Review ATI Pediatrics Exam NURS 243 Spring 2014

Exam Review

ATI Pediatrics Exam NURS 243 Spring 2014

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Total Questions : 48

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Question 1:

.The school-based nurse is working with the local school district to promote health and wellness in a school with a large proportion of minority and underprivileged students.
Which of the following will be included in the planning? Select all that apply.

A. Adding a school breakfast program. B. Reducing saturated fat in the school lunch offering. C. Calorically sweetened beverages. D. Making fruits or vegetables available with all meals. E. Offering after school physical fitness activities.

Answer and Explanation

Choice A:

Adding a school breakfast program is a crucial step in promoting health and wellness in schools. It ensures that all students, regardless of their socioeconomic status, start their day with a nutritious meal. This can improve their concentration, cognitive function, and academic performance.

Choice B:

Reducing saturated fat in the school lunch offering is another important measure. High intake of saturated fats is associated with increased risk of heart disease and obesity. By offering meals low in saturated fats, schools can help instill healthy eating habits in students.

Choice C:

Calorically sweetened beverages are not recommended for inclusion in school health and wellness programs. These beverages are high in sugar and can contribute to obesity, tooth decay, and other health problems.

Choice D:

Making fruits or vegetables available with all meals is a key part of a balanced diet. They provide essential vitamins, minerals, and dietary fiber, and their consumption can help prevent chronic diseases.

Choice E:

Offering after-school physical fitness activities can help students meet the recommended levels of physical activity, improve their physical fitness, and reduce the risk of obesity. These activities also provide opportunities for social interaction and skill development.

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Question 2:

.A nurse is teaching parents of a 10-month-old infant about home safety.
Which of the following information should the nurse include in the teaching? Select all that apply.

A. Keep plastic bags and plastic grocery bags in a secure place. B. Serve food in small pieces no larger than a cheerio. C. Lower the crib rails to the lowest level. D. Set the water heater to 65°C. E. Use plastic covers on all electrical outlets.

Answer and Explanation

Choice A:

Keep plastic bags and plastic grocery bags in a secure place. Plastic bags pose a choking hazard for young children who can easily put them over their heads and suffocate.

Choice B:

Serve food in small pieces no larger than a cheerio. This reduces the risk of choking, as infants have limited chewing ability and can easily swallow large pieces of food whole.

Choice C:

Lower the crib rails to the lowest level. While lowering the crib rails might seem convenient, it actually increases the risk of the infant climbing out and potentially falling and injuring themselves. Crib rails should be kept at the highest level possible once the infant can sit up on their own.

Choice D:

Set the water heater to 65°C (149°F). This temperature is scalding hot and can cause severe burns in infants. The recommended safe water heater temperature is 120°F (48.9°C) or lower to prevent accidental scalding.

Choice E:

Use plastic covers on all electrical outlets. This prevents the infant from sticking fingers or objects into the outlet, which could lead to electrical shock.

However, the following information is incorrect and should not be included:

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Question 3:

.A 3-year-old child is admitted to a pediatric unit with moderate dehydration.
The nurse would expect to see which of the following assessment findings in this child?

A. Pulse of 160, oliguria, sunken fontanels, and an admission weight of 30 lbs. B. Pulse of 180, furrowed tongue, mottled skin, and an admission weight of 28 lbs. C. Pulse of 120, dry mucous membranes, pale, and an admission weight of 30.2 lbs. D. Pulse of 150, poor skin turgor, oliguria, and an admission weight of 29.5 lbs.

Answer and Explanation

Choice A:

A: A pulse of 160 is slightly elevated for a 3-year-old (normal range is 90-140 bpm), but not significantly so. Oliguria (decreased urine output) is a common sign of dehydration. However, sunken fontanels are typically seen in infants with severe dehydration and not necessarily present in moderate cases. An admission weight of 30 lbs is irrelevant for assessing dehydration.

Choice B:

B: A pulse of 180 is significantly elevated and suggests potential tachycardia, which can be a sign of severe dehydration or other underlying conditions. While a furrowed tongue can occur with dehydration, it's not specific enough. Mottled skin can be caused by various factors and isn't a definitive sign of moderate dehydration. Admission weight alone isn't indicative of dehydration.

Choice C:

C: A pulse of 120 is within the normal range for a 3-year-old. Dry mucous membranes are a common sign of dehydration. However, pale skin can be caused by various factors and isn't specific to dehydration. Admission weight alone isn't indicative of dehydration.

Choice D:

D: A pulse of 150 is slightly elevated, potentially indicating dehydration or other factors. Poor skin turgor is a key assessment finding in moderate dehydration. It refers to the skin's slow return to its original shape after being pinched, indicating a lack of fluid. Oliguria is a common sign of dehydration, suggesting decreased fluid intake or output. An admission weight of 29.5 lbs might be slightly lower than the child's baseline weight due to dehydration, but weight alone shouldn't be used to diagnose dehydration. Therefore, considering the combination of a slightly elevated pulse, poor skin turgor, oliguria, and a potential decrease in weight, choice D presents the most likely assessment findings in a child with moderate dehydration. It's important to remember that a comprehensive assessment, including history, physical examination, and potentially laboratory tests, is crucial for diagnosing and classifying the severity of dehydration in children.

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Question 4:

.A nurse is caring for a child with asthma who is prescribed to use an albuterol inhaler with a spacer. The parents ask how albuterol helps the child’s breathing.
Which of the following responses will the nurse include? Select all that apply.

