ATI RN
Pediatric NCLEX Questions Questions
Question 1 of 5
Which is instituted for the therapeutic management of minimal change nephrotic syndrome?
Correct Answer: A
Rationale: Corticosteroids are the mainstay of therapy for minimal change nephrotic syndrome. Minimal change disease is the most common cause of nephrotic syndrome in children, and corticosteroids are highly effective in inducing remission in these patients. They work by reducing inflammation and decreasing the permeability of the glomerular filtration barrier in the kidneys, thereby reducing proteinuria. Antihypertensive agents are used to control blood pressure in patients with renal involvement, and long-term diuretics are not typically recommended in nephrotic syndrome due to the risk of worsening kidney function. Increased fluids to promote diuresis are also not indicated as the primary treatment for minimal change nephrotic syndrome.
Question 2 of 5
A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
Correct Answer: B
Rationale: Tetralogy of Fallot is a congenital heart defect characterized by four abnormalities - pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. The pulmonary stenosis in Tetralogy of Fallot results in decreased pulmonary blood flow, leading to cyanosis. The other choices (Atrial septal defect, Ventricular septal defect, Patent ductus arteriosus) do not result in decreased pulmonary blood flow.
Question 3 of 5
Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?
Correct Answer: A
Rationale: Osler nodes are painful, tender, pea-sized nodules that can appear on the pads of the fingers or toes and are associated with bacterial endocarditis. These nodules result from immune-complex deposition in the small blood vessels of the skin. They are not to be confused with Janeway lesions, which are painless, non-tender macules found on the palms and soles in infective endocarditis. Subcutaneous nodules are seen in conditions like rheumatic fever, while Aschoff nodes are characteristic of rheumatic fever involving the heart.
Question 4 of 5
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. Provide the answer using lowercase letters separated by commas (e.g., a, b, c, d).
Correct Answer: B
Rationale: In this scenario, the highest-priority intervention is option B) Place the infant in knee-chest position. This position helps improve systemic vascular resistance and reduces venous return to the heart, thus decreasing the degree of right-to-left shunting in tetralogy of Fallot, ultimately improving oxygenation. Option A) Administer 100% oxygen by blow-by is not as high a priority as changing the infant's position. While oxygen is essential, in tetralogy of Fallot, addressing the physiological shunting through positioning is critical before oxygen administration. Option C) Remaining calm is important for the nurse's demeanor but is not a direct intervention to address the cyanosis in the infant. Maintaining composure can help in delivering effective care, but it is not the immediate action needed in this situation. Option D) Giving morphine subcutaneously or through an existing IV line is not appropriate in this case. Morphine can cause respiratory depression, further compromising the infant's oxygenation status. It is not the recommended treatment for cyanosis in tetralogy of Fallot. Educationally, this scenario highlights the importance of understanding the pathophysiology of congenital heart defects like tetralogy of Fallot and the critical thinking skills needed to prioritize interventions based on the patient's condition. Nurses must be able to quickly assess and respond to emergent situations in pediatric patients with complex cardiac issues.
Question 5 of 5
Which of the ff. nursing actions is most appropriate when doing perineal care on an uncircumcised male patient?
Correct Answer: C
Rationale: When performing perineal care on an uncircumcised male patient, it is important to replace the foreskin over the head of the penis after washing. The foreskin should not be left retracted or pulled back forcibly as it can cause irritation and discomfort to the patient. Leaving the foreskin retracted can also lead to potential complications such as paraphimosis, where the foreskin becomes trapped behind the head of the penis. Proper hygiene involves gently retracting the foreskin to clean underneath it and then returning it to its natural position to protect the sensitive glans penis. Using gentle, warm water with mild soap is typically sufficient for cleaning, and alcohol should be avoided as it can cause irritation and dryness to the sensitive genital area.