ATI RN
Pediatric Nursing Study Guide Questions
Question 1 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 2 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 3 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.
Question 4 of 5
The Apgar score is
Correct Answer: C
Rationale: The correct answer is C) A systematic method to assess the newborn at birth. The Apgar score is a standardized assessment tool developed by Dr. Virginia Apgar in 1952 to quickly evaluate the overall health and well-being of a newborn immediately after birth. It assesses five key indicators: heart rate, respiratory effort, muscle tone, reflex irritability, and color. This score helps healthcare providers identify any immediate interventions needed to support the newborn's transition to life outside the womb. Option A) A predictor of future development quotients is incorrect because the Apgar score is not designed to predict long-term developmental outcomes. It is a snapshot assessment of the newborn's immediate condition. Option B) A predictor of cerebral palsy is incorrect because while a low Apgar score may indicate potential issues that could lead to cerebral palsy, it is not a direct predictor of this condition. Option D) A predictor of neonatal survival is incorrect because while a low Apgar score may indicate the need for immediate medical intervention to support neonatal survival, it is not a definitive predictor of survival outcomes. Understanding the importance of the Apgar score and how to interpret its findings is crucial for healthcare providers working in neonatal care settings. It helps them make timely decisions to ensure the best outcomes for newborns in those critical first moments of life.
Question 5 of 5
After days of phototherapy, the bilirubin level of the patient in Question 5 declines below mg/dL One day off phototherapy, the level of bilirubin remains less than mg/dL The patient is discharged home and grows well while breast-feeding At month of age, he returns with significant pallor, tachycardia, and a new heart murmur The most likely problem at this time is
Correct Answer: B
Rationale: In this scenario, the most likely problem the patient is experiencing at one month of age with significant pallor, tachycardia, and a new heart murmur is ductal dependent congenital heart disease (Option B). Ductal dependent congenital heart disease occurs when the ductus arteriosus, a connection between the pulmonary artery and the aorta that is crucial for fetal circulation, fails to close after birth. This leads to inadequate blood flow to the body, resulting in symptoms like pallor, tachycardia, and heart murmurs. Late-onset neonatal sepsis (Option A) is less likely in this case because the symptoms presented are more indicative of a cardiac issue rather than an infectious process. Hemolysis (Option C) is also less likely as the symptoms described are more suggestive of a cardiac etiology rather than hemolysis-related manifestations. Myocarditis (Option D) is less likely as well because the symptoms are more consistent with structural heart defects rather than inflammation of the heart muscle. Educationally, understanding the differentials for a child presenting with pallor, tachycardia, and a new heart murmur is crucial for pediatric nurses. Recognizing the signs and symptoms of ductal dependent congenital heart disease is essential for prompt identification and intervention to prevent potential complications and improve outcomes for the patient.