ATI RN
Pediatric Nursing Cardiovascular NCLEX Practice Quiz Questions
Question 1 of 5
Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?
Correct Answer: A
Rationale: In the context of pediatric nursing and managing gastroesophageal reflux in children, the correct answer is option A) Teach the client to elevate the head of the bed on blocks. Rationale: Elevating the head of the bed on blocks is crucial in managing gastroesophageal reflux as it helps prevent gastric contents from flowing back into the esophagus, reducing the likelihood of reflux episodes during sleep. This position promotes gravity-assisted drainage of stomach contents and helps alleviate symptoms like heartburn and regurgitation in pediatric patients. Explanation of Incorrect Options: B) Reminding the client to avoid high-fiber foods is not directly related to managing gastroesophageal reflux. High-fiber foods are generally considered healthy and should not be avoided unless specifically advised by a healthcare provider for other reasons. C) Encouraging the client to lie down and rest after meals can exacerbate reflux symptoms as lying down immediately after eating can increase the chances of stomach acid flowing back into the esophagus. D) Instructing the client to use antacids only as a last resort is not the primary recommendation for managing gastroesophageal reflux in pediatrics. While antacids can provide symptomatic relief, lifestyle modifications like positioning changes are preferred as initial interventions. Educational Context: Understanding the rationale behind each option in the context of pediatric nursing is essential for providing safe and effective care to pediatric patients with gastroesophageal reflux. By prioritizing non-pharmacological interventions like elevating the head of the bed, nurses can help improve outcomes and quality of life for children with this condition.
Question 2 of 5
After a transurethral resection of the prostate (TURP), a client has bloody urine output with large clots. The nurse implements the postoperative prescription to irrigate the indwelling catheter PRN to maintain the catheter's patency. Which action should the nurse implement?
Correct Answer: A
Rationale: In this scenario, the correct action is to clamp the catheter for 30 minutes prior to irrigating with saline (Option A). This process allows the clots to soften and break up, making it easier to clear the catheter without causing trauma. Option B (Manually irrigate the catheter with sterile saline) is incorrect because directly irrigating without clamping can potentially push the clots further into the catheter, leading to blockage. Option C (Increase the client's oral fluid intake) is not the immediate solution to clearing the catheter of clots. While hydration is essential, it may not be effective in dislodging existing clots. Option D (Remove the catheter and notify the healthcare provider immediately) is inappropriate as removing the catheter without attempting to clear the clots first could lead to urinary retention and potential complications for the client. Educationally, understanding the rationale behind clamping the catheter before irrigation post-TURP is crucial in preventing complications and ensuring proper postoperative care. This knowledge is essential for pediatric nurses to provide safe and effective care to their patients undergoing urological procedures.
Question 3 of 5
A client who is receiving chemotherapy is vomiting. Which nursing intervention should the nurse implement first?
Correct Answer: C
Rationale: In this scenario, the correct nursing intervention to implement first is option C) Administer ondansetron hydrochloride (Zofran). Chemotherapy-induced nausea and vomiting (CINV) are common side effects that can significantly impact a pediatric patient's quality of life. Ondansetron is a well-established antiemetic medication that works by blocking serotonin receptors in the central nervous system, effectively reducing nausea and vomiting. Administering ondansetron as the first intervention is crucial to provide immediate relief to the client and prevent further complications such as dehydration and electrolyte imbalances. By addressing the vomiting promptly, the nurse can help the client feel more comfortable and improve their overall well-being during chemotherapy treatment. Now, let's analyze why the other options are incorrect: A) Teaching the client about the importance of hydration is essential, but addressing the vomiting should take precedence to prevent dehydration due to ongoing emesis. B) Reporting the volume of emesis to the healthcare provider is important but not the first action to take. Immediate management of the vomiting is necessary before informing the provider. D) Encouraging the client to limit movement may be helpful in reducing nausea, but administering an antiemetic medication should be the initial priority to address the vomiting effectively. In an educational context, understanding the priority interventions in managing chemotherapy-induced side effects is crucial for pediatric nurses. By prioritizing interventions based on the client's immediate needs, nurses can provide safe and effective care to pediatric patients undergoing chemotherapy and improve their treatment experience.
Question 4 of 5
The nurse is evaluating a male client’s understanding of diet teaching about the DASH (Dietary Approaches to Stop Hypertension) eating plan. Which behavior indicates that the client is adhering to the eating plan?
Correct Answer: D
Rationale: The correct answer is D) Carefully cleans and peels all fresh fruit and vegetables. This behavior indicates adherence to the DASH eating plan because it emphasizes consuming a diet rich in fruits and vegetables, which are important sources of essential nutrients and fiber. By cleaning and peeling fresh produce, the client is ensuring that he is consuming them in a safe and healthy manner. Option A is incorrect because using only lactose-free dairy products is not a specific requirement of the DASH eating plan. Option B is incorrect because while fat-free yogurt can be a part of a healthy diet, enjoying it as an occasional snack food does not necessarily demonstrate adherence to the DASH eating plan. Option C is incorrect because excluding grains entirely from the daily diet goes against the recommendations of the DASH eating plan, which actually encourages whole grains as part of a balanced diet. In an educational context, understanding the principles of the DASH eating plan is crucial for managing hypertension in pediatric patients. Teaching clients about the importance of consuming a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products can help them improve their cardiovascular health and overall well-being. Encouraging behaviors such as cleaning and peeling fresh produce can ensure that clients are following the DASH eating plan effectively.
Question 5 of 5
A hospitalized client with chemotherapy-induced stomatitis complains of mouth pain. What is the best initial nursing action?
Correct Answer: D
Rationale: In this scenario, the best initial nursing action for a hospitalized client with chemotherapy-induced stomatitis complaining of mouth pain is to administer a topical analgesic per PRN protocol (Option D). This is the correct choice because a topical analgesic can provide direct relief to the specific area of pain in the mouth, offering immediate comfort to the client. Encouraging frequent mouth care (Option A) is important for overall oral health but may not address the immediate pain concern. Cleansing the tongue and mouth with glycerin swabs (Option B) can be soothing but may not provide adequate pain relief. Obtaining a soft diet for the client (Option C) is beneficial for comfort but does not directly address the pain concern as effectively as administering a topical analgesic. Educationally, it is essential for nursing students to understand the importance of prompt pain management in clients experiencing discomfort, especially in vulnerable populations like pediatric patients undergoing chemotherapy. By selecting the correct option, students learn the significance of assessing and addressing acute pain to improve the overall quality of care provided to patients.