ATI RN
NCLEX RN Pediatric Questions Questions
Question 1 of 5
A preterm newborn of 36 weeks of gestation is admitted to the NICU. Approximately 2 hours after birth, the newborn begins having difficulty breathing, with grunting, tachypnea, and nasal flaring. Which is important for the nurse to recognize?
Correct Answer: D
Rationale: The presentation of a preterm newborn with difficulty breathing, grunting, tachypnea, and nasal flaring is concerning and should not be considered a normal finding. This could indicate respiratory distress, which is common in preterm infants due to immature lung development. It is important for the nurse to recognize these symptoms as they may signify a potential underlying respiratory issue that requires further evaluation and intervention. Prompt assessment and management are crucial in ensuring the best outcomes for the newborn. Therefore, further evaluation by the healthcare team is warranted in this situation to determine the cause of the respiratory distress and provide appropriate treatment.
Question 2 of 5
The nurse is taking a health history on an adolescent. Which best describes how the chief complaint should be determined?
Correct Answer: B
Rationale: When determining the chief complaint for an adolescent during a health history, the best approach is to directly ask the adolescent, "Why did you come here today?" This allows the nurse to understand the reason for the visit from the adolescent's perspective and helps in identifying the primary concern or reason for seeking medical care. Adolescent patients should be encouraged to express their own concerns and symptoms in their own words, which can help in building trust and promoting open communication between the nurse and the patient. It is important to prioritize the adolescent's input in determining the chief complaint, as it relates to their own health and well-being.
Question 3 of 5
When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. What is the best explanation for this?
Correct Answer: D
Rationale: In this case, the tenderness, enlargement, and warmth of the child's cervical lymph nodes are likely due to an infection or inflammation that is close to the site. When lymph nodes are palpated and found to be tender, enlarged, and warm, it often indicates that the lymphatic system is responding to an infection or inflammation in the nearby area. The lymph nodes are part of the body's immune system and can become enlarged and tender as they work to fight off the infection. In this scenario, the most likely explanation is an infection or inflammation located near the cervical lymph nodes.
Question 4 of 5
At about what age does the Babinski sign disappear?
Correct Answer: D
Rationale: The Babinski sign is a reflex response in infants where their big toe moves upward and the other toes fan out when the sole of the foot is stroked. This reflex is normally present in infants up to around 2 years of age. By the age of 2, the nervous system has matured, and the Babinski sign disappears as the child's motor pathways develop and the reflex becomes suppressed. After the age of 2, the presence of the Babinski sign can indicate neurological issues, so its absence beyond this age is considered normal.
Question 5 of 5
A 4-month-old was born at 35 weeks of gestation. She seems to be developing normally, but her parents are concerned because she is a "more difficult" baby than their other child, who was term. What should the nurse's explanation include?
Correct Answer: A
Rationale: The nurse should explain to the parents that infants' temperaments are part of their unique characteristics. Temperament refers to an individual's natural predisposition towards certain behaviors and emotional responses. It is not uncommon for babies to have different temperaments, even within the same family. This 4-month-old baby may simply have a more difficult temperament compared to her sibling who was born at term. It is important for parents to understand and accept their baby's temperament as part of her individuality, rather than attributing it to other factors such as failure to bond or painful experiences in the neonatal period. While schedules and routines can help with managing challenging behaviors, it is essential for the parents to recognize and appreciate the uniqueness of their baby's temperament.