ATI LPN
ATI LPN Pediatrics II Questions
Extract:
Question 1 of 5
The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?
Correct Answer: B
Rationale: Require that the child have antibiotic coverage. This answer is incorrect because immunizations do not typically require antibiotic coverage. Should be delayed. Prednisone can suppress the immune response, potentially reducing the effectiveness of vaccines.
Therefore, immunizations should be delayed until the child has completed the course of prednisone and their immune system has recovered. Can interfere with the treatment for nephrosis. While prednisone can be part of nephrotic syndrome treatment, immunizations are not known to interfere directly with this treatment. Can be given in smaller, divided doses. This answer is incorrect because the issue isn't about the size or frequency of the vaccine doses but rather about the timing relative to the child's immunosuppressive treatment.
Question 2 of 5
A nurse is contributing to the plan of care for a child who has sickle cell crisis. Which of the following actions should the nurse recommend to include?
Correct Answer: D
Rationale: Apply cold compresses to the affected areas. Cold can cause vasoconstriction, which may worsen the sickling and pain. Heat packs are generally recommended to promote circulation and relieve pain. Implement pain management on a PRN basis. Pain management should be consistent and proactive rather than PRN (as needed). Regular pain control is essential in managing sickle cell crises. Active range-of-motion (ROM) exercises daily. During a crisis, the child should rest and avoid physical activity to prevent further pain and complications. ROM exercises are more appropriate during non-crisis times for maintaining joint function. Promote hydration with IV and oral fluids. Hydration is crucial during a sickle cell crisis as it helps to decrease blood viscosity, reducing the risk of further sickling and vaso-occlusive events.
Question 3 of 5
A nurse is assisting in the care of 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,E
Rationale: A. Measure the infant's head circumference. Measuring head circumference is a standard part of routine well-child exams and growth monitoring, but it is not directly relevant to the current diagnosis of hypertrophic pyloric stenosis. The immediate clinical focus is on the gastrointestinal symptoms and associated dehydration. B. Weigh the infant. Weighing the infant is crucial for monitoring weight loss and assessing hydration status. Infants with hypertrophic pyloric stenosis are at risk of dehydration and malnutrition due to frequent, forceful vomiting. Regular weight checks help in evaluating the effectiveness of treatment and the nutritional status of the infant. C. Monitor intake and output. Monitoring intake and output is vital in this scenario to assess the infant's hydration status and kidney function. Given the forceful vomiting, there's a high risk of dehydration, as indicated by the dry mucous membranes, depressed fontanel, and reduced urine output. Accurate measurement helps guide fluid replacement therapy. D. Offer small frequent feedings of thickened liquids. Offering feedings, even of thickened liquids, is inappropriate in this situation because the infant requires surgical intervention for pyloric stenosis. Continued feeding may exacerbate vomiting and dehydration. Instead, the infant should be kept NPO (nothing by mouth) to prepare for surgery and prevent further complications. E. Evaluate serum electrolyte levels: Infants with hypertrophic pyloric stenosis often develop electrolyte imbalances such as hypokalemia, hypochloremia, and metabolic alkalosis due to prolonged vomiting. Evaluating serum electrolytes is essential to identify and correct these imbalances, which are critical to stabilizing the infant before surgical intervention. F. Plan to administer a plain water enema. A plain water enema is not indicated and is inappropriate for treating hypertrophic pyloric stenosis. The issue is not related to bowel movements or lower gastrointestinal obstruction, but rather to the pyloric sphincter in the stomach, which requires surgical correction. G. Implement contact precautions. Contact precautions are typically used to prevent the spread of infectious diseases. Hypertrophic pyloric stenosis is not an infectious condition but a structural anomaly. Thus, there is no need for contact precautions in this context.
Question 4 of 5
A nurse is reinforcing teaching with 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: C
Rationale: Test the urine for ketones. While testing for ketones can be part of illness management in diabetes, it is not as immediate an action as contacting a healthcare provider when blood glucose levels are very high. Withhold insulin dose if feeling nauseous. Insulin should not be withheld due to nausea. It is important to maintain insulin to control blood glucose levels even when feeling unwell. Adjustments to insulin may be necessary based on blood glucose levels and food intake. Notify the provider if blood glucose levels are over 350 mg/dL. Blood glucose levels over 350 mg/dL are concerning and may indicate the need for medical intervention to prevent complications like diabetic ketoacidosis. The healthcare provider should be notified. Limit fluid intake during meal time. Adequate fluid intake is important, especially when blood glucose levels are high, to help prevent dehydration and facilitate glucose clearance. Limiting fluids is not appropriate.
Question 5 of 5
A nurse is reinforcing teaching with the guardian of a child who has a urinary tract infection. Which of the following instructions should the nurse include? SELECT ALL THAT APPLY
Correct Answer: A,B,E
Rationale: A. Empty bladder completely with each void: Ensuring the bladder is completely emptied helps to reduce the risk of residual urine, which can promote bacterial growth and increase the risk of UTIs. B. Avoid bubble baths: Bubble baths can irritate the urethra and promote bacterial growth, increasing the risk of UTIs. Avoiding them helps in prevention. C. Increase fiber intake: Increasing fiber intake is not directly related to UTI prevention and is more relevant to digestive health. D. Wear nylon underpants: Nylon underpants can trap moisture and create a warm environment that supports bacterial growth. Cotton underwear is recommended instead. E. Watch for manifestations of infection: Being vigilant for signs of infection such as fever, pain, or changes in urination patterns is crucial for early detection and treatment of UTIs.