PN Paediatrics Nursing 2023

ATI PN Paediatrics Nursing 2023

Total Questions : 64

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Question 1: View

A nurse is preparing to obtain the length and weight of a 6-month-old infant during a well-child visit. Which of the following actions should the nurse plan to take? (Select all that apply.)

Explanation

A. Covering the scale with a clean sheet of paper is unnecessary and does not affect the accuracy of the weight or length measurement.
B. Measuring the infant's length from the crown of the head to the heels of the feet is the correct method for obtaining length measurements in infants.
C. Placing a stadiometer on the top of the infant's head is incorrect; the measurement should be taken from head to heel.
D. Ensuring the scale is balanced to "0" before weighing the infant is essential for obtaining an accurate weight measurement.
E. Obtaining the infant's weight with their diaper on may add unnecessary weight, potentially affecting the accuracy of the weight measurement.


Question 2: View

A nurse is preparing to administer liquid ibuprofen to a school-age child. The prescription reads 200 mg every 8 hr. The amount available is 100 mg/5 mL. How many mL of ibuprofen should the nurse administer over a 24-hr period? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

To calculate the dosage of ibuprofen in milliliters for a 24-hour period, we start by determining the total milligrams required per day. Since the prescription is for 200 mg every 8 hours, the child will need three doses in 24 hours (200 mg x 3 = 600 mg). Next, we convert the total milligrams into milliliters using the concentration provided. The formula is: (Total mg needed / Concentration of mg) x Volume of each concentration = Total mL. Plugging in the numbers: (600 mg / 100 mg) x 5 mL = 30 mL.


Question 3: View

A nurse is reinforcing teaching with the parents of a 2-month-old infant who has gastroesophageal reflux. The parents are feeding the infant formula. Which of the following instructions should the nurse include in the teaching?

Explanation

A. Giving the infant a bottle immediately before bedtime is not recommended as it can increase the likelihood of reflux symptoms during sleep. It is better to have some time between feeding and sleeping to allow for digestion.
B. Keeping the infant at a 30° angle for 1 hr following each feeding helps to reduce the risk of reflux by using gravity to keep the stomach contents down. This position can aid in preventing the backflow of stomach contents into the esophagus.
C. Changing to a soy-based formula is not universally recommended for gastroesophageal reflux without a specific indication, such as a confirmed cow's milk protein allergy. It is important to follow a healthcare provider's specific recommendations regarding formula.
D. Limiting feedings to every 6 hours is not appropriate for a 2-month-old infant, who typically requires more frequent feedings to meet nutritional needs and maintain growth.


Question 4: View

A nurse is assisting with the care of a 15-year-old adolescent who has Streptococcus pneumonia.

Exhibits

The nurse is collecting data on the adolescent 24 hr later. How should the nurse interpret the findings?

For each finding, click to specify whether the finding is unrelated to the admitting diagnosis, an indication of potential improvement, or an indication of potential worsening condition.

Explanation

WBC count 17,000/mm3: Indication of Potential Improvement. The initial WBC count was 22,000/mm3, and 24 hours later, it has decreased to 17,000/mm3, indicating improvement.

Steatorrhea: Unrelated to Diagnosis. This symptom is typically associated with cystic fibrosis rather than pneumonia.

Oxygen saturation 95% on 1 L oxygen via nasal cannula: Indication of Potential Improvement. The decrease in oxygen requirement from 2 L to 1 L suggests the adolescent's respiratory status may be improving.

Barrel chest: Unrelated to Diagnosis. This physical finding is more indicative of chronic conditions such as cystic fibrosis rather than an acute pneumonia presentation.

Hemoptysis 300 mL: Indication of Potential Worsening Condition. The presence of significant hemoptysis indicates a worsening condition, possibly due to progression or complications of pneumonia.

Respiratory rate 32/min: Indication of Potential Improvement. The decrease in respiratory rate from 36/min to 32/min suggests a possible improvement in respiratory status.


Question 5: View

A nurse is collecting data from an adolescent who has hypocalcemia. Which of the following findings should the nurse expect?

