ATI LPN
ATI LPN Pediatrics Exam Questions
Extract:
Question 1 of 5
A nurse is contributing to the plan of care for a 5-week-old infant in the pediatric unit. The infant has been vomiting since week 2 of life and it has been progressively worse over the past 2 weeks. Parents report the vomiting is now forceful and projectile ('like a volcano erupting') immediately after every feeding, but the infant is eager to eat and seems to be constantly hungry. The infant has been receiving a cow's milk-based, iron-fortified formula since birth. The pediatrician reports the infant has not gained weight in the past 2 weeks. The last weight in the pediatrician's office is 3.54kg (8 lb). No other significant medical or surgical history. What condition is the client most likely experiencing and what actions should the nurse take to address that condition? What parameters should the nurse monitor to assess the client's progress?
Correct Answer: B
Rationale: Gastroesophageal Reflux Disease (GER
D) in infants is a condition where the stomach contents flow back into the esophagus causing discomfort. However, the symptoms described, such as projectile vomiting and constant hunger, are more consistent with Pyloric Stenosis. Pyloric Stenosis is a condition in infants where the opening from the stomach to the small intestine narrows, preventing food from entering the small intestine. The symptoms described by the parents, such as projectile vomiting after every feeding and constant hunger, align with this condition. The infant's lack of weight gain could be due to the fact that food is not being properly digested and absorbed. The nurse should refer the infant for a surgical consultation as the treatment for Pyloric Stenosis is usually surgical. The nurse should monitor the infant's weight and frequency of vomiting to assess the infant's progress. Lactose Intolerance in infants is a condition where the infant has difficulty digesting lactose, a sugar found in milk and dairy products. Symptoms can include gas, bloating, and diarrhea. However, the symptoms described by the parents do not align with this condition. Milk Protein Allergy in infants is a condition where the infant's immune system reacts negatively to the proteins in cow's milk. Symptoms can include hives, itching, wheezing, difficulty breathing, constipation, and bloody diarrhea. However, the symptoms described by the parents do not align with this condition.
Question 2 of 5
A nurse is caring for a school-age child who has a fracture to the right femur. Which of the following findings is the nurse's priority?
Correct Answer: B
Rationale: A 2+ right pedal pulse indicates a normal pulse and is not a cause for immediate concern in a child with a femur fracture. Tingling in the right foot could indicate nerve damage or compromised blood flow, which can be a serious complication of a femur fracture. This should be the nurse's priority as it could lead to long-term damage if not addressed promptly. A capillary refill time of less than 2 seconds is considered normal and is not a cause for immediate concern in a child with a femur fracture. A respiratory rate of 24/min is within the normal range for a school-age child and is not a cause for immediate concern in a child with a femur fracture.
Question 3 of 5
A nurse is caring for a toddler whose parent states that the child has a mass in his abdominal area and his urine is a pink color. Which of the following actions is the nurse's priority?
Correct Answer: B
Rationale: Schedule the child for an abdominal ultrasound. While an ultrasound may be necessary for further diagnosis, it is not the immediate priority. The child's symptoms suggest a possible Wilms' tumor, a type of kidney cancer that primarily affects children. An ultrasound can help confirm this diagnosis, but it should not be the first action. Instruct the parent to avoid pressing on the abdominal area. This is the correct answer. If the child has a Wilms' tumor, pressing on the abdominal area could potentially cause the cancer to spread.
Therefore, it is crucial to avoid any unnecessary pressure on the abdomen until further medical evaluation can be performed. Determine if the child is having pain. While assessing for pain is an important part of nursing care, it is not the immediate priority in this situation. The child's symptoms need urgent medical attention, and assessing for pain will not provide the necessary information to guide immediate care. Obtain a urine specimen for a urinalysis. Although a urinalysis can provide valuable information about a patient's health, it is not the immediate priority in this situation. The child's symptoms suggest a possible Wilms' tumor, which requires immediate medical attention. A urinalysis may be part of the diagnostic process, but it should not be the first action taken.
Question 4 of 5
A nurse working at a clinic speaks on the telephone with a parent of a 2-month-old infant. The parent tells the nurse that the infant has projectile vomiting followed by hunger after meals. Which of the following responses by the nurse is appropriate?
Correct Answer: A
Rationale: The symptoms described by the parent - projectile vomiting followed by hunger - could indicate a serious condition such as pyloric stenosis, which is a narrowing of the opening from the stomach to the small intestine. This condition can lead to severe dehydration and requires immediate medical attention. While burping can help to relieve gas and minor stomach discomfort, it would not address the underlying issue causing the projectile vomiting. This advice might be appropriate for a baby with simple colic or gas, but not for the symptoms described. While oral rehydrating solutions can help to replace lost fluids and electrolytes, they do not address the underlying cause of the projectile vomiting. Furthermore, if the baby is vomiting frequently, they may not be able to keep down the solution. Switching formulas can sometimes help babies who have allergies or intolerances to certain ingredients in their current formula. However, the symptoms described are not typical of a formula intolerance or allergy. Moreover, switching formulas without seeking medical advice can potentially lead to other complications.
Question 5 of 5
A nurse is collecting data from a child who has acute appendicitis. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: Bradycardia, or a slower than normal heart rate, is not typically associated with acute appendicitis. In fact, tachycardia, or a faster than normal heart rate, may occur due to the body's response to inflammation and infection. Hyperactive bowel sounds are not a typical finding in acute appendicitis. In fact, bowel sounds may be normal or decreased due to the inflammatory process. A white blood cell (WB
C) count of 17,000/mm is higher than the normal range, indicating the presence of an infection or inflammation in the body. This is a common finding in acute appendicitis. Pain from appendicitis is typically located in the right lower quadrant of the abdomen, not the left.