Review ATI Custom Pediatrics Comprehensive Exam

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ATI Custom Pediatrics Comprehensive Exam

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Total Questions : 58

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Question 1:

A nurse is teaching the parents of an infant with cerebral palsy on how to provide optimal care. What should the nurse include in the teaching?

A. Continue to offer a special formula to limit gagging B. Maintain immobility of the limbs with splints C. Preserve muscle tone to prevent joint contractures D. Focus on cognitive rather than motor skills.

Answer and Explanation

Choice A:

Continuing to offer a special formula to limit gagging is not a standard approach in the care of infants with cerebral palsy. The choice of formula should be based on the child's nutritional needs, and any feeding difficulties should be addressed by a healthcare professional.

Choice B:

Maintaining immobility of the limbs with splints is not recommended. Encouraging movement and mobility is important for the development and well-being of children with cerebral palsy.

Choice C:

Preserve muscle tone to prevent joint contractures.Cerebral palsy is a condition that can lead to problems with muscle tone and movement. Preserving muscle tone is important to prevent joint contractures, which can limit mobility and cause pain. Physical therapy and exercises can help maintain muscle tone and joint flexibility in children with cerebral palsy.

Choice D:

Focusing on cognitive rather than motor skills is not appropriate. Motor skills are a crucial aspect of development for children with cerebral palsy. The approach should encompass both cognitive and motor skill development as appropriate for the child's age and abilities.

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Question 2:

The nurse is planning care for an 18 month-old child. Which of the following should be included in the child's care?

A. Engage the child in games with other children B. Encourage the child to feed himself finger foods C. Allow the child to walk independently on the nursing unit D. Hold and cuddle the child often

Answer and Explanation

Choice A:

Engaging the child in games with other children is important for social development, but it depends on the child's individual readiness and comfort level with social interactions. It's crucial to consider the child's temperament and developmental stage.

Choice B:

Encourage the child to feed himself finger foods.At 18 months of age, children are typically developing their fine motor skills and independence. Encouraging self-feeding with finger foods is a developmentally appropriate activity. It promotes independence, fine motor skill development, and a positive feeding experience.

Choice C:

Allowing the child to walk independently on the nursing unit is appropriate if the child is developmentally ready and safe to do so. It promotes gross motor skill development and independence.

Choice D:

Holding and cuddling the child often is important for emotional and social development. However, the frequency and style of interaction should be individualized based on the child's preferences and needs. Some children may prefer more independence at this age.

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Question 3:

The nervous parent asks when the big "soft spot" (anterior fontanel) will be closed. The nurse's most informative response would be

A. That big soft spot will be covered in bone by the end of the second month B. "The big soft spot will close at around 24 months of age C. "The big soft spot is usually closed between 12 and 18 months of age D. "Babies' saft spots close at different times depending on their growth rate

Answer and Explanation

Choice A:

"That big soft spot will be covered in bone by the end of the second month" is not accurate. The closure usually occurs later than the second month.

Choice B:

"The big soft spot will close at around 24 months of age" is an overestimation of the typical closure time. It is usually closed earlier than 24 months.

Choice C:

"The big soft spot is usually closed between 12 and 18 months of age."The anterior fontanel is the soft spot located on the baby's head, and its closure is a natural part of an infant's development. The timing of closure can vary from one child to another. However, the typical range for the closure of the anterior fontanel is between 12 and 18 months of age. This information provides a general guideline for parents while acknowledging the natural variability in child development.

Choice D:

"Babies' soft spots close at different times depending on their growth rate" is true to some extent, but providing a general range (option C) is more informative for parents.

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Question 4:

A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?

A. Positive Western blot test B. CD4-T-cell count 180 cells/mm C. Platelets 150,000/mm D. WBC 5.000/mm³

Answer and Explanation

Choice A:

Positive Western blot test: A positive Western blot test confirms HIV infection but doesn't provide information about the current immune status or progression of the disease.

Choice B:

CD4-T-cell count 180 cells/mm³.The CD4-T-cell count is a crucial indicator of a person's immune system function, and it's a primary marker used to monitor the progression of HIV infection. A CD4 count of 180 cells/mm³ is significantly below the normal range (which is typically higher), indicating immunosuppression and an increased risk of opportunistic infections. Maintaining and improving immune function is a top priority in the care of clients with HIV.

Choice C:

Platelets 150,000/mm³: Platelet counts are important, but they are not the primary indicator for assessing the progression of HIV.

Choice D:

WBC 5.000/mm³: The white blood cell count (WBC) is important for assessing overall immune function, but it doesn't provide the same specific information about the immune system status as the CD4-T-cell count.

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Question 5:

A 16-year-old has been admitted to the hospital for advanced osteosarcoma with metastasis to the lungs. His prognosis is poor. He is continuing to require oxygen and needs to remain in the hospital for monitoring. The adolescent is very frustrated and states that he doesn't want to stay in the hospital and wants to be with his friends. Which of the following is the best option?

A. Explain to the teenager that he is lucky to receive such good care at a specialty hospital and he just needs to be patient B. Arrange for the teenager to have a video conference with his teacher and ensure he has his school work available C. Ask the child-life specialist to help find activities to distract the teenager D. Arrange a multi-disciplinary team meeting, including the teenager and his family to discuss the situation and set goals together

Answer and Explanation

Choice A:

Explaining to the teenager that he is lucky to receive good care does not address his emotional and social needs adequately and may minimize his feelings.

Choice B:

Arranging for a video conference with his teacher and ensuring schoolwork is available is important but does not address his desire to be with friends or his emotional needs.

