N371 Midterm- Take Home Knowledge Check questions

A mother of a 1-month-old infant states that she is curious as to whether her infant is developing normally. Which of the following developmental milestones would the nurse expect the infant to perform?

a. turning head from side to side

b. grabbing a toy that is placed in front of them

c. placing objects in their mouth

d. rolling from back to side

a) turning head from side to side

At 7 months of age, you would expect an infant to display all of the following skills except:

a. pick up a cheerio with a fine pincer grasp

b. roll over

c. ability to sit up with support

d. pick up objects with a palmer grasp

a) pick up a cheerio with a fine pincer grasp

The mother of an eighteen-month old mentions that she is concerned about her child's round abdomen. Which of the following statements indicates an understanding of the physical growth of an eighteen month old?

a. "have you traveled outside the US"

b. "I am very concerned & will call the doctor right away"

c. "she should be placed on a diet because of he size of her belly"

d. "this is a normal finding for this age due to immaturity of the abdominal muscles"

d) This is a normal finding for this age due to immaturity of the abdominal muscles

All of the following are physical differences found in infants and toddlers when compared with adults except:

a. kidneys are unable to concentrate urine

b. eustachian tubes are shorter

c. larynx/trachea are rigid

d. urethra is shorter

c) larynx/ trachea are rigid

A 6 month old baby is in your clinic for a well child/preventative health visit. The following assessments are your priority for this healthy visit:

a. abdominal girth

b. weight, length, & head circumference

c. oxygen saturation & respiratory rate

d. blood pressure, temperature, & oxygen saturation

b) weight, length, and head circumference

Which of the following factors are critical in order to mitigate or lessen the effects of cumulative stress on the child (and family)?

a. having a household where 2 parents (mom & dad) are present

b. having a strong social support network

c. having access to the resources (financial, household, community) needed by the child & family

d. having the ability to deny or ignore problems

e. both b & c are critical to help mitigate the effects of stress

e. both b & c are critical to help mitigate the effects of stress

Assessing the child's family or household situation is only marginally important when providing care to the hospitalized child.

a. true

b. false

b) false

Which of the following statements reflect the key principles of pediatric nursing care?

a. the child & family are both central to our care

b. family dependence on & conformity with the health care system is promoted

c. providing care to the child should be done in a manner that minimizes harm to the child (ie should be atraumatic)

d. pediatric nursing focuses on promotion of health & prevention of illness & injury

e. a, c, & d are all key principles of pediatric nursing

e. a, c, & d are all key principles of pediatric nursing

You are caring for Fern. She is here for her six month old well child visit. Upon assessment, you note that Fern's anterior fontanel is open. Which of the following is your MOST appropriate action?

a. do nothing because this is a normal finding for this age

b. perform an intensive developmental examination

c. notify the physician immediately because there is a problem

d. perform an intensive neurologic examination

a. do nothing because this is a normal finding for this age

A mother who brings her five month old infant to the clinic for a regular check-up is concerned that her infant is not developing appropriately. When assessing the infant, which of the following would the nurse expect to find?

a. ability to feed themselves

b. fine motor finger to thumb pincer grasp

c. absence of head lag when pulled upright

d. ability to say mama or dada

c) absence of head lag when pulled upright

A 4-year-old child is scheduled to have two different medications at 9 am. As the nurse caring for this child, which of the following approaches is the most appropriate?

a. ask the child if she would like to take her medications

b. if the child is resistant to taking her medications, find another nurse to help restrain her while giving her medications

c. wait until the child's mother is in the room before giving the medication

d. let the child decide which medication to take first

d. let the child decide which medication to take first

Jessica is a 10 month-old infant who has been assigned to you. Answer the following question regarding Jessica's nursing care. Jessica has an appointment in the clinic for a preoperative history and physical exam. When you enter the room to perform her physical exam, Jessica is sitting contentedly on her Mother's lap, sucking a pacifier. Which of the following techniques will help you to successfully complete your examination and assessments?

