ATI LPN
ATI LPN Pediatrics II Questions
Extract:
Question 1 of 5
The nurse is caring for a hospitalized child newly diagnosed with type 1 diabetes mellitus. At 1100, the child suddenly complains of weakness, headache, and blurred vision. How would the nurse respond?
Correct Answer: A
Rationale: Give the child 1â„2 cup of orange juice to drink. These symptoms indicate hypoglycemia, a common early complication of diabetes treatment. Orange juice contains quick-acting sugars that can rapidly raise blood glucose levels and alleviate symptoms. This is the immediate action to manage the child's symptoms. Call the dietary department and ask that the lunch tray be delivered early. Delayed action compared to treating the immediate hypoglycemia. Contact the physician. While eventually necessary, immediate treatment of hypoglycemia takes precedence. Obtain a blood glucose reading. Important to confirm hypoglycemia but not as urgent as providing immediate treatment.
Question 2 of 5
A nurse working at a clinic speaks on the telephone with a parent of a 2-month-old infant. The parent tells the nurse that the infant has projectile vomiting followed by hunger after meals. Which of the following responses by the nurse is appropriate?
Correct Answer: C
Rationale: Give your infant an oral rehydration solution.' While rehydration is important, projectile vomiting could indicate a more serious underlying issue that needs medical evaluation. 'You might want to try switching to a different formula.' Formula intolerance is less likely to cause projectile vomiting. A change in formula should not be suggested without ruling out more serious conditions first. 'Bring your infant into the clinic today to be seen.' Projectile vomiting in an infant, especially when followed by hunger, can indicate pyloric stenosis, a condition that requires prompt medical evaluation. The infant should be seen by a healthcare provider to determine the cause and initiate appropriate treatment. 'Burp your child more frequently during feedings.' Burping can help with regular gas and minor feeding issues, but it is unlikely to resolve projectile vomiting.
Question 3 of 5
What is an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome?
Correct Answer: C
Rationale: Keep edematous areas moist and covered. Keeping edematous areas moist and covered can worsen edema by trapping moisture and heat, leading to increased swelling. Reach the child to minimize body movement. Minimizing body movement is not appropriate as it can lead to muscle weakness and stiffness. Encouraging gentle movement and position changes is beneficial. Change the child's position frequently. Changing the child's position frequently helps prevent complications such as pressure ulcers and improves circulation, which can aid in reducing edema. Keep the head of the child's bed flat. Elevating the head of the bed can help reduce edema by promoting venous return and reducing fluid accumulation in dependent areas.
Question 4 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 5 of 5
A nurse is assisting with the admission of a 2-year-old toddler who has acute gastroenteritis. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: Initiate isotonic fluids with 20 mEq/L potassium chloride. The priority in treating acute gastroenteritis in a toddler is to manage dehydration, which is often severe due to fluid loss from vomiting and diarrhea. Isotonic fluids with electrolytes like potassium chloride help to restore fluid balance and prevent complications like electrolyte imbalances. This is the most urgent action to stabilize the child's condition. Request evaluation of the toddler's serum electrolytes. While important, this can be done after fluid resuscitation has begun to assess the severity of electrolyte imbalances. Determine if the toddler is voiding. Important for assessing renal function, but not the first priority in acute gastroenteritis. Collect a stool sample from the toddler. Useful for identifying the causative organism but not as urgent as fluid resuscitation.