ATI RN
ATI Nur223g Pediatrics Sect 2 Final Exam Questions
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 1 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.
Extract:
A child who is in sickle cell crisis.
Question 2 of 5
A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: Pain is the most common and significant symptom of a sickle cell crisis, caused by the obstruction of blood flow by sickled red blood cells, leading to ischemia and severe pain. This requires immediate attention and pain management.
Extract:
A 15-month-old toddler.
Question 3 of 5
A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?
Correct Answer: C
Rationale: By 15 months, a toddler should be able to stand upright without support. Failure to do so could indicate a delay in motor development.
Extract:
A school-age child who has a new diagnosis of type 1 diabetes mellitus.
Question 4 of 5
A nurse is providing teaching to a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching?
Correct Answer: D
Rationale: Eating a snack before physical activity is crucial to prevent hypoglycemia, especially in a child with type 1 diabetes. This response shows an understanding of managing blood glucose during exercise.
Extract:
A school-aged child with sickle-cell anemia.
Question 5 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.