ATI RN
Pediatric NCLEX Practice Quiz Questions
Question 1 of 5
Septic shock usually shows a combination of hypovolemic and distributive shock in addition to:
Correct Answer: D
Rationale: In pediatric patients with septic shock, the combination of hypovolemic and distributive shock is often present. The correct answer, option D, disseminated intravascular coagulation (DIC), is associated with severe sepsis and septic shock. DIC results from the widespread activation of clotting factors and consumption of clotting factors and platelets, leading to both bleeding and thrombosis. Option A, obstructive shock, occurs when there is physical obstruction of blood flow, such as in pulmonary embolism or cardiac tamponade, but it is not typically seen in septic shock. Option B, cardiogenic shock, results from the heart's inability to pump effectively, which is not a typical feature of septic shock. Option C, acute respiratory distress syndrome (ARDS), is a severe lung condition often seen in critically ill patients but is not a defining characteristic of septic shock. Educationally, understanding the different types of shock and their potential complications is crucial for nurses caring for pediatric patients, especially in high-acuity settings like the pediatric intensive care unit. Recognizing the signs and symptoms of septic shock and its associated complications, such as DIC, can lead to prompt intervention and improved patient outcomes.
Question 2 of 5
In the context of neonatal respiratory distress syndrome (RDS), which of the following is typically administered?
Correct Answer: B
Rationale: In the context of neonatal respiratory distress syndrome (RDS), which is characterized by insufficient surfactant production in premature infants leading to respiratory complications, the typical administration is corticosteroids (Option B). Corticosteroids are given to stimulate surfactant production in the lungs, helping to improve respiratory function and prevent complications associated with RDS. Antibiotics (Option A) are not typically administered for RDS because it is not an infectious condition. RDS is primarily a result of surfactant deficiency, not a bacterial infection. Bronchodilators (Option C) are not indicated in the treatment of RDS as the primary issue is not bronchoconstriction but rather surfactant deficiency. Oxygen therapy (Option D) is often used in the management of RDS to support oxygenation, but corticosteroids specifically target the underlying cause of surfactant deficiency. In an educational context, understanding the rationale behind the treatment of neonatal RDS is crucial for nurses and healthcare providers working in neonatal intensive care units. Knowing the appropriate medications and interventions for RDS can help improve patient outcomes and prevent complications associated with respiratory distress in premature infants. It is essential to prioritize treatments that address the underlying pathophysiology of RDS, such as corticosteroids to stimulate surfactant production, to provide optimal care for neonates with this condition.
Question 3 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 4 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 5 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.