a. measure the blood pressure first to make sure this important task gets done

b. leave the baby on the mother's lap for most assessments & perform traumatic procedures last

c. remove the pacifier from the infant's mouth to begin your examination

d. remove the child's clothes first and place them on the examination table for all assessments

e. check to see if she has a wet diaper first

b. leave the baby on the mother's lap for most assessments & perform traumatic procedures last

Jessica is a 10 month-old infant who has been assigned to you. Answer the following question regarding Jessica's nursing care. On the day of discharge you observe Jessica's parents playing with her. Which behavior indicates that Jessica has developed object permanence?

a. she returns the play blocks to the same spot on the table

b. she looks for the toy that her parents hid under the blanket

c. she bangs 2 cubes in her hands and throws them to the floor

d. she recognizes that a ball of clay is the same object even when flattened out

b. she looks for the toy that her parents hid under the blanket

An eight-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing response is which of the following?

a. determine why she is so anxious

b. explain in simple terms how it works

c. tell her she will see how it works as it is used

d. ask her why she wants to know

b. explain in simple terms how it works

You are in charge of planning a pre-hospitalization program for preschoolers that are coming in for elective surgery. To best address the needs of this age group include the following content in your plan except:

a. let the child play with some of the objects they will see during the hospital stay (stethoscope, thermometer)

b. identify comfort objects or toys that the child can bring with them to the hospital

c. give the children a tour of the surgery unit followed by a snack and chance to play

d. provide a detailed explanation to the child of what will take place during surgery and hospital admission

d. provide a detailed explanation to the child of what will take place during surgery and hospital admission

Effective communication with families and children involves all of the following actions except:

a. minimize the family's concerns in order to reduce their stress level

b. respect the family's cultural norms

c. practice the use of open, friendly, non-judgmental body language behavior

d. ask open ended questions

e. build trust by listening, answering questions, and addressing the family's concerns

a. minimize the family's concerns in order to reduce their stress level

Toddlers should transition from breast milk or formula to Vitamin D whole milk at what age?

a. 9 months of age

b. one year of age

c. 18 months of age

d. 2 years of age

b. one year of age

Which of the following statements is correct when considering whether to administer MMR vaccination?

a. MMR vaccines may be administered to a child whose Mother is pregnant

b. MMR vaccines should not be administered to a child whose Mother is pregnant

c. MMR is administered orally

d. MMR should be administered to children no later than 6 months of age

a. MMR vaccines may be administered to a child whose Mother is pregnant

Which of the following strategies is your first priority when a parent tells you that they are uncertain about vaccinating their young infant.

a. inform the parent about research that refutes the dangers of vaccination during infancy

b. educate the parent about why vaccinations are important during infancy

c. tell the parent that vaccinations are not linked to autism

d. ask the parent to tell you why they are uncertain about vaccination

d. ask the parent to tell you why they are uncertain about vaccination

Children who began primary immunization at the recommended age but failed to receive all doses must begin the series over again.

a. true

b. false

b. false

Which of the following statements is incorrect regarding differences in the respiratory anatomy and physiology of a two month old compared to older children and adults?

1. The infant's eustachian tubes and airway are shorter placing them at risk for ear and respiratory infections.

2. The infant is an obligate nose breather until about four months of age.

3. Infants and children have smaller and less developed lower airways.

4. Infants have lower metabolic rates and less oxygen consumption compared to older children and adults.

4. Infants have lower metabolic rates and less oxygen consumption compared to older children and adults.

Otitis media (ear infection) is one of the most common infections during early childhood. Which of the following are pre-disposing factors for OM? Select all that apply.

1. Down syndrome

2. Older age

3. Cleft palate

4. Attendance at day care

5. Breastfeeding

1. down syndrome

3. cleft palate

4. attendance at day care

Match these commonly used monitoring equipment or assessment techniques with their intended purpose.

