ATI RN
Pediatric Nursing Study Guide Questions
Question 1 of 5
Of the following, the MOST appropriate initial therapy for a 12-year-old female adolescent with mild arthritis and a faint malar rash is
Correct Answer: C
Rationale: In the case of a 12-year-old female adolescent with mild arthritis and a faint malar rash, the most appropriate initial therapy is hydroxychloroquine (Option C). This choice is based on the consideration of the patient's age, symptoms, and the most conservative approach to treatment. Hydroxychloroquine is a disease-modifying antirheumatic drug (DMARD) commonly used in the treatment of mild arthritis in children due to its favorable safety profile compared to other DMARDs. It is particularly effective in managing mild symptoms and can help control the autoimmune response that leads to arthritis and rash in this case. Steroids (Option A) may be effective in suppressing inflammation but are generally not the first choice due to their potential long-term side effects, especially in children. Systemic methotrexate (Option B) and cyclophosphamide (Option D) are more potent medications typically reserved for more severe cases of arthritis and lupus, and their use in mild cases without trying milder options first would not be appropriate. In an educational context, it is essential for healthcare providers to consider the patient's age, disease severity, potential side effects of medications, and the goal of achieving symptom control with the least harm. Understanding the hierarchy of treatment options and tailoring therapy to the individual patient's needs are crucial aspects of pediatric nursing practice.
Question 2 of 5
The most common gastrointestinal manifestation that may occur in up to 80% of children with Henoch-Schonlein purpura (HSP) is
Correct Answer: A
Rationale: In Henoch-Schonlein purpura (HSP), the most common gastrointestinal manifestation in up to 80% of children is abdominal pain and ileus. This is because HSP primarily affects small blood vessels, leading to inflammation in the gastrointestinal tract. Abdominal pain and ileus are classic symptoms seen in HSP due to the deposition of immune complexes in the intestines. Regarding the incorrect options: - Diarrhea is less common in HSP compared to abdominal pain and ileus. While it can occur, it is not the most prevalent symptom. - Vomiting is also a possible symptom in HSP, but it is not as commonly reported as abdominal pain and ileus. - Paralytic ileus is a severe complication that can occur in some cases of HSP but is not the most common gastrointestinal manifestation seen in the majority of affected children. Educational Context: Understanding the common gastrointestinal manifestations of HSP is crucial for pediatric nurses to provide effective care. Recognizing abdominal pain and ileus as the primary symptoms can aid nurses in prompt assessment and intervention, leading to better outcomes for children with HSP. This knowledge helps in differentiating HSP from other conditions with similar symptoms, ensuring accurate diagnosis and appropriate management.
Question 3 of 5
Regarding physical abuse, the physical signs in abused children (as bite marks) may be found in up to
Correct Answer: A
Rationale: In pediatric nursing, it is crucial to recognize signs of physical abuse in children to ensure their safety and well-being. The correct answer is A) 5%. Bite marks are a relatively uncommon physical sign of abuse, accounting for only a small percentage of cases. This rarity makes it important for healthcare professionals to be vigilant and thorough in their assessments to detect such subtle indicators. Option B) 15%, Option C) 25%, and Option D) 35% are incorrect because they overestimate the prevalence of bite marks as a sign of physical abuse. Selecting these options could lead to misinterpretation of findings and potentially missing other more common indicators of abuse. Educationally, understanding the prevalence of physical signs like bite marks in abused children helps nurses and healthcare providers make informed decisions when assessing and caring for pediatric patients. By knowing the accurate statistics, professionals can prioritize their assessments and interventions effectively to protect vulnerable children from harm. Vigilance, knowledge, and a comprehensive understanding of all potential signs of abuse are essential in pediatric nursing practice.
Question 4 of 5
A 15-month-old male child with failure to thrive, diarrhea, and fatty stool. Of the following, the MOST common possible cause of his illness is
Correct Answer: A
Rationale: In this scenario, the most common possible cause of the 15-month-old male child's symptoms of failure to thrive, diarrhea, and fatty stool is malabsorption, which is option A. Malabsorption refers to the impaired absorption of nutrients in the gastrointestinal tract. In children with malabsorption, essential nutrients like fats, proteins, and carbohydrates are not properly absorbed, leading to symptoms like failure to thrive, diarrhea, and fatty stool. Intestinal parasites (option B) can also cause similar symptoms, but malabsorption is more common in this age group. Milk protein intolerance (option C) can lead to symptoms like diarrhea, but it typically presents differently, such as with blood or mucus in the stool. Pancreatic insufficiency (option D) is a less common cause of these symptoms compared to malabsorption in pediatric patients. Educationally, understanding the common causes of failure to thrive in children is crucial for pediatric nurses. By recognizing the signs and symptoms associated with malabsorption, nurses can work with healthcare providers to diagnose and manage the condition effectively. This knowledge helps in providing appropriate care and support to children and their families facing such health challenges.
Question 5 of 5
You are called to the delivery of a boy at weeks' gestational age with thick meconium-stained fluid and type II decelerations The obstetrician rapidly delivers the infant and hands him to you for care The boy is hypotonic, cyanotic, apneic, and bradycardic The most appropriate step is to
Correct Answer: D
Rationale: In this scenario, the most appropriate step is to select option D, which is to intubate the trachea and provide positive-pressure ventilation. This is the correct choice because the infant is presenting with signs of severe respiratory distress, including hypotonia, cyanosis, apnea, and bradycardia. Immediate intervention to establish an airway and provide ventilatory support is crucial in this critical situation. Option A, stimulating the infant to breathe, is not appropriate in this case as the infant is already apneic and bradycardic, indicating the need for more advanced respiratory support. Option B, administering epinephrine, is not the initial step in managing a neonate with respiratory distress. Option C, providing positive-pressure bag-and-mask ventilation, may not be sufficient to adequately ventilate the infant in this critical condition where intubation is required for more effective ventilation and oxygenation. Educationally, this scenario highlights the importance of quick and accurate assessment of neonatal resuscitation needs during delivery. Healthcare providers must be prepared to intervene promptly and appropriately in neonatal emergencies to optimize outcomes and prevent further complications. Understanding the steps in neonatal resuscitation and being able to prioritize interventions based on the infant's presentation are crucial skills for healthcare professionals working in obstetric and neonatal care settings.