ATI RN
Pediatric CCRN Practice Questions Questions
Question 1 of 9
A 5-year old girl presents to ER with fever, convulsions and unconsciousness of one day duration. On examination she is pale, Glasgow coma scale is 8 and there are no signs of meningial irritation and no focal neurological signs. The most likely diagnosis is:
Correct Answer: D
Rationale: Cerebral malaria can cause fever, seizures, altered consciousness, and normal cerebrospinal fluid findings without focal neurological signs.
Question 2 of 9
A nurse has determined that a newborn's respiratory breathing is within a normal range. How should the nurse document this finding?
Correct Answer: B
Rationale: A newborn with normal respiratory breathing would typically exhibit regular breathing patterns, with abdominal movements indicating effective diaphragmatic breathing. The normal respiratory rate for a newborn is considered to be 25 to 35 breaths per minute. Therefore, documenting the newborn's respiratory breathing as "Regular, abdominal, 25 to 35 breaths/min" would accurately represent a normal finding.
Question 3 of 9
The patient is dangling at the bedside and states, "Oh, my stomach is tearing open." Which of the following actions should the nurse immediately take when dehiscence occurs?
Correct Answer: B
Rationale: When dehiscence, which is the separation of the layers of a surgical incision, occurs in a patient, it is important to have the patient lie down. This position will help decrease intra-abdominal pressure and reduce the risk of further complications. Having the patient sit upright in a chair can increase intra-abdominal pressure, worsening the dehiscence. Slowing IV fluids may be necessary to prevent fluid overload in certain situations, but it is not the immediate action required when dehiscence occurs. Obtain a sterile suture set may eventually be needed, but the priority in this situation is to stabilize the patient by having them lie down.
Question 4 of 9
The statement about sleep which is NOT true is
Correct Answer: B
Rationale: Slow-wave sleep is primarily restorative, not protective against brain injury.
Question 5 of 9
Metabolic derangement secondary to tumor lysis syndrome in children includes all the following EXCEPT
Correct Answer: B
Rationale: Hypernatremia is not typically associated with tumor lysis syndrome, whereas hyperuricemia, hyperkalemia, and hyperphosphatemia are common.
Question 6 of 9
An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.
Question 7 of 9
A client who was diagnosed with type I diabetes mellitus 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?
Correct Answer: B
Rationale: A blood glucose level of 470 mg/dl indicates severe hyperglycemia in a client with type I diabetes mellitus. Arm and leg trembling, known as tremors, is a common symptom associated with high blood glucose levels. Tremors are often a result of the body's stress response to the extreme levels of glucose in the blood. Other common symptoms of hyperglycemia include increased thirst, frequent urination, blurred vision, and fatigue. Cool, moist skin, rapid, thready pulse, and slow, shallow respirations are not typically associated with hyperglycemia and are more indicative of other conditions or clinical situations.
Question 8 of 9
Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation?
Correct Answer: D
Rationale: Tetralogy of Fallot is a congenital heart defect characterized by four primary abnormalities: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Due to the pulmonary stenosis, less blood reaches the lungs to be oxygenated, resulting in deoxygenated blood entering the systemic arterial circulation. This leads to cyanosis, which is often referred to as "Tet spells" in these patients. Cyanosis is the bluish discoloration of the skin and mucous membranes caused by the presence of deoxygenated hemoglobin. The other conditions listed do not typically result in deoxygenated blood entering the systemic arterial circulation and causing cyanosis.
Question 9 of 9
Marichu is admitted to the hospital because of hepatic failure and was prescribed with lactulose (Duphalac). The primary action of this drug is:
Correct Answer: B
Rationale: Lactulose (Duphalac) is a synthetic sugar that is not absorbed in the small intestine but is broken down by bacteria in the colon into short-chain fatty acids and low molecular weight organic acids. The primary action of lactulose is to decrease resident intestinal flora. This reduces the production of ammonia in the colon and leads to acidification of the colonic contents. By doing so, lactulose helps in treating hepatic encephalopathy, a condition associated with hepatic failure where ammonia levels are elevated in the body. It works by promoting the excretion of ammonia through the stool, thereby reducing the toxic effects of ammonia on the brain.