1. Pulse oximeter

2. Electrocardiograph

3. Capnography

4. Arterial blood gas

5. Apnea monitor

6. Stethoscope

A. Assess depth of breathing and breath sounds. B. Assesses end-tidal carbon dioxide which reflects adequate ventilation.

C. Assesses heart rate and rhythm.

D. Assesses respiratory rate and rhythm.

E. Measures the levels of oxygen and carbon dioxide in the blood as well as acids and bases. F. Measures oxygen saturation in the blood.

1) F

2) C

3) B

4) E

5) D

6) A

You are assigned to triage a 3 year old boy who presents to the emergency room with mild fever and a barking-like cough. You suspect the child has laryngotracheobronchitis (croup) and prioritize your assessment appropriately. Place the following items to reflect the most appropriate order for your assessment.

- Assess the parent's ability to adhere to discharge instructions.

- Assess the child's vital signs and oxygen saturation.

- Assess the child's general appearance and responsiveness.

- Auscultate the child's breath sounds.

- Assess the child's general appearance and responsiveness.

- Auscultate the child's breath sounds.

- Assess the child's vital signs and oxygen saturation.

- Assess the parent's ability to adhere to discharge instructions.

The 3 year old is diagnosed with severe croup and admitted to your inpatient unit. The orders include administration of oral dexamethasone for which of the following indications:

1. Reduce airway inflammation

2. Provide mild sedation

3. Relive discomfort in the chest and throat

4. Prevent bacterial infection

1) reduce airway inflammation

Signs of respiratory distress in this child might include:

1. Nasal flaring, intercostal and substernal retractions.

2. A respiratory rate of 36 breaths per minute.

3. Oxygen saturation of 97% with a respiratory rate of 30.

4. Clubbing of the finger nails.

1. Nasal flaring, intercostal and substernal retractions.

Administering supplemental oxygen will prevent respiratory deterioration and failure in the child with croup, epiglottitis and other respiratory infections.

True

False

False

Infants and young children in respiratory distress do not deteriorate as rapidly as adults in respiratory distress because they are young and resilient.

True

False

False

Cardiopulmonary arrest in children is most often due to respiratory obstruction or failure compared to adults where the cause is most often due to a cardiac reason.

True

False

True

Listed below are many of the medications used to manage symptoms of asthma. Correctly categorize each medication. Categories: Rescue medication (relieves acute bronchospasm), maintenance medication (manage airway inflammation), Leukotriene or immunoglubulin E inhibitor (maintenance)

- albuterol

- epinephrine

- fluticasone (Flovent)

- fluticasone propriatate + salmeterol (Advair)

- monoclonal antibodies (Fasenra, Dupixent)

- montelukast sodium (Singulair)

Rescue medication (relieves acute bronchospasm:

- epinephrine

- albuterol

Maintenance medication (manage airway inflammation):

- fluticasone (Flovent)

- fluticason propriatate + salmeterol (Advair)

Leukotriene or immunoglobulin E inhibitor (maintenance):

- monoclonal antibodies (Fasenra, Dupixent)

- montelukast sodium (Singulair)

Kara is an 8-year-old girl being seen in the pulmonary clinic for new diagnosis of bronchial asthma. As the nurse educator in the clinic you are providing the patient education for Kara and her parents. When teaching Kara about her asthma, which of the following statements may best help Kara and her parents to understand her condition?

1. Asthma is a chronic condition that causes narrowing in the airways - making it hard to breathe.

2. Asthma can be readily cured with good management and adhering to the asthma plan.

3. The single cause of asthma is an allergic hypersensitivity.

4. Asthma is, in part, managed by abstaining from vigorous sports activities.

1. Asthma is a chronic condition that causes narrowing in the airways - making it hard to breathe.

Kara is an 8-year-old girl being seen in the pulmonary clinic for new diagnosis of bronchial asthma. The goals of Kara's asthma management are to maintain near normal lung function and normal activity as well as to prevent exacerbation of symptoms. When educating Kara and her family you will include the following strategies with the exception of which?

