Questions 64

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ATI RN Pediatric Nursing 2023 II Questions

Extract:

Exhibit 2 Nurses' Notes 0730: Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted. 0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, nonproductive cough present.


Question 1 of 5

For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process.

Finding Acute Laryngotracheobronchitis pneumonia
Irritability
Temperature
Cough findings at 0800
Stridor

Correct Answer: A,B,C,D

Rationale: A. This finding is consistent with both acute laryngotracheobronchitis and pneumonia, as both conditions can cause discomfort and distress in children. B. Fever can be present in both acute laryngotracheobronchitis and pneumonia as they are both infections of the respiratory tract. C. This finding is more consistent with acute laryngotracheobronchitis than pneumonia, as acute laryngotracheobronchitis is characterized by a barking, non-productive cough that worsens at night or with agitation. D. This finding is more consistent with acute laryngotracheobronchitis than pneumonia, as acute laryngotracheobronchitis causes inflammation and narrowing of the upper airway, leading to a high-pitched sound during inhalation.

Extract:


Question 2 of 5

A nurse is preparing to perform a venipuncture on a 4-year-old child. Which of the following actions should the nurse take to ensure atraumatic care?

Correct Answer: C

Rationale: Asking the child's parent to leave the room during the procedure may increase the child's anxiety and make the procedure more traumatic. Performing the procedure in the unit's playroom may not provide the necessary equipment and sterile environment required for a venipuncture. Applying a topical anesthetic cream helps reduce pain and discomfort during the venipuncture, promoting atraumatic care. Explaining the procedure in detail to the child 3 hours prior to the procedure may increase anxiety and anticipation, making the procedure more traumatic.

Question 3 of 5

A nurse is teaching the parent of an infant who has a new diagnosis of heart failure about nutrition. Which of the following instructions should the nurse include in the teaching?

Correct Answer: C

Rationale: Allowing the infant to cry before feeding increases energy expenditure and may worsen fatigue in infants with heart failure. A recumbent position can increase the risk of aspiration; a semi-upright position is preferred. Implementing a 3-hour feeding schedule ensures the infant receives adequate nutrition without excessive fatigue. Feedings should be limited to 30 minutes to prevent excessive energy expenditure.

Question 4 of 5

A nurse is providing teaching to the parents of a school-age child newly diagnosed with a seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure?

Correct Answer: B

Rationale: Placing the child in a prone position can obstruct the airway and increase the risk of aspiration. Clearing the area of hard objects helps prevent injury during a seizure. Inserting a tongue blade between the teeth can cause oral trauma and should be avoided. Minimizing movement of the limbs is not necessary during a seizure; the focus should be on ensuring safety and preventing injury.

Question 5 of 5

A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?

Correct Answer: A

Rationale: The nurse should weigh the child once per day, preferably in the morning and using the same scale and clothing, to monitor fluid status and response to treatment. Weight is the most accurate indicator of fluid balance in children with nephrotic syndrome. Positioning the child supine at bedtime is not specifically indicated for the acute stage of nephrotic syndrome. This can worsen edema and respiratory distress. Limiting calorie intake to 45 cal/kg/day is too low and can cause malnutrition and growth failure. Increasing fluid intake to 2 L/day is contraindicated in a child with nephrotic syndrome, as it can exacerbate edema and fluid overload.

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