ATI RN
NCLEX RN Pediatric Questions Questions
Question 1 of 5
Appropriate nursing interventions for J.E. would be
Correct Answer: A
Rationale: For J.E., who suffered head injuries in a motor vehicle accident, appropriate nursing interventions should focus on holistic care to prevent complications and promote recovery. Option A includes skin care and position changes every 2 hours (q2h) and as needed, which is crucial for preventing pressure injuries in the immobile patient. Maintaining alignment of extremities helps prevent muscle contractures. Respiratory exercises are essential for preventing atelectasis and improving lung function in patients at risk for pneumonia due to decreased mobility. These interventions address the immediate needs of the patient and aim to prevent further complications related to immobility and head injury. Options B, C, and D lack the comprehensive approach to care provided in option A, making it the most appropriate choice for J.E.
Question 2 of 5
A client has the following blood lab values: platelets 50,000/ul, RBC's 3.5 (X 106), hemoglobin 10 g/dl, hematocrit 30 percent, WBCs 10,000/ul. Which nursing instruction should be included in the teaching plan?
Correct Answer: A
Rationale: The client's platelet count of 50,000/ul is significantly low (normal range is around 150,000-450,000/ul). A low platelet count places the client at risk for bleeding tendencies. Therefore, the most appropriate nursing instruction to include in the teaching plan is bleeding precautions. This would involve educating the client on measures to prevent bleeding such as avoiding activities that may cause injury, using a soft toothbrush, avoiding tight clothing, and being cautious while shaving.
Question 3 of 5
The nurse closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?
Correct Answer: A
Rationale: In a child with minimal change nephrotic syndrome, the nurse closely monitors the temperature to detect an early sign of infection. Children with nephrotic syndrome are more susceptible to infections due to loss of immunoglobulins in the urine, decreased serum complement levels, and altered immune function. Monitoring the temperature is important to identify any signs of infection early, as prompt treatment is crucial in preventing complications such as sepsis.
Question 4 of 5
The nurse caring for a 14-year-old girl with DI understands which of the following about this disorder?
Correct Answer: C
Rationale: Diabetes Insipidus (DI) is a condition characterized by the inability of the kidneys to conserve water, leading to excessive thirst and excretion of large volumes of dilute urine. Central DI, the most common form in children, is treated with a synthetic form of the hormone vasopressin, also known as desmopressin. Vasopressin helps the kidneys to retain water, thereby reducing urine output and preventing excessive dehydration. Since DI is a chronic condition, treatment with vasopressin is typically required on a lifelong basis to manage symptoms and prevent complications. It is important for healthcare providers to understand the long-term nature of DI treatment in order to provide appropriate care and support to patients with this condition.
Question 5 of 5
Streptococcal pharyngitis should be treated with antibiotics to avoid which of the following?
Correct Answer: C
Rationale: Streptococcal pharyngitis, commonly known as strep throat, is caused by group A Streptococcus bacteria. If left untreated, the infection can lead to complications such as poststreptococcal glomerulonephritis, which is a type of nephrotic syndrome affecting the kidneys. Antibiotic treatment for streptococcal pharyngitis is important to prevent these potential severe complications, including nephrotic syndrome. Otitis media, acute laryngitis, and hemorrhagic fever are not direct complications of untreated streptococcal pharyngitis.