HESI Patient Review--Pediatrics-Chronic Pediatric Health Problems (Austin Brown)
Terms in this set (43)
1. For each patient seen, your nursing assessment upon meeting the patient is usually brief. This brief nursing assessment generally includes: (Select 5)
-The child's stature (length) and weight
-Any allergies the child may have
-Current medications being taken by the child
-The child's vital signs
-The reason for the clinic visit
2. You made the judgment that Austin's breathing is labored, based on a quick observation. Which of the following, when observed in an infant, is a sign of labored breathing?
Grunting with inspiration
3. You take Austin and his parents to an exam room. Given your initial impression of Austin, your next action should be to:
Obtain Austin's vital signs
4. Austin is crying and is in his mother's arms. Which approach is best as you plan your assessment of Austin?
Allow Austin to stay in his mother's arms as you begin your assessment
5. Besides oxygen saturation and rhythm of respirations, respiratory function assessment should include: (Select 5)
-Mechanics of breathing
-Chest rise and fall
6. Given the respiratory data you have collected on Austin, you determine that Austin is:
Having labored respirations, but not in acute distress
7. Before weighing Austin, you determine his height (length) by measuring from his heels to the top of his head as he lies supine.
8. Infants with CF commonly experience which of the following? (Select 3)
9. Which of the following manifestations may also occur in infants and children with CF? (Select 2)
10. Of the vital signs and clinical data collected during your assessment of Austin, which do you interpret as abnormal? (Select 2)
-Respiratory rate of 62
-Crackles in all lung fields
11. If Austin's condition were to change, which of the following changes would suggest hypoxia and the need for prompt medical evaluation to determine if oxygen was indicated? (Select 5)
-Increase in respiratory rate from 62 to 70
-Increase in pulse rate from 150 to 170
-Change in behavior from quiet to irritable
-Decrease in oxygen saturation from 95% to 93%
-Decrease in respiratory rate from 62 to 28
12. The malabsorption that occurs in CF is commonly characterized by: (Select 3)
-Poor weight gain and delayed growth despite constant eating
13. Which of the following is true with regard to normal fat digestion?
Most healthy people absorb at least 93% of the fat the eat
14. Austin's poor weight gain, slow growth, and placement below the 5th percentile for weight and height (length) indicate failure to thrive. In Austin's case, failure to thrive is classified as:
15. The gold standard test for diagnosing cystic fibrosis is a/an:
16. The best answer to Mr. Brown's question at this time will be:
17. Which of the following responses to Mr. Brown's questions, "How can this be? How did this happen?" is best?
"You and Mrs. Brown are both carriers of the cystic fibrosis gene."
18. Which of the following responses would be best?
"There is no way at this time to predict how sick Austin may be or what his life expectancy might be."
19. Which of these medications is being given to help correct Austin's malabsorption?
Creon 5 (pancreatic enzymes)
20. Inhalation Pulmozyme (dornase alfa) is being used with Austin to:
Facilitate airway clearance
21. Given his age and condition, which mode of delivery would be most beneficial with Austin?
22. You notice that Austin becomes agitated after his nebulizer treatment. You also determine that his pulse rate increases. Which of the following is indicated?
Continue to monitor and document Austin's response to nebulizer treatments
23. Besides tachycardia and agitation, what other effects of Ventolin (albuterol) therapy might Austin experience? (Select 2)
-Increase in coughing
-Onset of or increase in wheezing
24. Which of the following would indicate that Ventolin (albuterol) therapy is effective?
25. To prevent spread of infection from a hospitalized infant or child with cystic fibrosis to other vulnerable children, which is most important?
Strict adherence to hand hygiene guidelines
26. In a hospital setting, if a child with CF had Burkholderia cepacia cultured from his respiratory secretions, which of the following would apply?
It would not be wise to have him share a room with another CF patient
27. Austin's Respiratory Therapist contacts you to discuss timing and method of chest physiotherapy (CPT). Which time is best for CPT?
28. Given Austin's age, what form of chest physiotherapy (CPT) is most appropriate?
Postural drainage with percussion
29. Austin's parents will need to perform chest physiotherapy (CPT) at home. What techniques will be most useful in teaching Austin's parents how to perform CPT at home? (Select 3)
-Written instructions on how to do CPT
-Video or live demonstration of CPT being done
-Monitored return demonstration of CPT technique
30. Austin's parents have had some initial teaching about chest physiotherapy (CPT). Which of the following statements by Austin's mother would lead you to believe more teaching is necessary?
"I feel bad about having to wake Austin during the night for a treatment."
31. Creon 5 is a small gel cap filled with tiny enteric-coated beads. In reviewing possible methods of giving the enzymes, you offer Mrs. Brown the following options: (Select 2)
-"Open the capsule in Austin's mouth and immediately give him his bottle."
-"Open the capsule, pour the beads into some cereal, and feed this to Austin."
32. You tell Mrs. Brown that it is not difficult to make an increased calorie formula. You explain that the best way is to:
Add one additional scoop of formula powder to each 8 ounce bottle
33. You review Emily's lab results. Which of the following lab tests might you expect to see elevated with liver dysfunction? (Select 5)
34. For an adolescent, what forms of chest physiotherapy (CPT) are appropriate? (Select 5)
-Postural drainage with hand or mechanical percussion
-Positive expiratory pressure (PEP)
-High frequency chest wall oscillation (inflatable vest)
35. Austin is displaying signs of developmental delay.
36. When you review Emily's pulmonary function tests (PFTs), you realize that she has severe CF lung disease.
37. Information to present in your discussion with Emily includes: (Select 5)
-The importance of appropriate protection to prevent sexually transmitted diseases
-Her ability to conceive
-The impact of a pregnancy on her CF disease process
-The likelihood of having a baby with CF
-Referral to a women's health provider who is familiar with cystic fibrosis
all but c
38. After your discussion with Emily, you explain that you will be caring for her again tomorrow. You need to review and validate Emily's knowledge and understanding related to: (Select 5)
-Who to call with questions