ATI RN
Nursing Interventions for Pediatric Respiratory Distress Questions
Question 1 of 5
SITUATION: Susie, 9 y/o has been diagnosed with tracheoesophageal fistula. Which of the following actions is most important for Susie's care?
Correct Answer: B
Rationale: In the case of Susie, a 9-year-old with a tracheoesophageal fistula, the most important action for her care is Option B) Prevent aspiration. Aspiration is a critical concern for individuals with this condition as it involves an abnormal connection between the trachea and the esophagus, leading to the potential for food, liquids, or gastric contents to enter the lungs, causing aspiration pneumonia, respiratory distress, and other serious complications. Preventing aspiration is crucial to maintain Susie's respiratory function and prevent further complications. This can be achieved by ensuring proper positioning during feeding, monitoring for signs of aspiration such as coughing or choking, and working with the healthcare team to develop a safe feeding plan. Option A) Prevent infection, while important, is not as immediate a concern as preventing aspiration in this situation. Option C) Prevent bleeding is not directly related to the primary issue of tracheoesophageal fistula and would be a secondary consideration. Option D) Provide oxygenation is important but addressing the risk of aspiration takes precedence in this scenario to prevent respiratory compromise and potential life-threatening consequences. Educationally, understanding the priority interventions in pediatric patients with specific respiratory conditions like tracheoesophageal fistula is essential for nurses caring for these vulnerable populations. By prioritizing prevention of aspiration, nurses can optimize patient outcomes and provide safe, effective care tailored to the individual needs of the child.
Question 2 of 5
A 2-week-old infant with Down syndrome is being seen in the clinic. The mother tells the nurse that the infant is difficult to hold. 'The baby is like a rag doll and doesn't cuddle up to me like my other babies did.' The nurse interprets the infant's behavior as a
Correct Answer: B
Rationale: In this scenario, the correct answer is B) result of the physical characteristics of Down syndrome. Infants with Down syndrome may exhibit hypotonia, which is decreased muscle tone. This characteristic can make them feel floppy or like a "rag doll" when being held, as described by the mother. This physical trait is a common feature of Down syndrome and can impact the infant's ability to engage in typical cuddling behaviors. Option A) sign of maternal deprivation is incorrect because the infant's behavior is related to their physical condition rather than maternal care or attachment issues. Option C) sign of detachment and rejection is incorrect as there is no indication of intentional rejection or detachment on the part of the infant. Option D) sign of autism associated with Down syndrome is incorrect because the behavior described is more closely linked to the physical characteristics of Down syndrome rather than autism. From an educational perspective, understanding the physical characteristics associated with genetic conditions like Down syndrome is crucial for healthcare professionals working with pediatric populations. Recognizing these traits can help nurses provide appropriate care and support to both the infant and their family, promoting better outcomes and enhancing the quality of care provided. This case highlights the importance of knowledge about developmental disorders and their impact on infant behavior.
Question 3 of 5
A parent has asked the nurse about how her child can be tested for pinworms. The nurse responds by stating that which is the most common test for diagnosing pinworms in a child?
Correct Answer: C
Rationale: The correct answer is C) Tape test prior to defecating. This test involves placing a piece of clear tape near the child's anus in the morning before they defecate. The tape is then examined under a microscope for pinworm eggs, which are indicative of an infection. This method is non-invasive, simple, and cost-effective, making it the most common and preferred test for diagnosing pinworms in children. Option A, three stool specimens at intervals of 4 days, is not the most common test for pinworms. While stool samples can sometimes be used to detect pinworm eggs, the tape test is more specific and reliable for diagnosing pinworm infections. Option B, observation for the presence of worms after the child defecates, is not a recommended diagnostic method. Pinworms are typically small and difficult to see with the naked eye, making this method unreliable for diagnosis. Option D, a lower GI series, is not typically used to diagnose pinworm infections. This imaging study is more invasive and not necessary for the diagnosis of pinworms, which can be easily confirmed through non-invasive methods like the tape test. In an educational context, understanding the most appropriate and commonly used diagnostic tests for common childhood infections like pinworms is crucial for nurses working in pediatric healthcare settings. By knowing the most effective methods for diagnosis, nurses can ensure accurate and timely identification of infections, leading to appropriate treatment and improved outcomes for pediatric patients.
Question 4 of 5
In which communicable diseases are Koplik spots present?
Correct Answer: D
Rationale: The correct answer is D) Measles (rubeola) because Koplik spots are a specific symptom associated with measles. Koplik spots are small white or bluish-white spots with a red halo that appear inside the mouth on the buccal mucosa opposite the molars. They are considered a pathognomonic sign of measles. Option A) Chickenpox (varicella) is incorrect because it does not present with Koplik spots. Chickenpox typically manifests as a vesicular rash that starts on the trunk and spreads to the limbs. Option B) Rubella is incorrect because Koplik spots are not associated with rubella. Rubella is characterized by a fine, pink-red rash that starts on the face and spreads downward. Option C) Exanthema subitum (roseola) does not present with Koplik spots. Roseola is distinguished by high fever followed by a rash. Understanding the presence of Koplik spots in measles is crucial for nurses caring for pediatric patients with respiratory distress. Recognizing this symptom can aid in early identification and isolation of measles cases to prevent its spread in healthcare settings and communities. This knowledge is essential for providing safe and effective care to pediatric patients with communicable diseases.
Question 5 of 5
The school nurse is concerned about an outbreak of chickenpox because two children at the school have cancer and are immunodeficient from chemotherapy. The most appropriate recommendation by the school nurse is that
Correct Answer: B
Rationale: The correct answer is option B: Varicella-zoster immune globulin (VZIG) to prevent chickenpox. This option is the most appropriate recommendation because children undergoing chemotherapy are immunocompromised and at high risk for severe complications from chickenpox. VZIG provides passive immunity by giving antibodies to fight the varicella-zoster virus, reducing the severity of the infection in these vulnerable individuals. Option A (Acyclovir) is incorrect because it treats the symptoms but does not prevent the disease. Option C (Stopping chemotherapy) is also incorrect as it could jeopardize the cancer treatment and is not a guarantee that the immune system will recover quickly enough to prevent chickenpox. Option D (No precautions necessary) is the riskiest choice as it neglects the heightened vulnerability of immunocompromised children to infections like chickenpox. In an educational context, it is crucial for healthcare providers, including school nurses, to be aware of the specific needs of immunocompromised individuals, especially in environments like schools where infectious diseases can easily spread. Understanding the appropriate interventions to protect these vulnerable populations is essential in providing safe and effective care.