ATI RN
NCLEX Pediatric Respiratory Nursing Questions Questions
Question 1 of 5
A 7-month infant presented in emergency department with history of choking. On examination he is cyanosed. You are suspecting foreign body aspiration. What will be your immediate step in management?
Correct Answer: B
Rationale: In this scenario, the correct immediate step in managing a 7-month-old infant with suspected foreign body aspiration is to give five back blows between the scapulae (Option B). This action is recommended by the American Heart Association and American Academy of Pediatrics for infants under 1 year of age. Giving abdominal thrusts (Option A) is not recommended for infants as it can cause harm. Performing the Heimlich maneuver (Option C) is also not recommended for infants as it can be ineffective and potentially harmful. Giving oxygen inhalation (Option D) is not the immediate priority in this situation where airway obstruction is suspected. In an educational context, it is crucial for nurses to be familiar with the appropriate first aid interventions for foreign body aspiration in pediatric patients. Understanding the differences in managing airway obstruction in infants versus adults is essential to prevent further complications and provide timely and effective care. Nursing students preparing for the NCLEX exam need to grasp these critical pediatric respiratory emergency interventions to ensure safe and competent practice in clinical settings.
Question 2 of 5
Gross motor development of an infant can also be seen to the head onto what degree the infant can lift it when prone. When can you expect an infant to raise his head 90° when prone?
Correct Answer: D
Rationale: The correct answer is D) 4 months. At around 4 months of age, infants typically develop the strength and control in their neck and upper body muscles to lift their head to a 90° angle when placed in a prone (on stomach) position. This milestone is an important indicator of the infant's gross motor development and is a crucial step towards achieving further motor skills, such as rolling over and eventually crawling. Option A) 1 month is too early for an infant to lift their head to a 90° angle. At this stage, most infants are still developing their neck muscles and have limited control over their head movement. Option B) 2 months is also premature for this milestone as infants are still in the early stages of building neck strength and control. Option C) 3 months is closer to the correct timeline, but most infants will not have the full capability to lift their head to 90° at this stage. Understanding the timeline of gross motor development in infants is crucial for pediatric nurses as it allows them to assess a child's growth and development accurately. By recognizing the expected milestones, nurses can identify any potential delays or concerns early on and provide appropriate interventions to support the child's progress.
Question 3 of 5
Imaginary friends are common among pre-school as a way for them to manipulate their environment. The parents of Jillian a 4 year old child told the nurse that the child has an invisible friend named Jonjon. Jillian blames Jonjon for any misbehaviour and is often heard scolding him calling him a bad boy. The nurse understands that the best interpretation of this behaviour is which of the following?
Correct Answer: C
Rationale: The correct answer is C) A way of the child to assume control. This behavior of Jillian having an imaginary friend named Jonjon and blaming him for misbehavior is likely a way for Jillian to assert control over her environment. Imaginary friends are common in preschoolers and can serve as a coping mechanism for children to navigate their emotions and situations they may not fully understand. By placing blame on Jonjon, Jillian may be trying to distance herself from negative behavior and attribute it to an external source, giving her a sense of control over her actions. Option A) A delay in moral development is incorrect because having an imaginary friend and assigning blame to them is a normal part of child development and does not necessarily indicate a delay in moral development. Option B) Impaired parent-child relationship is incorrect as there is no evidence in the scenario to suggest a strained relationship between Jillian and her parents. Option D) Inconsistent parental discipline strategies is incorrect as there is no information provided that links Jillian's behavior to inconsistent discipline from her parents. In an educational context, understanding the significance of imaginary friends and the role they play in children's development can help nurses and caregivers support children's emotional and cognitive growth. By recognizing these behaviors as normal and age-appropriate, adults can provide appropriate guidance and support to help children navigate their emotions and experiences effectively.
Question 4 of 5
Gino Ang, who weighed 7 lbs. at birth, was discharged from the hospital on his 3rd day of life. During the nest 2 weeks at home he developed severe vomiting & weight loss, although his appetite remained good. Finally, Gino's mother brought him to the hospital ER for treatment. Gino's PE revealed severe dehydration, epigastric pain & distention, and a palpable olive-size mass in the right upper quadrant. Vomiting due to this type of obstruction is typically characterized as: 1. Bile stained 2. Initiated with great force 3. Decreasing in severity in time 4. Unaccompanied by nausea
Correct Answer: A
Rationale: The correct answer is A) 1,2 because the symptoms described in the scenario are indicative of pyloric stenosis, a condition commonly seen in infants. Vomiting in pyloric stenosis is typically bile-stained (option 1) due to the obstruction near the pyloric sphincter preventing food from reaching the intestines where bile is added. The characteristic projectile vomiting (option 2) occurs as the stomach tries to forcefully expel the contents. This pattern of vomiting can lead to severe dehydration and weight loss as seen in Gino. Option B) 1,3 and Option C) 2,3 are incorrect because vomiting in pyloric stenosis does not decrease in severity over time; it actually worsens if left untreated. Option D) 2,4 is incorrect because vomiting in pyloric stenosis is typically associated with nausea due to the forceful nature of the vomiting. For nursing students preparing for the NCLEX, understanding common pediatric conditions like pyloric stenosis is crucial. Recognizing the signs and symptoms, as well as understanding the pathophysiology behind them, can help in early identification and intervention, ultimately improving patient outcomes. Being able to differentiate between different types of vomiting patterns can aid in clinical decision-making and providing appropriate care for pediatric patients.
Question 5 of 5
The x-ray findings of right ventricular hypertrophy combined with decreased pulmonary blood flow are suggestive of:
Correct Answer: A
Rationale: In this question, the correct answer is A) Tricuspid atresia. Tricuspid atresia is a congenital heart defect where the tricuspid valve is missing or abnormally developed, leading to a lack of communication between the right atrium and right ventricle. This results in right ventricular hypertrophy as the right ventricle has to work harder to pump blood into the pulmonary artery, causing decreased pulmonary blood flow. Option B) Patent ductus arteriosus is incorrect because it is characterized by a persistent opening between the pulmonary artery and the aorta, leading to increased pulmonary blood flow, not decreased. Option C) Pulmonic valve stenosis is incorrect as it would typically present with increased pressure in the right ventricle and increased pulmonary blood flow, rather than decreased. Option D) Aortic valve stenosis is incorrect as it affects the left side of the heart, leading to left ventricular hypertrophy and symptoms such as chest pain and dizziness, not right-sided findings. Educationally, understanding the pathophysiology of congenital heart defects is crucial in pediatric nursing. Recognizing the specific characteristics of each defect, such as in this case, helps nurses provide appropriate care and anticipate potential complications for pediatric patients with cardiac conditions. This knowledge is essential for NCLEX preparation as it tests the ability to apply theoretical knowledge to clinical scenarios.