___ Cherry red or black colored skin, flat dehydrated skin.

$300 Answer from H5

___3___4___2___1

The question asks you to prioritize in order of importance the nursing management plan. Remember that when prioritizing, the ABCs (airway, breathing, and circulation) come first. The level of care will be highest with a full thickness burn. In caring for a child with a full thickness burn, the airway may be affected. With this type of burn the child may not be experiencing pain (due to destruction of nerve endings), but will be at risk for infection, fluid loss, and shock. The next highest level of care will be for a child with a deep partial thickness burn, next with a superficial partial thickness burn, and last with a superficial burn.

$400 Question from H5

The process of burn shock continues until what physiologic mechanism occurs?a. Heart rate returns to normal.b. Airway swelling decreases.c. Body temperature regulation returns to normal.d. Capillaries regain their seal.

$400 Answer from H5

d. Capillaries regain their seal.

D Within minutes of the burn injury, the capillary seals are lost with a massive fluid leakage into the surrounding tissue, resulting in burn shock. The process of burn shock continues for approximately 24 to 48 hours, when capillary seals are restored.

$500 Question from H5A 4-year-old child is admitted to the burn unit with injuries sustained in a house fire. She has partial thickness burns on 10% of her body and full thickness burns on 10% of her body. Areas involved include her hands, arms, and head. Which nursing assessments and care hold the highest priority in the initial care for this child’s burn injury? Prioritize the following nursing concerns in the management for this child. Use the numbers 1, 2, 3, 4, and 5. Prioritize from highest priority (number 1) to lowest priority (number 5).___ Insertion of a nasogastric tube into the stomach to supply adequate nutrition___ Comforting the parents, who are emotionally distraught___ Establishing and maintaining the child’s airway___ Establishing and maintaining intravenous access___ Insertion of a catheter to monitor hourly urine output

$500 Answer from H5

5 Insertion of a nasogastric tube into the stomach to supply adequate nutrition4 Comforting the parents, who are emotionally distraught1 Establishing and maintaining the child’s airway2 Establishing and maintaining intravenous access3 Insertion of a catheter to monitor hourly urine output1 C. Establishing and maintaining the child’s airway is always the priority focus for assessment and care.2 D. Establishing intravenous access is the second priority in this situation, after the airway has been established.3 E. Inserting a catheter and monitoring hourly urine output is the third most important nursing intervention.

Final JeopardyWhat Congenital heart defect is this?

Final Jeopardy AnswerTransposition of the Great Arteries

5% to 7% of cardiac defects

Abnormal separation and rotation of the fetal common truncal vessel causes the aorta to arise from the right ventricle and the pulmonary artery to arise from the left ventricle

Associated VSD