ATI RN
ATI Nur307 Pediatrics Quiz Questions
Extract:
Nurses' Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream apply to skin lesions daily. Assessment: Child is alert and responsive. Respiratory rate even and nonlabored at rate of 24/min. No adventitious sounds auscultated. Heart rate 108/min. Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities.
Question 1 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian? Select all that apply.
Correct Answer: A,B,D,F,G
Rationale: The correct statements to include in the discharge instructions are A, B, D, F, and G.
A: Cutting and filing the child's fingernails frequently can help prevent scratching and worsening of lesions.
B: Using a mild detergent reduces the risk of skin irritation for the child.
D: Informing the guardian about occasional flare-ups prepares them for potential worsening of the condition.
F: Gloves can help protect the child's hands from further irritation and prevent spreading of the condition.
G: Applying emollients after bathing helps keep the child's skin moisturized and can alleviate symptoms.
These choices focus on practical care strategies and education to manage the child's condition effectively.
Extract:
Nurses' Notes: 0915: Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent heard the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual and witnessed them gagging periodically. 0930: Child is lying on parent's chest with eyes open and requesting 'sippy cup.' Continues to have expiratory wheezing in bilateral upper lobes. Preparing child for diagnostic testing. Vital Signs: 0915: Blood pressure 88/45 mm Hg, Heart rate 90/min, Respiratory rate 30/min, Axillary temperature 36.9° C (98.4° F), Oxygen saturation 96%. 0930: Blood pressure 86/46 mm Hg, Heart rate 88/min, Respiratory rate 28/min, Axillary temperature 36.9° C (98.4° F), Oxygen saturation 95%. Assessment: 0915: Child awake and sobbing, asking parent for 'sippy cup' with excessive drooling and occasionally gagging. Breath sounds with small expiratory wheezing noted in bilateral upper lobes; respirations slightly elevated as child continues to cry and sob. Oxygen saturation 96% on room air. Penlight used to inspect throat with no visual signs of foreign object; no visual objects in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation. Abdomen soft and nontender with active bowel sounds in all four quadrants. Skin warm, pink, and smooth. Yellow urine noted in child's diaper. Provider notified of assessment findings. Laboratory Results: 0930: X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies object in esophagus. No foreign objects visualized in the chest or abdomen.
Question 2 of 5
Complete the following sentence by using the list of options. The nurse should first __ followed by __.
Correct Answer: A,B
Rationale: The correct answer is A,B. First, keeping the child NPO (nothing by mouth) is crucial to prevent aspiration during endoscopy. Second, preparing the child for flexible endoscopy ensures a successful procedure.
Choice C is important but not the first step.
Choice D should be done after preparing the child.
Choice E is relevant but not immediate.
Choice F is unnecessary.
Extract:
History and Physical: A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10. Vital Signs: Temperature 37.8° C (100° F), Heart rate 100/min, Blood pressure 110/72 mm Hg, Respiratory rate 20/min, Oxygen saturation 95% on room air. Assessment: Awake, alert, and oriented x 3, Yellow sclera of eyes noted bilaterally, Right upper quadrant tender to palpation, Hands painful to touch and swollen bilaterally, Right knee is swollen, warm to palpation, and the client reports pain as 8 on a scale of 0 to 10. Client is tearful and grimacing during the examination. Laboratory Results: Hct 28% (32% to 44%), Hgb 6 g/dL (10 to 15.5 g/dL), WBC count 20,000/mm3 (6,200 to 17,000/mm3), ALT 50 units/L (4 to 36 units/L), AST 62 units/L (10 to 40 units/L), Total bilirubin 3.0 mg/dL (0.3 to 1.0 mg/dL).
Question 3 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: A,C,D,E,G
Rationale: The correct interventions for an adolescent include monitoring oxygen saturation (
A) for respiratory status, giving oral hydroxyurea (
C) for sickle cell disease treatment, administering meperidine IV for pain management (
D), ensuring the pneumococcal vaccine is current (E) for infection prevention, and administering folic acid as prescribed (G) for nutritional support. Monitoring oxygen saturation is crucial for detecting respiratory distress. Hydroxyurea helps reduce sickle cell complications. Meperidine IV is effective for moderate to severe pain. Pneumococcal vaccine prevents infection. Folic acid is essential for managing sickle cell disease. Restricting oral intake (
B) and strict bed rest (F) are not recommended unless specifically indicated, which is not the case here.
Extract:
History and Physical: School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K. Barrel-shaped chest, Clubbing of the fingers bilaterally, Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough. Vital Signs: Temperature 38.4° C (101.1° F), Heart rate 100/min, Respiratory rate 40/min, Blood pressure 100/57 mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa, Stool analysis positive for presence of fat and enzymes, Chest x-ray indicates obstructive emphysema, WBC count 20,000/mm3 (5,000 to 10,000/mm3).
Question 4 of 5
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.
Correct Answer: B,D,E
Rationale: The correct answer is B, D, and E. Dornase alfa is used for cystic fibrosis, water-soluble vitamins are commonly prescribed for children, and pancreatic lipase aids in digestion. Meperidine is not typically used in pediatrics, acetaminophen is a common over-the-counter medication but may not always be prescribed or reconciled, and the last options are not commonly prescribed medications for children.
Therefore, choices A, C, F, and G are incorrect.
Extract:
Question 5 of 5
A nurse is teaching the guardian of a newborn about how to prepare their 3-year-old child to meet their new sibling. Which of the following statements should the nurse make?
Correct Answer: C
Rationale:
Correct
Answer: C
Rationale:
1. Providing a doll for the 3-year-old child to imitate parental behaviors helps them understand and prepare for the arrival of a new sibling by role-playing.
2. This activity allows the child to express emotions, practice caregiving skills, and feel involved in the process.
3. It fosters a sense of responsibility and helps the child adjust to the new family dynamic.
4. Options A and B do not focus on preparing the child for the arrival of the new sibling and may not be as effective.
5. Option D is not directly related to preparing the child for the new sibling but focuses on a separate issue of transitioning from a crib to a bed.