ATI RN
Pediatric Nursing Review Questions Questions
Question 1 of 5
The BEST treatment for a 5-year-old boy with Henoch-Schonlein purpura (HSP) presenting with acute onset palpable purpura over the lower extremities and buttocks is
Correct Answer: A
Rationale: In treating a 5-year-old boy with Henoch-Schonlein purpura (HSP) presenting with acute onset palpable purpura over the lower extremities and buttocks, the BEST treatment is supportive measures (Option A). Rationale: 1. Supportive Measures: The primary approach in managing HSP is supportive care, including rest, hydration, and pain management. HSP is a self-limiting condition in most cases, and supportive measures help alleviate symptoms and promote recovery. Why others are wrong: 1. Steroids (Option B): While steroids may be used in severe cases of HSP with significant renal or gastrointestinal involvement, they are not the first-line treatment for uncomplicated cases like the one described in the question. 2. Azathioprine (Option C) and Cyclophosphamide (Option D): These are immunosuppressive medications that are not typically indicated for initial treatment of uncomplicated HSP in children. They are reserved for cases with severe organ involvement or refractory disease. Educational context: Understanding the appropriate treatment for common pediatric conditions like HSP is crucial for pediatric nurses. By opting for supportive measures as the initial management strategy, nurses can provide safe and effective care for children with HSP, promoting positive outcomes and minimizing unnecessary interventions. This knowledge enhances nursing practice and ensures evidence-based care delivery in pediatric settings.
Question 2 of 5
A 2-year-old child with failure to thrive, recurrent wheezing, and pulmonary infections. Of the following, the LEAST common cause of his illness is
Correct Answer: A
Rationale: In this scenario, the least common cause of the child's symptoms is asthma. Asthma is a common respiratory condition in children characterized by reversible airway obstruction, wheezing, and shortness of breath. However, in this case, the child's presentation of failure to thrive, recurrent wheezing, and pulmonary infections is more indicative of other conditions. Aspiration (Option B) can lead to recurrent respiratory infections and wheezing, especially in young children who may aspirate food or liquids into their lungs. This can mimic symptoms of asthma but is not as common. Food allergy (Option C) can also present with respiratory symptoms such as wheezing and recurrent infections. Children with food allergies may experience respiratory distress as a result of an allergic reaction, which can be mistaken for asthma. Cystic fibrosis (Option D) is a genetic disorder that primarily affects the lungs and digestive system. It commonly presents with respiratory symptoms like recurrent infections, wheezing, and failure to thrive in children. Cystic fibrosis is a more likely cause of the child's symptoms compared to asthma in this case. Educationally, understanding the differential diagnosis of common pediatric conditions is crucial for healthcare providers caring for children. By recognizing the key differences between asthma, aspiration, food allergy, and cystic fibrosis, healthcare professionals can provide appropriate treatment and management tailored to the specific underlying cause of a child's symptoms.
Question 3 of 5
A 6 -g, breast-fed white female, weeks' gestational age, is noted to have persistent hyperbilirubinemia at weeks of age On physical examination, the infant has not gained weight since birth and has decreased tone, an umbilical hernia, and an anterior fontanel measuring X 6 cm The most likely diagnosis is
Correct Answer: D
Rationale: In this case, the correct answer is D) Hypothyroidism. The infant presents with signs and symptoms consistent with congenital hypothyroidism, also known as cretinism. This condition can lead to persistent hyperbilirubinemia, poor weight gain, decreased tone, umbilical hernia, and delayed fontanel closure. Option A) Crigler-Najjar syndrome is a rare genetic disorder leading to unconjugated hyperbilirubinemia but would not present with the other signs observed in the infant. Option B) Gilbert disease is a benign condition causing mild unconjugated hyperbilirubinemia without the associated physical findings. Option C) Biliary atresia presents with jaundice, but not with the specific constellation of symptoms seen in this case. Educationally, understanding the clinical manifestations of hypothyroidism in infants is crucial for pediatric nursing practice. Recognizing these signs early can lead to prompt diagnosis and treatment, preventing potential complications associated with untreated hypothyroidism in infants.
Question 4 of 5
Reasons to avoid the early discharge of a normal term infant include all of the following EXCEPT
Correct Answer: D
Rationale: In pediatric nursing, it is crucial to understand why early discharge of a normal term infant should be avoided to ensure optimal health outcomes. The correct answer, option D, "Two successful feedings," is the exception because successful feedings indicate that the infant is able to feed adequately, which is a positive sign for discharge. Option A, "Jaundice evident on day," is a reason to avoid early discharge as jaundice in newborns can be a sign of underlying health issues that require monitoring and intervention. Option B, "Positive VDRL," indicates the presence of syphilis which can have serious implications for the infant's health and requires treatment and monitoring. Option C, "Bleeding after circumcision," can be a complication that needs close monitoring and care before considering discharge. Educationally, this question highlights the importance of thorough assessment and monitoring before discharging a newborn. It emphasizes the need for healthcare providers to consider various factors that could impact the infant's health and well-being. Understanding these reasons helps nurses provide comprehensive care and make informed decisions regarding the discharge of newborns.
Question 5 of 5
Jaundice appearing on day of life suggests all of the above EXCEPT
Correct Answer: D
Rationale: In this question, the correct answer is option D) Fetal-to-maternal transfusion. Jaundice appearing on the first day of life is suggestive of pathological causes of hyperbilirubinemia in newborns. Fetal-to-maternal transfusion typically presents with jaundice within the first 24 hours. Option A) TORCH infections are a group of infections that can cause fetal anomalies but typically present with jaundice after the first day of life. Option B) Erythroblastosis fetalis, also known as hemolytic disease of the newborn, is caused by Rh or other blood group incompatibility between the mother and fetus. Jaundice in this condition usually appears after the first day. Option C) ABO incompatibility can also lead to hemolytic disease of the newborn but, like erythroblastosis fetalis, the jaundice usually appears after the first day. Educationally, understanding the timing of jaundice onset in newborns is crucial for pediatric nurses to differentiate between various causes and provide appropriate care. Early recognition of fetal-to-maternal transfusion can prompt timely interventions to manage hyperbilirubinemia and prevent complications in the newborn.