1. Teach Kara how to use a peak flow meter to measure forced expiratory volume.

2. Ensure that Kara and her parents understand the importance of maintaining daily use of inhaled albuterol (SABA).

3. Have Kara and her family assess for potential asthma triggers in her environment.

4. Ensure that Kara and her parents understand the importance of adhering to daily use of her inhaled corticosteroid (Flovent) as ordered.

2. Ensure that Kara and her parents understand the importance of maintaining daily use of inhaled albuterol (SABA).

Kara is an 8-year-old girl being seen in the pulmonary clinic for new diagnosis of bronchial asthma. Since her asthma diagnosis last year, Kara has been admitted to the emergency department three times with wheezing and shortness of breath. Her medication regimen includes:Advair (salmeterol/fluticasone) 2 puffs twice dailyVentolin (short-acting beta-2 agonist) 2 puffs every 6 hours as needed.Kara is stabilized in the emergency room and ready for discharge. She will continue on her current regimen and is to follow-up with her primary care provider. Which of the following statements by Kara's parents indicate a need for further education regarding Kara's condition and treatment plan?

1. "We'll make sure that Kara avoids all exercise to prevent further attacks."

2. "Kara should use her bronchodilator before her advair until her symptoms are well-managed."

3. "We should make sure that Kara uses her advair every day as ordered."

4. "We will keep a log of activities and exposures that trigger Kara's wheezing."

1. "We'll make sure that Kara avoids all exercise to prevent further attacks."

Parents of an infant diagnosed with cystic fibrosis ask the nurse about the genetic implications of CF to better understand the disorder in order and to plan for future pregnancies. Which statement, made by the nurse accurately describes the genetic implications?

1. Both parents are carriers of this defective gene since the infant has CF.

2. CF is inherited as an autosomal dominant trait - with one parent carrying the gene.

3. CF is inherited from parents and found primarily in non-White infants.

4. There is a 50% chance that siblings of an affected child will also inherit this condition.

1. Both parents are carriers of this defective gene since the infant has CF.

Which of the following instructions are important for most children with cystic fibrosis. Select all that apply.

1. avoid vaccinations if the child is underweight

2. maintain a high calorie diet

3. take pancreatic enzymes 10-20 minutes prior to meals or snacks

4. crush pancreatic enzymes and take immediately after every meal or snack

5. avoid antibiotics to prevent drug resistant strains of bacteria

6. adhere to daily chest physiotherapy schedule

7. adhere to a low fat protein diet

8. take water soluble vitamins (B6, B12, C) every day

9. take fat soluble vitamins (A, D, E, K) on a daily basis

10. use pulmonyze to thin respiratory secretions

2. maintain a high calorie diet

3. take pancreatic enzymes 10-20 minutes prior to meals or snacks

6. adhere to daily chest physiotherapy schedule

9. take fat soluble vitamins (A, D, E, K) on a daily basis

10. use pulmonyze to thin respiratory secretions

ou are caring for a 12 year old boy in urgent care who presents with sore throat.

In addition to a positive throat swab, which of the following signs and symptoms are consistent with group A beta-hemolytic streptococcus (GABHS) (i.e., strep throat)? Select all that apply.

1. right lower abdominal pain

2. throat pain or swallowing

3. headache

4. fever

5. constipation for past 3 days

6. tonsils are inflamed and covered in exudate

2. throat pain or swallowing

3. headache

4. fever

6. tonsils are inflamed and covered in exudate

It is important that a child with acute streptococcal (Strep B) pharyngitis be treated with a complete course of antibiotics in order to prevent:

1. Acute rheumatic fever

2. Otitis media

3. Nephrotic syndrome

4. Pneumonia

5. Drug resistant strains of viruses

1. Acute rheumatic fever

Match the following terms to the correct definition.