Explanation

A. Tinnitus is not commonly associated with hypocalcemia. It is more often related to issues with the auditory system or certain medications.
B. Elevated blood pressure is not a typical sign of hypocalcemia. Hypocalcemia usually affects neuromuscular function rather than causing changes in blood pressure.
C. Constipation is not commonly linked to hypocalcemia. More frequent symptoms include neuromuscular irritability and spasms.
D. Muscle tremors are a common finding in hypocalcemia due to increased neuromuscular excitability. Hypocalcemia can lead to symptoms such as muscle cramps, spasms, and tremors due to the low levels of calcium affecting nerve and muscle function.


Question 6: View

A nurse in an emergency department is assisting in the care of a 13-year-old adolescent.

Exhibits

Complete the following sentence by using the lists of options. The nurse identifies the parent is having difficulty discussing the metastasis of the cancer with their adolescent. The nurse should 

and .

Explanation

In a sensitive and challenging situation such as this, the nurse should consult the child life specialist for guidance and reinforce teaching to the parent regarding the adolescent's potential emotional responses. The child life specialist is trained to support children and families during difficult medical experiences, providing them with the necessary tools to cope with the situation. Reinforcing teaching to the parent about the adolescent's potential emotional responses ensures that the parent is prepared to support their child's emotional well-being, fostering an environment of open communication and trust. This approach respects the family's needs and the adolescent's right to be informed, while also providing the support needed to navigate the complexities of a cancer diagnosis.


Question 7: View

A nurse in a clinic is assisting with the care of a 3-year-old toddler.

Exhibits

The nurse is reviewing the collected data.

For each finding, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than 1 disease process.

Explanation

Acute Laryngotracheobronchitis (Croup): This condition typically presents with a barking, seal-like cough and inspiratory stridor due to inflammation of the upper airway, often caused by a viral infection such as parainfluenza virus.

Pneumonia: While irritability and fever can be present in both conditions, the presence of stridor (especially inspiratory) is more characteristic of Acute Laryngotracheobronchitis. Pneumonia typically presents with a productive cough, fever, and signs of lower respiratory tract involvement such as crackles or decreased breath sounds on auscultation.


Question 8: View

A nurse is preparing to assist with the administration of scheduled medications for a school-age child.

Exhibits

Drag 1 medication and 1 child finding to fill in each blank in the following sentence. The nurse should clarify the child's prescription of

because of the child's .

Explanation

The nurse should clarify the child's prescription of dextrose 5% in 0.45% sodium chloride with 20 mEq potassium chloride/L at 75 mL/hr because of the child's laboratory values. The elevated potassium level of 6.2 mEq/L, which is above the normal range of 3.4 to 4.7 mEq/L, indicates hyperkalemia. Administering additional potassium could exacerbate this condition, therefore, it is crucial to review the prescription and adjust it accordingly to ensure the safety and well-being of the child.


Question 9: View

A nurse is assisting in the care of an 8-month-old infant.

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the infant is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters where the nurse should collect data to monitor the infant's progress.

Explanation

Potential Condition: Increased intracranial pressure

Actions to Take:

Measure head circumference: This action is important to monitor for signs of increasing intracranial pressure, as a bulging and tense fontanel suggests possible hydrocephalus or other intracranial pathology.

Plan to assist with administration of antibiotics: Antibiotics may be necessary if there is suspected meningitis or another infectious cause contributing to increased intracranial pressure.

Parameters to Monitor:

Behavioral changes: Monitor for irritability, difficulty to console, and other behavioral changes which can indicate neurological distress.

Pupillary response: Assess for changes in pupillary size and reactivity, as altered pupillary responses can indicate neurological involvement and increased intracranial pressure.


Question 10: View

A nurse is assisting with the care of a 5-month-old infant who was just admitted to the pediatric unit.

Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the infant.

Explanation

Continuous pulse oximetry: Anticipated because the infant has respiratory distress and requires continuous monitoring of oxygen saturation.

Chest x-ray: Anticipated to assess the extent of lung involvement due to the respiratory distress and wheezing noted.

Peripheral IV line: Anticipated since the peripheral line will be used to administer intravenous medications and fluids.

Supine position: Contraindicated because the infant prefers to sit upright and shows signs of respiratory distress, such as nasal flaring and retractions.

Small, frequent feedings: Anticipated to ensure adequate nutrition despite feeding difficulties.

Monitor intake and output: Anticipated to assess hydration status, especially since the infant has had decreased intake and output.


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