ATI PN Pediatrics Nursing 2023 II

Extract:

Question 1 of 5

A nurse is caring for a child who is 3 days postoperative following a below-the-knee amputation of the left leg. Which of the following actions should the nurse take first?

A. Reinforce teaching about phantom limb pain to the child.B. Inspect the skin at the incision site for manifestations of infection.C. Perform range-of-motion exercises to the affected extremity.D. Assist in placing the child in the prone position three times a day.

Correct Answer: B

Rationale: Infection inspection is critical early post-op to ensure healing. Other actions follow.

Question 2 of 5

A nurse is caring for a toddler who has been vomiting for the past 8 hours. Which of the following findings indicates to the nurse that the child is dehydrated?

A. Increased blood pressure.B. Flat anterior fontanel.C. Increased pulse.D. Distended jugular veins.

Correct Answer: C

Rationale: Increased pulse compensates for hypovolemia in dehydration. BP decreases, fontanels sink, and veins collapse, not distend, with dehydration.

Question 3 of 5

A nurse is preparing to collect data from a 1-month-old infant. Which of the following locations should the nurse palpate to find the anterior fontanel?

A. Top of the head near the hairline.B. Middle of the forehead.C. Intersection of the parietal and frontal bones.D. Behind the soft spot on the back of the head.

Correct Answer: C

Rationale: The anterior fontanel is at the frontal-parietal intersection, a diamond-shaped area allowing skull flexibility.

Question 4 of 5

A nurse is preparing to perform a heel stick using a spring-loaded automatic puncture device on a 1-week-old infant. In which of the following locations should the nurse puncture the infant's foot?

A. The center of the heel.B. The lateral side of the heel.C. The arch of the foot.D. The ball of the foot.

Correct Answer: B

Rationale: The lateral heel is capillary-rich and safe, minimizing pain and ensuring blood flow. Other sites risk trauma or insufficient yield.

Question 5 of 5

A nurse is receiving a change-of-shift report for a group of clients. Which of the following clients should the nurse plan to see first?

A. A toddler who has coarctation of the aorta and weak pedal pulses.B. A school-age child who has rheumatic fever and an increased erythrocyte sedimentation rate.C. A school-age child who has endocarditis and a new onset of lethargy.D. A toddler who has Kawasaki disease and erythema of the lips.

Correct Answer: C

Rationale: New lethargy in endocarditis signals potential worsening, requiring urgent assessment. Weak pulses, elevated ESR, and lip erythema are expected or less acute.