1. Cyanosis

2. Clubbing

3. Tachypnea

4. Apnea

A. Absent respirations

B. Blue gray tint to the skin, mucosa, or nailbeds

C. Enlargement of the fingertips and downward sloping of the nails; due to chronic hypoxemia

D. Rapid respiratory rate

1) B

2) C

3) D

4) A

A 3 year old is hospitalized following tonsillectomy to relieve obstructive sleep apnea. The child has received an opioid analgesic and acetaminophen to promote comfort, and is receiving humidified air by blow-by device. The child has been sleeping all evening, and the nurse has received several paging notifications for oxygen desaturation events (SpO2 < 90%). The first thing the nurse should assess when entering the child's room is:

1. The blow-by device for proper functioning.

2. The pulse oximeter for potential artifact.

3. The child's respiratory effort and breath sounds.

4. The child's IV line for proper functioning.

3. The child's respiratory effort and breath sounds.

Which of the following instructions are important when discharging a 5 year old child following tonsillectomy for obstructive sleep apnea? Select all that apply.

1. Administer the prescribe opioid around the clock, even if the child is really sleepy.

2. Encourage frequent sips of cool liquids.

3. Avoid over-the-counter analgesics in young children.

4. Watch for frequent swallowing behavior which might indicate bleeding in throat.

5. Administer non-opioid analgesics (acetaminophen) routinely to minimize pain.

6. Administer codeine as needed for throat pain.

7. Observe the child for restlessness or difficulty breathing.

2. Encourage frequent sips of cool liquids.

4. Watch for frequent swallowing behavior which might indicate bleeding in throat.

5. Administer non-opioid analgesics (acetaminophen) routinely to minimize pain.

7. Observe the child for restlessness or difficulty breathing.

Categorize the defects based on their likely hemodynamic flow pattern. increased pulmonary flow

a. atrial septal defect (ASD)

b. coarctation of aorta

c. aortic stenosis

d. tetralogy of fallot

e. ventricular septal defect (VSD)

f. pulmonic stenosis

g. hypoplastic left heart syndrome (HLHS)

h. patent ductus arteriosus

i. transposition of the great arteries

a. atrial septal defect (ASD)

e. ventricular septal defect (VSD)

h. patent ductus arteriosus

Categorize the defects based on their likely hemodynamic flow pattern. decreased pulmonary flow

a. atrial septal defect (ASD)

b. coarctation of aorta

c. aortic stenosis

d. tetralogy of fallot

e. ventricular septal defect (VSD)

f. pulmonic stenosis

g. hypoplastic left heart syndrome (HLHS)

h. patent ductus arteriosus

i. transposition of the great arteries

d. tetralogy of fallot

Categorize the defects based on their likely hemodynamic flow pattern. obstructed blood flow from ventricles.

a. atrial septal defect (ASD)

b. coarctation of aorta

c. aortic stenosis

d. tetralogy of fallot

e. ventricular septal defect (VSD)

f. pulmonic stenosis

g. hypoplastic left heart syndrome (HLHS)

h. patent ductus arteriosus

i. transposition of the great arteries

b. coarctation of aorta

c. aortic stenosis

f. pulmonic stenosis

Categorize the defects based on their likely hemodynamic flow pattern. mixed blood flow pattern

a. atrial septal defect (ASD)

b. coarctation of aorta

c. aortic stenosis

d. tetralogy of fallot

e. ventricular septal defect (VSD)

f. pulmonic stenosis

g. hypoplastic left heart syndrome (HLHS)

h. patent ductus arteriosus

i. transposition of the great arteries

g. hypoplastic left heart syndrome (HLHS)

i. transposition of the great arteries

Categorize the following congenital heart defects with their correct classification. acynotic defect

