what is a common finding that the nurse can identify in most children with symptomatic cardiac malformations
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Nursing Elites

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Pediatric HESI 2024

1. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?

Correct answer: C

Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.

2. The nurse is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

Correct answer: A

Rationale: Abdominal swelling is frequently the initial assessment finding associated with a Wilms tumor. This swelling is caused by the tumor's mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a primary finding, as it may occur later due to tumor growth or fluid retention. Hypotension (Choice C) is not typically associated with Wilms tumor unless severe complications like hemorrhage develop. Increased urinary output (Choice D) is not a common initial finding; instead, hematuria or other urinary changes may be observed later in the disease process.

3. What is the most common cause of shock (hypoperfusion) in infants and children?

Correct answer: A

Rationale: Infection is the leading cause of shock in infants and children due to their heightened vulnerability to sepsis. Infants and children possess developing immune systems, rendering them more susceptible to infections that can progress to septic shock. While cardiac failure is a severe condition, it is not as commonly the primary cause of shock in this age group. Accidental poisoning, though a potential shock inducer, is less prevalent in infants and children compared to infections. Severe allergic reactions, though significant, are not as frequent as infections in precipitating shock in infants and children.

4. A healthcare provider is assessing a child with suspected bacterial meningitis. What is a common clinical manifestation that the provider is likely to observe?

Correct answer: D

Rationale: A common clinical manifestation of bacterial meningitis is a positive Kernig sign, which indicates meningeal irritation. Kernig sign is elicited when the leg is bent at the hip and knee at 90-degree angles, and pain and resistance are felt with extension at the knee due to inflamed meninges. Options A, B, and C are not typically associated with bacterial meningitis. A rash is more commonly seen in viral illnesses, photophobia can be present but is not specific to bacterial meningitis, and jaundice is not a typical clinical manifestation of this condition.

5. In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?

Correct answer: A

Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.

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