ATI RN
Pediatric NCLEX Practice Quiz Questions
Question 1 of 5
Prior to extubation, and in order to reduce airway narrowing, it is advised to use:
Correct Answer: C
Rationale: In pediatric patients, airway narrowing can occur due to various reasons like inflammation, secretions, or edema. In this scenario, using inhaled budesonide prior to extubation is advised to reduce airway narrowing. Budesonide is a corticosteroid that helps decrease inflammation in the airways, making extubation smoother and reducing the risk of complications. Option A, dexamethasone IV, is a systemic corticosteroid that may not specifically target the airways as effectively as inhaled budesonide. Systemic corticosteroids also have a higher risk of systemic side effects. Option B, betamethasone IV, is also a systemic corticosteroid and not the preferred choice for reducing airway narrowing prior to extubation in pediatric patients. Option D, nebulized budesonide, may seem like a plausible choice, but inhaled budesonide is preferred over nebulized budesonide due to its direct delivery to the airways and its ability to provide targeted anti-inflammatory effects. In an educational context, understanding the rationale behind using specific medications in pediatric patients is crucial for nursing students preparing for the NCLEX exam. It not only tests their knowledge of pharmacology but also reinforces the importance of selecting the most appropriate intervention to achieve optimal patient outcomes. By grasping the rationale for using inhaled budesonide in this scenario, students can apply this knowledge in clinical practice to provide safe and effective care to pediatric patients undergoing extubation.
Question 2 of 5
A 5-year-old underwent a tonsillectomy and an adenoidectomy under general anesthesia. The parents tell you that the anesthesiologist said that she “fought the mask and cried a lot†on induction. You are the pediatrician for this child, and 8 days after surgery, the parents call to report that the child, who previously slept well at night, now awakens nightly screaming with bad dreams. She is more irritable and cranky than before surgery and has angry outbursts. She is more “clingy†and wants her parents to cuddle her frequently. She reports that in her dreams, she can’t move, there is a tube in her throat, and she feels the surgeon cutting her throat. A review of her anesthetic record suggests an uneventful intraoperative course, with stable vital signs. All of the following statements about this situation are true EXCEPT
Correct Answer: A
Rationale: The correct answer is A) this is an extreme reaction and suggests a severe underlying tendency toward psychiatric illness. This statement is incorrect because the child's postoperative behavioral changes are likely due to the traumatic induction of anesthesia and not indicative of a severe underlying psychiatric illness. Option B is true as traumatic induction of anesthesia can commonly produce behavioral changes that usually resolve within 4-6 weeks. Option C is also true as parental presence during mask induction can help reduce distress for some children. Option D is true as intraoperative awareness can lead to the content of disturbing dreams and behavioral changes. In an educational context, it is important for healthcare providers to recognize and address the potential psychological impact of medical procedures on children. Understanding the effects of anesthesia induction and postoperative behavioral changes can help healthcare professionals provide appropriate support and interventions for pediatric patients and their families.
Question 3 of 5
Matching: Anesthetic risks
Correct Answer: C
Rationale: In the context of pediatric anesthesia, the correct answer is C) Succinylcholine. Succinylcholine is a depolarizing muscle relaxant that carries the risk of causing hyperkalemia in pediatric patients, especially those with neuromuscular disorders like muscular dystrophy. This can lead to life-threatening cardiac arrhythmias. Therefore, it is crucial for healthcare providers to be aware of this risk and use succinylcholine judiciously in pediatric patients. Option A) Retroviral agents are not relevant to anesthetic risks in this context. Option B) Cocaine is a vasoconstrictor and local anesthetic that can have hemodynamic effects but is not specifically associated with the risks related to succinylcholine in pediatric patients. Option D) Oxygen is a necessary component for respiration but does not pose specific risks related to succinylcholine administration in pediatric patients. In an educational context, understanding the risks associated with different anesthetic agents in pediatric patients is crucial for safe anesthesia administration. Healthcare providers need to be knowledgeable about the potential adverse effects of medications like succinylcholine to ensure the safety and well-being of their pediatric patients undergoing procedures requiring anesthesia.
Question 4 of 5
A 32-week gestational age male neonate is born to a 30-year-old mother due to abruptio placentae. The baby has been developed intracranial hemorrhage in the first few hours after birth. The mother has a history of using multiple drugs and substances during her pregnancy. Of the following, the MOST likely offending substance
Correct Answer: D
Rationale: The correct answer is D) cocaine. Cocaine is a potent vasoconstrictor that can lead to vasoconstriction of placental blood vessels, reducing blood flow to the fetus and increasing the risk of placental abruption. This can result in fetal hypoxia and subsequent intracranial hemorrhage in the neonate. Alcohol (option A) can lead to fetal alcohol syndrome and other developmental issues but is not typically associated with intracranial hemorrhage. Codeine (option B) is a less likely cause of intracranial hemorrhage compared to cocaine. Cigarette smoking (option C) can lead to low birth weight and other complications, but it is not typically associated with intracranial hemorrhage. Educationally, this question highlights the importance of understanding the effects of maternal substance use during pregnancy on the developing fetus. It underscores the need for healthcare providers to educate pregnant women about the dangers of using drugs like cocaine during pregnancy and the potential serious consequences it can have on the baby's health.
Question 5 of 5
Which condition is characterized by inflammation of the blood vessels?
Correct Answer: B
Rationale: In this question from the Pediatric NCLEX Practice Quiz, the correct answer is option B) Vasculitis, which is characterized by inflammation of the blood vessels. Vasculitis is the correct answer because it specifically refers to the inflammation of blood vessels, which is a key characteristic of this condition. In vasculitis, the body's immune system mistakenly attacks blood vessels, leading to inflammation and potential damage to the vessels. Option A) Lupus is an autoimmune disease that can cause inflammation throughout the body, including blood vessels. However, it is a broader term compared to vasculitis, which specifically focuses on blood vessel inflammation. Option C) Scleroderma is a connective tissue disorder that involves thickening and hardening of the skin and other tissues. While it can affect blood vessels, it is not primarily characterized by inflammation of blood vessels. Option D) Fibromyalgia is a chronic pain condition that does not involve inflammation of blood vessels. It is characterized by widespread musculoskeletal pain and other symptoms such as fatigue and sleep disturbances. In an educational context, understanding the differences between these conditions is crucial for healthcare professionals, especially those working with pediatric patients. Recognizing the specific characteristics of each condition helps in accurate diagnosis, treatment planning, and patient care. Identifying vasculitis correctly in a pediatric patient is important for timely intervention to prevent potential complications associated with inflammation of blood vessels.