ATI RN
ATI Nur223g Pediatrics Sect 2 Final Exam Questions
Extract:
A school-age child who has type 1 diabetes mellitus.
Question 1 of 5
A nurse is teaching a school-age child who has type 1 diabetes mellitus and his parents about illness management. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: Testing urine for ketones is crucial during illness because it helps in early detection of diabetic ketoacidosis, which can be life-threatening.
Extract:
A 13-year-old client with right lower quadrant abdominal pain, nausea, and fever. Client reports pain around belly button the previous evening, now in right lower quadrant. Abdomen soft with tenderness to palpation in right lower quadrant. Verbalizes increase in pain when right hip is flexed and rotated internally. Rates pain as 6 on a 0 to 10 pain scale. Client reports increase in right lower quadrant pain, rating pain as 9 on a 0 to 10 pain scale. Vomits 50 ml gastric contents into basin. WBC count 22,000/mm3, C-Reactive Protein 1.8 mg/dL.
Question 2 of 5
A nurse in the emergency department (ED) is caring for a 13-year-old client who presented with right lower quadrant abdominal pain, nausea, and fever. The nurse has notified the provider of the client's 0700 assessment data and lab results. Which of the following prescriptions should the nurse anticipate? (Select all that apply.)
Correct Answer: A,B,E,F
Rationale: Given the client's symptoms and elevated WBC count indicating a possible infection, IV antibiotics are anticipated. Maintaining NPO status is necessary for potential surgery. Informed consent is required for surgical procedures like appendectomy. An abdominal ultrasound helps confirm appendicitis.
Extract:
A school-aged child with sickle-cell anemia.
Question 3 of 5
The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child's diagnosis?
Correct Answer: C
Rationale: Slightly yellow sclera (jaundice) is consistent with sickle-cell anemia due to the breakdown of red blood cells, which can lead to an increased level of bilirubin.
Extract:
An infant whose guardian reports intermittent vomiting for several days. Guardian reports infant has been forcefully vomiting after feedings. Infant is very fussy and rooting and sucks vigorously on a pacifier. Axillary temperature: 38.2° C (100.8° F), Heart rate: 152/min, Respiratory rate: 30/min. Mucus membranes are dry. Anterior fontanel depressed and soft. Small amount of urine noted in the diaper, dark in color. Upper portion of the abdomen is distended. Palpable olive-shaped mass noted in the right mid-abdominal region. Ultrasound shows a mass that encircles the pyloric canal consistent with hypertrophic pyloric stenosis.
Question 4 of 5
A nurse is caring for an infant whose guardian reports intermittent vomiting for several days. Which of the following actions should the nurse take? (Select all that apply)
Correct Answer: B,C,D
Rationale: Measuring head circumference monitors for increased intracranial pressure due to dehydration. Weighing the infant assesses weight loss from vomiting. Monitoring intake and output manages hydration status.
Extract:
Received 4-year-old child with an exacerbation of heart failure. Family reports history of congenital mitral stenosis. Breath sounds with wheezing noted in bilateral lower lobes. Nonproductive cough noted. Dyspnea with respiratory rate 30/min. Oxygen at 2 L/min applied per nasal cannula. Telemetry applied: Sinus rhythm @rate 116/min. Abdomen soft, nontender. Bowel sounds positive all 4 quadrants. Lower extremities with 2+ edema noted. Pedal pulses palpable bilaterally. Peripheral saline lock intact to right forearm with no signs and symptoms of infection, Weight 20 kg (44 lb). Increase in dyspnea noted with orthopnea. Nasal flaring with respiratory rate of 36/min. Lung sounds with wheezing noted throughout. Lower extremity edema 3+ to bilateral lower extremities. Extremities cool with decreased skin pigmentation noted. Peripheral pulses weak bilateral. Jugular vein distention noted. Furosemide 40 mg IV every 6 hr. Administered at 1755. Give digoxin 250mcg IV now. Administered at 1800. Give digoxin 125 mcg 12 hr after initial dose. Administered at 0608. Give digoxin 125 mcg 12 hr after second dose. Administered at 1804. Furosemide 10 mg IV now. Administered at 2020.
Question 5 of 5
A nurse on a cardiac care unit is caring for a preschooler. The client is at risk for developing and
Correct Answer: A,C
Rationale: The child has been administered digoxin, a cardiac glycoside, multiple times. Digitalis toxicity is a risk due to the narrow therapeutic window of digoxin and the potential for adverse effects, especially if there are signs of worsening heart failure or electrolyte imbalances. The administration of furosemide, a loop diuretic, increases the risk of hypokalemia (low potassium levels), which can exacerbate the risk of digitalis toxicity.