a. transposition of the great arteries

b. VSD

c. aortic stenosis

d. HLHS

e. coarctation of the aorta

f. tetralogy of fallot

g. ASD

b. VSD

c. aortic stenosis

e. coarctation of the aorta

g. ASD

Categorize the following congenital heart defects with their correct classification. cyanotic defect

a. transposition of the great arteries

b. VSD

c. aortic stenosis

d. HLHS

e. coarctation of the aorta

f. tetralogy of fallot

g. ASD

a. transposition of the great arteries

d. HLHS

f. tetralogy of fallot

Congestive heart failure (CHF) in children occurs most commonly in those with congenital defects that limit or prevent blood from pumping to the systemic circulation; this results in congestion of fluid in the heart, lungs, liver and periphery. The following interventions and assessments are imperative when caring for the child with CHF with the exception of:

a. Daily weights and accurate intake and output assessments

b. Promotion of rest to decrease cardiac demands

c. Ensuring adequate caloric intake

d. Forcing fluids to improve circulation

d. Forcing fluids to improve circulation

Which of the following are signs of heart failure during infancy? Select all that apply.

a. cool extremities

b. weight loss

c. jugular venous distension

d. tachycardia

e. tachypnea

f. blood pressure higher in upper extremities compared to lower extremities

g. difficulty feeding

h. warm extremities

a. cool extremities

d. tachycardia

e. tachypnea

g. difficulty feeding

Which of the following actions is appropriate when caring for a hospitalized infant with congestive heart failure?

a. Educate parents that fever and cyanosis are normal symptoms of heart failure

b. Awaken and stimulate the infant frequently to ensure responsiveness

c. Restrict fluids and sodium intake

d. Schedule care to provide for rest periods between feedings

d. Schedule care to provide for rest periods between feedings

Which of these treatment goals is addressed by administering digitalis?

a. Improve cardiac function (increase contractility and decrease afterload)

b. Decrease cardiac demands

c. Remove accumulated fluid and sodium (decrease preload)

d. Improve tissue oxygenation and decrease oxygen consumption

a. Improve cardiac function (increase contractility and decrease afterload)

In order to obtain the most accurate heart rate prior to administering digoxin, the child's heart rate should be assessed in the following manner:

a. Use the heart rate value from the pulse oximeter

b. Radial pulse x 30 seconds and multiply x 2

c. Brachial pulse for 15 seconds and then multiply x 4

d. Apical pulse for 1 minute

d. Apical pulse for 1 minute

Which of these symptoms will lead you to withhold the dose of digoxin for a 4 month old infant?

Which of these symptoms will lead you to withhold the dose of digoxin for a 4 month old infant?

a. Polycythemia and clubbing of nails

b. A drop in blood pressure and fussiness

c. Heart rate > 140 with cyanosis

d. Heart rate < 90 - 110

d. Heart rate < 90 - 110

Which of the following goals of treating congestive heart failure is addressed by administering a diuretic (Lasix or furosemide)?

a. Remove excess fluid (decrease preload)

b. Improve tissue oxygenation and decrease oxygen consumption.

c. Improve cardiac function (increase contractility and decrease afterload)

d. Decrease cardiac demands

a. Remove excess fluid (decrease preload)

An infant with congestive heart failure is receiving diuretic therapy. The nurse is closely monitoring the intake and output. Which is the most appropriate method to assess the urine output for an infant?

a. Weigh the baby before and after each diaper change

b. Insert a foley catheter after every feeding

c. Measure the amount of water added to formula

d. Weigh the diapers

d. Weigh the diapers

A 3 month old infant on the cardiac unit is receiving Furosemide (Lasix). Which of the following side effects may occur in children taking furosemide, mandating close monitoring?

a. Hypotension, cough, renal dysfunction

b. Hypernatremia, hypokalemia, weight loss, weakness

c. Hypokalemia, hyponatremia, hypocalcemia, postural hypotension

d. Bradycardia, extreme weakness, pallor

c. Hypokalemia, hyponatremia, hypocalcemia, postural hypotension

Providing for rest and comfort for infants and children addresses which of these goals when treating congestive heart failure?

