ATI RN
ATI Nur 223a Sect 4 Pediatrics Final Exam Questions
Extract:
Child who is having a tonic-clonic seizure and vomiting.
Question 1 of 5
A nurse is caring for a child who is having a tonic-clonic seizure and vomiting. Which of the following actions is the nurse's priority?
Correct Answer: B
Rationale: Side-lying position prevents aspiration during vomiting.
Extract:
School-aged child develops a nosebleed (epistaxis).
Question 2 of 5
A school-aged child develops a nosebleed (epistaxis). Which action should the nurse take?
Correct Answer: C
Rationale: Upright position with pressure on the nose sides stops the bleeding effectively.
Extract:
Adolescent who has type 1 diabetes mellitus.
Question 3 of 5
A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?
Correct Answer: A
Rationale: Annual influenza vaccine reduces infection risks in diabetes.
Extract:
School-age child who has mild persistent asthma.
Question 4 of 5
A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.)
Correct Answer: A,C,E
Rationale:
Choice A: Daytime symptoms more than twice a week are expected.
Choice B: Nighttime symptoms twice a month indicate intermittent asthma.
Choice C: Minor activity limitations are expected.
Choice D: Continuous symptoms indicate severe asthma.
Choice E: PEF ≥80% is expected.
Extract:
Nurses Notes: Emergency Department - 0900: Two-year-old toddler brought in by parents due to concerns about child's breathing. Parents report child has a history of asthma and woke up today with a bad asthma attack. Parents state child has had a runny nose and occasional cough for 2 days and has not been eating or drinking well. Child is restless and crying intermittently while clinging to parent. Appears ill with flushed face. Large amount of clear thick nasal drainage from bilateral nares and marked nasal flaring noted. Oral mucosa pink and slightly dry. Moderate to severe suprasternal and substernal retractions. Bilateral wheezes in upper lobes throughout inspiration and expiration. Diminished breath sounds in bilateral bases. Frequent dry hacking cough when crying. Pediatric Unit - 1200: Two-year-old toddler admitted from the emergency department due to exacerbation of asthma. Child currently asleep in parent's arms but rouses easily when touched. Oral mucosa pink and moist. No nasal flaring noted. Mid substernal retractions noted. Mild bilateral expiratory wheezes auscultated in upper lobes with breath sounds diminished in bilateral bases. No cough noted. O2 at 2 L/min via nasal cannula. Vital Signs 0900: Temperature: 38.3°C (100.9°F), Heart rate: 130 bpm, Respiratory rate: 40 breaths/min, Oxygen saturation: 88% on room air. 1200: Temperature: 37.8°C (100.0°F), Heart rate: 120 bpm, Respiratory rate: 32 breaths/min, Oxygen saturation: 94% on 2 L/min O2 via nasal cannula. Physical Examination Results 0900: Child appears ill with flushed face. Large amount of clear thick nasal drainage from bilateral nares. Marked nasal flaring noted. Oral mucosa pink and slightly dry. Moderate to severe suprasternal and substernal retractions. Bilateral wheezes in upper lobes throughout inspiration and expiration. Diminished breath sounds in bilateral bases. Frequent dry hacking cough when crying. 1200: Child currently asleep in parent's arms but rouses easily when touched. Oral mucosa pink and moist. No nasal flaring noted. Mid substernal retractions noted. Mild bilateral expiratory wheezes auscultated in upper lobes with breath sounds diminished in bilateral bases. No cough noted. Diagnostic Results 0900: Chest X-ray: Hyperinflation of lungs, no focal consolidation. Blood gas analysis: pH 7.35, PaCO2 45 mmHg, PaO2 60 mmHg, HCO3 24 mEq/L. 1200: Chest X-ray: No significant change from previous. Blood gas analysis: pH 7.38, PaCO2 42 mmHg, PaO2 75 mmHg, HCO3 24 mEq/L. Provider's Prescriptions 0900: Albuterol nebulizer treatment every 4 hours. Prednisolone 2 mg/kg/day PO divided into two doses. Oxygen therapy at 2 L/min via nasal cannula. IV fluids at maintenance rate. 1200: Continue Albuterol nebulizer treatment every 4 hours. Continue Prednisolone 2 mg/kg/day PO divided into two doses. Continue oxygen therapy at 2 L/min via nasal cannula. Continue IV fluids at maintenance rate.
Question 5 of 5
Which of the following findings should the nurse on the pediatric unit identify as an indication that the treatment plan is effective? (Select all that apply)
Correct Answer: C,D,F
Rationale:
Choice A: Nasal flaring is a sign of respiratory distress. The absence of nasal flaring indicates improvement.
Choice B: Retractions are a sign of respiratory distress. Their presence indicates ongoing distress.
Choice C: Oxygen saturation improvement (88% to 94%) indicates effective treatment.
Choice D: Decreased respiratory rate (40 to 32 breaths/min) shows reduced distress.
Choice E: Pulse rate is not a specific indicator of respiratory function.
Choice F: Improved breath sounds indicate better lung function.
Choice G: Heart rate is not a specific indicator of respiratory function.