Choice C:

Asking the child-life specialist to help find activities to distract the teenager can be helpful for providing emotional support but may not address his concerns about being with friends and feeling frustrated.

Choice D:

Arrange a multi-disciplinary team meeting, including the teenager and his family, to discuss the situation and set goals together.In this challenging situation, it's important to involve the patient and their family in decision-making and goal-setting. Advanced osteosarcoma with metastasis to the lungs is a serious and potentially terminal illness. The teenager's feelings and wishes should be respected and taken into consideration. A multi-disciplinary team meeting allows for open communication, including the patient, family, healthcare providers, and specialists, to discuss the situation, the patient's preferences, and the overall care plan.

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Question 6:

A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following at the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?

A. Vary the child's schedule each day. B. Provide a daily session with a play therapist. C. Encourage the client to complete school work D. Discourage visits from the client's friends

Answer and Explanation

Choice A:

Varying the child's schedule each day may add unnecessary stress and disrupt the child's sense of routine and stability, which is important during a hospitalization.

Choice B:

Providing a daily session with a play therapist may be valuable but does not directly address the child's developmental need for competence and mastery.

Choice C:

Encourage the client to complete school work.Erikson's psychosocial stage theory suggests that children at the age of 10 are in the "Industry vs. Inferiority" stage. During this stage, children strive to develop a sense of competence and mastery in various activities. Encouraging the child to complete school work aligns with this stage, as it fosters a sense of accomplishment, competence, and success, which is crucial for their psychosocial development.

Choice D:

Discouraging visits from the client's friends would not support the child's social and emotional well-being during the hospitalization, and social connections are important for psychosocial development.

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Question 7:

Which would the nurse assess in a child diagnosed with osteomyelitis? Select all that apply.

A. Fever B. Unwillingness to move affected extremity. C. Previous closed fracture of an extremity D. Redness and swelling at the site E. Severe pain

Answer and Explanation

Choice A:

Fever: Osteomyelitis is often associated with fever as it is an infectious process that can cause an elevated body temperature.

Choice B:

Unwillingness to move the affected extremity: Children with osteomyelitis may experience pain and discomfort, leading to a reluctance to move the affected limb.

Choice C:

A previous closed fracture of an extremity is not typically a direct assessment finding for osteomyelitis. Osteomyelitis is more commonly associated with infections that can spread to the bone, and a previous fracture may not always be present.

Choice D:

Redness and swelling at the site: Osteomyelitis can cause local inflammation, leading to redness and swelling at the affected area.E. Severe pain: Pain is a common symptom of osteomyelitis, and it can be severe, leading to the child's unwillingness to move the affected extremity.

Choice E:

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Question 8:

Which action should the nurse take when providing postoperative nursing care to a child after insertion of ventriculoperitone (VP) shunt?

A. Check the urine for glucose and protein B. Administer narcotics for pain control C. Test cerebrospinal (CSP) fluid leakage for protein D. Monitor for increased temperature

Answer and Explanation

Choice A:

Checking urine for glucose and protein is not directly related to the care of a child with a VP shunt. The focus is on monitoring the child for signs of complications related to the shunt.

Choice B:

Administering narcotics for pain control may be indicated if the child is in pain, but it is not the primary action and should be determined based on the child's pain assessment.

Choice C:

Testing cerebrospinal (CSF) fluid leakage for protein is not typically a nursing responsibility in the immediate postoperative period. Leakage of CSF should be reported to the healthcare provider, and diagnostic tests would be conducted by medical staff as needed.

Choice D:

Monitor for increased temperature.Monitoring for an increased temperature is essential because postoperative fever could be an early sign of infection or complications related to the VP shunt. Infection and shunt malfunction are potential risks in the postoperative period.

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Question 9:

A nurse is preparing to administer levothyroxine 0.175 mg PO once a day. The amount available is levothyroxine 88 mcg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)

Answer and Explanation

Correct Answer: "2" tablets

Explanation

To calculate the number of tablets to administer, you need to convert the dose to micrograms (mcg) to match the tablet strength:

0.175 mg is equivalent to 175 mcg (since 1 mg = 1000 mcg).

Now, divide the required dose (175 mcg) by the strength of the available tablets (88 mcg/tablet):

175 mcg ÷ 88 mcg/tablet ≈ 1.9886

Rounding to the nearest whole number, you should administer 2 tablets per dose.

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Question 10:

The nurse anticipates that there will be two classic hematologic characteristics in the blood chemistry of a child with nephrotic syndrome which are: (Select all that apply.)

A. Anemia B. Hypolipidemia C. Hyperipidemia D. Hypoproteinemia E. Hypoglycemia

Answer and Explanation

Choice A:

Anemia: Anemia is not a classic hematologic characteristic of nephrotic syndrome. Anemia may occur in other medical conditions or as a secondary effect of chronic kidney disease.

Choice B:

Hypolipidemia: Nephrotic syndrome often leads to the loss of lipids in the urine, resulting in low levels of lipids (such as cholesterol) in the blood.

Choice C:

Hyperlipidemia: Nephrotic syndrome is associated with hypolipidemia, not hyperlipidemia.

Choice D:

Hypoproteinemia: Nephrotic syndrome is characterized by significant protein loss in the urine, leading to low levels of protein in the blood, including low levels of albumin.E. Hypoglycemia: Hypoglycemia is related to low blood sugar levels and is not a classic hematologic characteristic of nephrotic syndrome.

Choice E:

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ATI Custom Pediatrics Comprehensive Exam

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