RN ATI Pediatric Nursing Proctored Exam with NGN 2023 -Nurselytic

Questions 60

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RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions

Extract:


Question 1 of 5

A nurse is preparing to measure the temperature of an infant. Which of the following actions should the nurse take?

Correct Answer: B

Rationale:
Correct Answer: B - Place the tip of the thermometer under the center of the infant's axilla.


Rationale: The axillary temperature is a common method for measuring an infant's temperature. Placing the thermometer under the center of the axilla ensures an accurate reading without causing discomfort or harm to the infant.

Incorrect

Choices:
A: Pulling the pinna of the infant's ear forward before inserting the probe is not necessary for measuring temperature.
C: Inserting the probe 3.8 cm (1.5 in) into the infant's rectum is invasive and not appropriate for routine temperature measurement.
D: Inserting the oral thermometer in front of the infant's tongue is incorrect as oral thermometers are not suitable for infants due to the risk of choking.

Question 2 of 5

A nurse is caring for a 1-month-old infant who has manifestations of severe dehydration and a prescription for parenteral fluid therapy. The guardian asks, 'What are the indications that my baby needs an IV?' Which of the following responses should the nurse make?

Correct Answer: A

Rationale: The correct response is A: Your baby needs an IV because she is not producing tears. In infants, the inability to produce tears is a sign of severe dehydration, indicating a deficit in body fluids. Tears are composed of water and electrolytes, and the absence of tears suggests a significant fluid imbalance. This makes it crucial to administer parenteral fluid therapy via an IV to restore hydration levels.



Choices B, C, and D are incorrect because they do not directly correlate with the need for IV fluid therapy in this scenario. A decreased heart rate, slower breathing, and bulging fontanels may be signs of distress or other issues but do not specifically indicate the need for immediate IV fluid administration due to dehydration.
Therefore, option A is the most appropriate and relevant response given the infant's presentation of severe dehydration.

Question 3 of 5

A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit. Which of the following actions should the nurse take?

Correct Answer: A

Rationale: The correct answer is A: Assign the child to a negative air pressure room. Varicella (chickenpox) is highly contagious and spreads through airborne particles. Placing the child in a negative air pressure room helps prevent the spread of the virus to other patients and staff. Administering aspirin to a child with varicella can lead to Reye's syndrome, making choice B incorrect. Droplet precautions are used for illnesses like influenza or pertussis, not varicella, so choice C is incorrect.
Choice D is incorrect because the characteristic rash in varicella is not described as health spots.

Question 4 of 5

A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit. Which of the following actions should the nurse take?

Correct Answer: A

Rationale: The correct answer is A: Assign the child to a negative air pressure room. Varicella, commonly known as chickenpox, is highly contagious and spreads through respiratory droplets. Placing the child in a negative air pressure room helps prevent the spread of the virus to others by containing the infectious particles within the room. This isolation measure is crucial in protecting both the child and other patients.


Choice B is incorrect because aspirin should not be administered to children with varicella due to the risk of Reye's syndrome.
Choice C is incorrect as droplet precautions are not necessary for varicella, which primarily spreads through airborne respiratory droplets.
Choice D is incorrect as Koplik spots are associated with measles, not varicella.

Question 5 of 5

A nurse is planning care for a toddler who has epiglottitis. Which of the following interventions should the nurse include?

Correct Answer: C

Rationale: The correct answer is C: Initiate droplet precautions. Epiglottitis is a serious condition that involves inflammation of the epiglottis, which can lead to airway obstruction. Droplet precautions are necessary to prevent the spread of infection, as epiglottitis is usually caused by a bacterial infection. Offering a high-calorie, high-protein diet (choice
A) is not the priority in the acute phase of epiglottitis. Administering pancreatic enzymes with meals (choice
B) is unrelated to the care of a toddler with epiglottitis. Carefully suctioning the child's oropharynx to remove secretions (choice
D) can potentially worsen the condition by triggering a gag reflex and causing further airway obstruction.

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