ATI RN
NCLEX RN Pediatric Questions Questions
Question 1 of 5
Which blood product replaces missing clotting factors in the patient who has a bleeding disorder?
Correct Answer: D
Rationale: Cryoprecipitate is a blood product that contains concentrated amounts of clotting factors, including fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor. These clotting factors are essential for the formation of blood clots, and when a patient has a bleeding disorder such as hemophilia or von Willebrand disease, cryoprecipitate is used to replace the missing or deficient clotting factors. Platelets are used to help with clot formation in cases of thrombocytopenia, albumin is used to treat low albumin levels in conditions like liver disease, and packed RBCs are used to treat anemia by providing oxygen-carrying red blood cells. However, for a patient with a bleeding disorder needing replacement of missing clotting factors, cryoprecipitate is the most appropriate blood product.
Question 2 of 5
A client has the following blood lab values: platelets 50,000/ul, RBC's 3.5 (X 106), hemoglobin 10 g/dl, hematocrit 30 percent, WBCs 10,000/ul. Which nursing instruction should be included in the teaching plan?
Correct Answer: A
Rationale: The client's platelet count of 50,000/ul is significantly low (normal range is around 150,000-450,000/ul). A low platelet count places the client at risk for bleeding tendencies. Therefore, the most appropriate nursing instruction to include in the teaching plan is bleeding precautions. This would involve educating the client on measures to prevent bleeding such as avoiding activities that may cause injury, using a soft toothbrush, avoiding tight clothing, and being cautious while shaving.
Question 3 of 5
Under which of the ff situations should a nurse notify the physician when caring for a client with lymphangitis? Choose all that apply
Correct Answer: A
Rationale: In caring for a client with lymphangitis, it is crucial for the nurse to be vigilant for any signs of worsening condition. The correct answer is option A, which states that the affected area appears to enlarge. This is the most critical symptom indicating progression of the infection along the lymphatic vessels. Enlargement suggests increasing inflammation and potential complications, necessitating immediate physician notification for further evaluation and intervention. Options B, C, and D are incorrect. Red streaks extending up the arm or leg (option B) are actually a classic sign of lymphangitis and should not trigger physician notification unless they worsen significantly or are accompanied by other concerning symptoms. Additional lymph nodes becoming involved (option C) is a common response to infection and does not necessarily warrant immediate physician notification unless they are unusually enlarged or painful. Enlargement of the liver and spleen (option D) is not directly related to lymphangitis and would typically be indicative of a different condition. In an educational context, understanding the progression of lymphangitis and recognizing concerning signs is crucial for nurses caring for pediatric patients. This knowledge helps in timely interventions and preventing complications. Nurses need to prioritize assessments and interventions based on the most critical indicators of worsening condition to provide optimal care for their patients.
Question 4 of 5
A client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?
Correct Answer: B
Rationale: Rationale: The correct answer is option B) "Keep the stoma dry." In caring for a neck stoma post-laryngectomy, it is crucial to keep the stoma dry to prevent irritation and infection. Moisture can lead to breakdown of the skin around the stoma, increasing the risk of infection. Keeping the stoma dry also helps in maintaining the integrity of the stoma site and promotes healing. Option A) "Keep the stoma uncovered" is incorrect because covering the stoma helps protect it from environmental contaminants and can prevent accidental trauma. Option C) "Have a family member perform stoma care initially until you get used to the procedure" is incorrect as it is important for the client to learn how to care for the stoma themselves to promote independence and self-care. Option D) "Keep the stoma moist" is incorrect as moisture can lead to skin breakdown and increase the risk of infection, as mentioned earlier. Educationally, it is essential for nurses to provide accurate and detailed instructions to clients undergoing laryngectomy to ensure proper stoma care, prevent complications, and promote optimal healing and adaptation to the changes post-surgery. Empowering the client with the knowledge and skills to care for their stoma is crucial for their long-term well-being and quality of life.
Question 5 of 5
The nurse is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?
Correct Answer: A
Rationale: It is appropriate to inform the male client that testicular cancer is a highly curable type of cancer. Testicular cancer has a high cure rate, especially when detected early through self-examinations. By emphasizing the curability of this cancer, the nurse can empower the client to perform regular self-exams and seek prompt medical attention if any abnormalities are detected. This information can help alleviate fears and encourage proactive health behaviors.