ATI RN
Free Pediatric CCRN Practice Questions Questions
Question 1 of 9
Which of the following parameters would Nurse Max monitor to evaluate the effectiveness of thickened feedings for an infant with gastroesophageL REFLUX (GER)?
Correct Answer: C
Rationale: Nurse Max would monitor the infant's weight to evaluate the effectiveness of thickened feedings for gastroesophageal reflux (GER). Weight monitoring is crucial because it can indicate if the infant is gaining, maintaining, or losing weight, which can be reflective of how well they are tolerating the thickened feedings. An increase in weight would suggest that the infant is receiving adequate nutrition and that the thickened feedings are effective in managing GER symptoms. Monitoring weight can also help assess if the infant's overall growth and development are progressing appropriately in the context of their GER condition.
Question 2 of 9
A client was brought to the school clinic wuth severe, constant, localized abdominal pain. Abdominal muscles are rigid, and rebound tenderness is present. Peritonitis is suspected. The client is hypotensive and tachycardic. The nursing diagnosis most appropriate to the client's signs/symptoms is:
Correct Answer: A
Rationale: The client's signs and symptoms point towards a diagnosis of peritonitis, which is an inflammation of the peritoneum lining the abdominal cavity. The presence of severe, constant abdominal pain, rigid abdominal muscles, rebound tenderness, hypotension, and tachycardia are all indicative of peritonitis. These symptoms are typically seen when there is an infection or inflammation in the abdominal cavity, leading to fluid shifting from the intravascular space to the peritoneal cavity. This shifting of fluid results in hypovolemia, causing hypotension and tachycardia.
Question 3 of 9
The nurse teaches a client with newly diagnosed hypothyroidism about the need for thyroid hormone replacement therapy to restore normal thyroid function. Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy?
Correct Answer: D
Rationale: Levothyroxine (Synthroid) is the agent of choice for thyroid hormone replacement therapy in clients with hypothyroidism. Levothyroxine is a synthetic form of the thyroid hormone T4 and is considered a stable and reliable medication for thyroid replacement. It is usually well tolerated and has a consistent potency, making it easier to adjust the dosage based on the client's thyroid hormone levels. Levothyroxine is typically taken orally once daily on an empty stomach, preferably in the morning, to ensure optimal absorption. In contrast, Methimazole (Tapazole) is used to treat hyperthyroidism by inhibiting the production of thyroid hormones, Livothyronine (Cytomel) is a synthetic form of the thyroid hormone T3, and Thyroid USP dessicated (Thyroid USP) is a natural preparation derived from porcine thyroid glands,
Question 4 of 9
The nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:
Correct Answer: C
Rationale: Cushing's syndrome is a disorder characterized by excessive levels of cortisol in the body. One of the classic physical manifestations of Cushing's syndrome is the accumulation of adipose (fat) tissue in specific areas, such as the trunk (central obesity) and dorsocervical area (referred to as a "buffalo hump"). This redistribution of body fat is a key feature in Cushing's syndrome. The thick, coarse skin is commonly seen in conditions like acromegaly, not in Cushing's syndrome. Weight gain in the arms and legs is not a typical finding in Cushing's syndrome. Additionally, hypertension, rather than hypotension, is more commonly associated with excess cortisol levels in Cushing's syndrome.
Question 5 of 9
Which refers to a newborn whose rate of intrauterine growth was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
Correct Answer: D
Rationale: A newborn who is small for gestational age (SGA) refers to a baby whose rate of intrauterine growth was slowed, leading to a birth weight falling below the 10th percentile on intrauterine growth charts. SGA infants are at an increased risk for various health complications due to their smaller size at birth, such as difficulties in regulating body temperature, low blood sugar, and respiratory distress. Postterm refers to a pregnancy that has extended beyond 42 weeks, while postmature refers specifically to a fetus that has been in the womb beyond the expected due date. Low birth weight may refer to a baby born below a certain weight threshold regardless of gestational age.
Question 6 of 9
The nurse is examining an infant for hip placement and has abducted her flexed legs. The nurse should next:
Correct Answer: C
Rationale: In this scenario, the nurse is performing Ortolani's maneuver, which is used to assess for developmental dysplasia of the hip (DDH) in infants. After abducting the infant's flexed legs, the nurse should then listen for a "click" that may indicate hip instability. A positive click suggests subluxation of the femoral head and may indicate the presence of DDH. It is important for the nurse to recognize this finding promptly and report it to the healthcare provider for further evaluation and management. Rotation of the hips, extending the legs, and palpating for a mass are not the appropriate next steps in this specific assessment for DDH.
Question 7 of 9
When assessing a client with a disorder of the hematopoietic or the lymphatic, why is it important for the nurse to obtain a dietary history?
Correct Answer: A
Rationale: When assessing a client with a disorder of the hematopoietic or lymphatic system, obtaining a dietary history is important because compromised nutrition can interfere with the production of blood cells and hemoglobin. Hematopoiesis, the process of blood cell formation, requires adequate nutrition to support the production of red and white blood cells, as well as platelets. Nutrient deficiencies, such as iron, vitamin B12, and folate, can lead to anemia, which affects the oxygen-carrying capacity of red blood cells. Therefore, understanding the client's dietary intake can help the nurse identify any potential deficiencies or excessive intake that may be impacting hematopoiesis.
Question 8 of 9
Which of the following parameters would Nurse Max monitor to evaluate the effectiveness of thickened feedings for an infant with gastroesophageL REFLUX (GER)?
Correct Answer: C
Rationale: Nurse Max would monitor the infant's weight to evaluate the effectiveness of thickened feedings for gastroesophageal reflux (GER). Weight monitoring is crucial because it can indicate if the infant is gaining, maintaining, or losing weight, which can be reflective of how well they are tolerating the thickened feedings. An increase in weight would suggest that the infant is receiving adequate nutrition and that the thickened feedings are effective in managing GER symptoms. Monitoring weight can also help assess if the infant's overall growth and development are progressing appropriately in the context of their GER condition.
Question 9 of 9
A client with ascites has a paracentesis, and 1500 ml of fluid is removed. Immediately following the procedure it is most important for the nurse to observe for:
Correct Answer: C
Rationale: Following a paracentesis procedure where a large amount of ascitic fluid is removed, there is a risk of developing a fluid shift and a potential complication known as "paracentesis-induced circulatory dysfunction" (PICD). This may cause a sudden increase in central blood volume due to rapid re-distribution of fluid, leading to respiratory congestion, dyspnea, and hypoxemia. Therefore, it is crucial for the nurse to monitor the client closely for signs of respiratory distress or congestion immediately after the procedure to prevent any respiratory complications. A rapid, thready pulse (choice A) may indicate hypovolemia, but it is not the most important immediate concern in this case. Decreased peristalsis (choice B) and an increased temperature (choice D) are not typically associated with the immediate post-paracentesis period and are therefore lower priorities compared to monitoring for signs of respiratory congestion.