NR-328 Pediatric Nursing - Set 2 - Part 3

Correct Answer: Keep the right leg straight while offering fluids

The catheterized leg stays extended for the ordered hours so the puncture can seal, and extra fluid helps the kidneys clear the contrast load. Both belong in the first part of recovery. Option a is incorrect because withholding fluid works against recovery. Contrast draws water out through the kidneys, and a toddler who has also been without drink before the procedure can slip toward dehydration. Option b is incorrect because walking bends the hip and loads the fresh puncture with pressure from the blood column. Bed rest with the extremity flat is what holds the site closed during these hours. Option d is incorrect because the original dressing is left undisturbed and simply inspected for blood or swelling. Peeling it back on a schedule would disrupt the clot forming underneath and invite bleeding.

Correct Answer: Draw blood cultures from separate sites

Cultures drawn from more than one site before the first antibiotic dose are what identify the organism and guide weeks of therapy. Once the drug runs, the cultures may grow nothing. Option b is incorrect because antibiotics started ahead of the draw sterilize the sample and leave the team guessing at the organism for a four to six week course. Sequence matters here. Option c is incorrect because an antipyretic treats a symptom while the infection on the valve keeps seeding the bloodstream. Comfort has its place, though it does not belong ahead of diagnostic sampling. Option d is incorrect because imaging shows vegetations but never names the organism. Scheduling it for morning also wastes hours that could be spent collecting samples the laboratory needs before therapy begins.

Correct Answer: A non-rebreather mask with the reservoir inflated

A non-rebreather delivers close to ninety-five percent oxygen when run at high flow, making it the emergency choice. The reservoir bag must stay partly inflated so the child draws from it rather than room air. Option a is incorrect because a cannula tops out near forty percent and is chosen for a stable child who wants to eat and talk. That ceiling is far below what this child needs. Option c is incorrect because blow-by is a compromise for a child who will not tolerate anything on the face. Concentration is low and unpredictable, which makes it useless when saturation must be driven up now. Option d is incorrect because a hood suits infants under about a year and cannot be fitted to an older child. Access for assessment is also limited every time the hood is opened.

Correct Answer: Ask a second nurse to hold the tube

Two people change tracheostomy ties: one steadies the tube while the other works, since a short soft trachea and a squirming toddler make accidental decannulation easy. The new ties admit one finger. Option a is incorrect because a single pair of hands cannot hold the tube and secure the ties at the same time. One pull from a toddler is all it takes for the tube to come out. Option b is incorrect because two fingers of slack leaves the tube loose enough to slip out with coughing. The standard is snug enough to admit one finger between the tie and the neck. Option c is incorrect because emergency equipment stays where it is. A spare tube in the same size, one a size smaller, the obturator, and a resuscitation bag belong at the bedside always.

Correct Answer: A point where the two circuits can mix

With the aorta off the right ventricle and the pulmonary artery off the left, the two circuits run in parallel. Only an opening between them, such as the duct, lets oxygenated blood reach the body. Option b is incorrect because falling lung resistance matters for defects that flood the lungs over several weeks. Here the circuits never connect, so shifting resistance does nothing to move oxygenated blood into the aorta. Option c is incorrect because oxygen enriches blood that is already circling back to the lungs and never reaches the body. The stem states the saturation held steady, which is the clue that separates this lesion from lung disease. Option d is incorrect because the aortic valve is not the trouble in transposition; the vessel simply arises from the wrong ventricle. Widening a valve would not join two circulations that remain completely separate.

Correct Answer: "I will use saline and suction the nose before feeds."

Clearing the nose with saline and gentle suction before feeds lets a small infant breathe and suck at the same time. Small frequent feeds and watching wet diapers complete the plan. Option a is incorrect because cough and cold preparations are not recommended for children under four years and carry real dosing hazards. They do nothing for plugged bronchioles, and sedation would blunt the infant's own effort. Option b is incorrect because a tired infant with a blocked nose cannot finish a large volume, and the effort raises the risk of choking. Small frequent feeds suit the work of breathing far better. Option d is incorrect because dry air thickens secretions and makes the nose harder to clear. Cool humidified air is recommended at home, and germ control comes from handwashing rather than from removing moisture.

Correct Answer: "Treating early protects the coronary arteries from forming aneurysms."

Aneurysms of the coronary arteries are the danger in this vasculitis, and immune globulin given inside the first ten days cuts that risk sharply. Waiting costs the child that protection. Option a is incorrect because fever often persists through the infusion and may even return afterward, prompting a second dose. Temperature control is not the reason the timing of this therapy is watched so closely. Option c is incorrect because the rash fades and the hands and feet peel on their own schedule as the illness moves through its phases. Skin changes never drive the decision to infuse. Option d is incorrect because this vasculitis is not passed from child to child. No isolation or contact restriction applies, so protecting siblings and classmates plays no part in how quickly therapy begins.

Correct Answer: "He takes it every day because the swelling is still there."

Airway inflammation persists between attacks and slowly scars the airway when left untreated, so the controller is taken at the same time daily whether or not the child has symptoms. Option a is incorrect because feeling well reflects good control produced by the drug itself, not a cure. Stopping during quiet periods is the single most common reason asthma slips out of control. Option b is incorrect because an inhaled steroid needs days to blunt inflammation and does nothing useful once an attack has started. Saving it for bad weeks turns a preventive drug into a useless one. Option d is incorrect because caregivers never adjust steroid doses on their own; changes belong to the provider and the written action plan. Coughing calls for the rescue inhaler and a peak flow check.

Correct Answer: "I will run cool mist in the room all night."

Cool moist air narrows the swollen vessels of the subglottis, and a calm caregiver keeps the child from crying, which worsens turbulent flow. Mild croup with no resting stridor is managed at home. Option b is incorrect because croup comes from a virus, most often parainfluenza, and antibiotics do nothing for it. Reusing a leftover supply also breeds resistance and hides whatever the original prescription was meant to finish. Option c is incorrect because a flat position lets a swollen airway close further and makes breathing harder for a toddler already working. Children with upper airway obstruction choose upright postures for a reason. Option d is incorrect because topical vapor rubs are not used under age two and can irritate small airways. They add no benefit for subglottic swelling, and the fumes sometimes trigger more coughing.

Correct Answer: Apply lip balm and cool moist cloths

Cool cloths on the skin and balm on the cracked lips ease two of the worst discomforts in this phase. A quiet dim room with minimal handling rounds out the plan. Option a is incorrect because hot liquids and acidic juice burn an inflamed mouth and pharynx. Soft bland foods with cool drinks keep the toddler drinking without adding pain to every swallow. Option b is incorrect because a child this irritable and this sore needs rest, not stimulation. Group play would raise the cardiac workload at a point when the heart is already inflamed. Option c is incorrect because waking a miserable toddler that often works against the goal. Vital signs are followed closely, yet the interval is spaced to protect sleep and cluster the handling.