a. Improve cardiac function (increase contractility and decrease afterload)

b. Remove accumulated fluid and sodium (decrease preload)

c. Improve tissue oxygenation and decrease oxygen consumption.

d. Decrease cardiac demands

d. Decrease cardiac demands

Tetralogy of Fallot (TOF) is a congenital heart defect that includes four defects: ventricular septal defect, overriding aorta, pulmonic stenosis, and right ventricular hypertrophy. Common symptoms that you will see in the child with this combination of defects include the following except:

a. Polycythemia

b. Lower blood pressure in the lower extremities compared to arms

c. Failure to thrive

d. Chronic hypoxemia with cyanosis

e. Shortness of breath with activity

b. Lower blood pressure in the lower extremities compared to arms

Which physiological changes occur as a result of chronic hypoxemia in children with congenital cyanotic heart disease?

a. Elevated erythrocyte sedimentation rate and peripheral edema

b. Polycythemia and clubbing

c. Anemia and barrel chest

d. Increased white blood cells and low platelets

b. Polycythemia and clubbing

A 2 year old child with Tetralogy of Fallot presents to the ED with dehydration. After the nurse inserts an intravenous (IV) catheter, the child becomes acutely cyanotic, hyperpneic, and has an abrupt decrease in arterial oxygen saturation (SpO2). All of the following are appropriate nursing interventions except:

a. Provide comfort measures to decrease distress

b. Administer supplemental "blow by" oxygen

c. Start a low dose epinephrine infusion through the existing IV line

d. Place the child in knee/chest position

c. Start a low dose epinephrine infusion through the existing IV line

Administration of supplemental oxygen addresses which of the following goals when treating children with congestive heart failure?

a. Improve cardiac function (increase contractility and decrease afterload)

b. Improve tissue oxygenation by increasing available oxygen during inspiration

c. Decrease cardiac demands

d. Remove accumulated fluid and sodium (decrease preload)

b. Improve tissue oxygenation by increasing available oxygen during inspiration

Supplemental oxygen can increase pulmonary blood flow at the expense of systemic and cardiac perfusion which is detrimental for some children with complex congenital heart disease.

a. True

b. False

a. True

Acute rheumatic fever can permanently damage the heart valves and can result from incomplete antibiotic treatment of which of the following infections:

a. Staphylococcus aurius

b. Group A Beta Hemolytic Streptococcus

c. Haemophilis influenzae

d. Hepatitis B

e. Adenovirus

b. Group A Beta Hemolytic Streptococcus

Inflammatory conditions of the heart can result from viral or bacterial infections in the blood stream.

Children with congenital heart defects may be at higher risk for bacterial endocarditis. Which of the following signs and symptoms suggest bacterial endocarditis in the child with CHD? Select all that apply.

a. Afebrile

b. Weight gain

c. Petechia on oral mucous membranes

d. Splinter hemorrhages under nails

e. Anorexia

f. Painful nodes on fingers

c. Petechia on oral mucous membranes

d. Splinter hemorrhages under nails

e. Anorexia

f. Painful nodes on fingers

Kawasaki disease should be suspected in a young child who presents with which of the following symptoms? Select all that apply.

a. Enlarged cervical lymph nodes

b. Tender, swollen abdomen

c. Edema and erythema of the palms of hands or soles of feet

d. Persistent high fever (>100 degrees F [37.8 C]) unresponsive to antipyretics

e. Hypothermia

f. Irritability

g. Loud heart murmer

h. Erythema of lips/oral cavity with cracked lips (strawberry tongue)

a. Enlarged cervical lymph nodes

c. Edema and erythema of the palms of hands or soles of feet

d. Persistent high fever (>100 degrees F [37.8 C]) unresponsive to antipyretics

f. Irritability

h. Erythema of lips/oral cavity with cracked lips (strawberry tongue)