A. The medication is a bronchodilator, which opens airways. B. The medication will thin the child’s mucus. C. The medication will reduce wheezing. D. The medication will decrease coughing and shortness of breath. E. The medication is a steroid, which reduces inflammation.

Answer and Explanation

Choice A:

Albuterol is a bronchodilator, which means it works by relaxing the muscles around the airways in the lungs. This allows the airways to open up, making it easier for the child to breathe.

Choice B:

Choice C:

Albuterol can help reduce wheezing, a common symptom of asthma. Wheezing occurs when the airways are narrowed or blocked, causing a whistling sound when the child breathes. By opening the airways, albuterol can help alleviate this symptom.

Choice D:

Albuterol can also decrease coughing and shortness of breath, two other common symptoms of asthma. By improving airflow in the lungs, albuterol can help the child breathe more easily and comfortably.

Choice E:

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Question 5:

.A nurse is caring for a year-old child who has a new diagnosis of diabetes mellitus and is distressed.
The nurse recognizes that which of the following therapeutic actions will help improve the child’s cooperation?

A. A period of play in the playroom. B. A needleless syringe and a doll. C. A storybook about a cat who has diabetes.

Answer and Explanation

Choice A:

While a period of play in the playroom can be a good distraction and provide a sense of normalcy for a child in a hospital setting, it may not specifically improve cooperation in a child distressed about a new diagnosis of diabetes mellitus.

Choice B:

A needleless syringe and a doll can be useful tools for explaining procedures and reducing fear in children. However, they might not directly address the distress caused by a new diagnosis of diabetes.

Choice C:

A storybook about a cat who has diabetes can be an effective therapeutic action. It can help the child understand their condition in a non-threatening way, see that they are not alone, and learn how to manage diabetes in daily life. This can improve their cooperation with their new routine of diabetes management.

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Question 6:

.The nurse is caring for a child who is suffering from hypotonic hyponatremia with a sodium level below 114 mEq/L. Which of the following symptoms will the nurse anticipate when assessing the child?

A. Seizures, confusion, and weakness. B. Mild tingling and numbness in fingers. C. Frequent urination and fluid retention. D. Temperature of 96°F orally and drowsiness.

Answer and Explanation

Choice A:

Seizures, confusion, and weakness are symptoms that a nurse should anticipate when assessing a child suffering from hypotonic hyponatremia with a sodium level below 114 mEq/L2. Severe hyponatremia can lead to cerebral edema, resulting in neurologic symptoms such as seizures and confusion.

Choice B:

Mild tingling and numbness in fingers are not typically associated with hyponatremia. These symptoms are more commonly associated with conditions affecting the nervous system or with electrolyte imbalances such as hypocalcemia.

Choice C:

Frequent urination and fluid retention are not typical symptoms of hyponatremia. They are more commonly associated with conditions such as kidney disease or heart failure.

Choice D:

A temperature of 96°F orally and drowsiness are not specific symptoms of hyponatremia. While drowsiness can occur with severe hyponatremia due to cerebral edema, a low body temperature is not typically associated with this condition.

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Question 7:

.A nurse is providing care for a 3-month-old infant diagnosed with RSV bronchiolitis. The infant is tachypneic, rubbing his eyes, and appears sleepy.
The mother places the infant flat, but the baby becomes more short of breath and irritable. Which of the following is the best advice for the nurse to give?

A. Suggest the mother rock the baby to sleep then lay the baby in the crib. B. Take the baby from the mother and lay the baby in the crib. C. Recommend the mother feed the baby and then lay the baby down. D. Advise swaddling the baby and placing the baby on its back at a 30-degree angle in the crib.

Answer and Explanation

Choice A:

Rocking the baby to sleep and then laying the baby in the crib might not alleviate the baby’s shortness of breath and irritability. While rocking can be soothing, it does not address the underlying issue of respiratory difficulty.

Choice B:

Taking the baby from the mother and laying the baby in the crib might not be the best advice. Separation from the mother might increase the baby’s distress and does not address the baby’s respiratory difficulty.

Choice C:

Feeding the baby and then laying the baby down might not be the best advice. Feeding can be difficult for a baby who is tachypneic and might increase the risk of aspiration.

Choice D:

Advising swaddling the baby and placing the baby on its back at a 30-degree angle in the crib is the best advice. This position can help to decrease work of breathing and increase comfort, which might help the baby to rest better.

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Question 8:

.A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler.

Which of the following statements by the parents indicates an understanding of the teaching?

A. “The average daily intake should be about 3,000 calories.”. B. “The quality of food I provide him is more important than the quantity.”. C. “I should expect him to have an increased appetite.”. D. “Because he is such a picky eater, I will give him one of my vitamins each day.”. .

Answer and Explanation

Choice A:

An average daily intake of about 3,000 calories is too high for a toddler. The recommended caloric intake for a toddler varies depending on age, size, and activity level, but it is generally much lower than 3,000 calories.

Choice B:

“The quality of food I provide him is more important than the quantity.”. This statement indicates an understanding of the teaching. It’s important to focus on providing nutrient-dense foods rather than just a large quantity of food.

Choice C:

Expecting an increased appetite in a toddler is not necessarily accurate. Toddlers often have variable appetites and may eat well one day and eat very little the next.

Choice D:

Giving a toddler an adult vitamin is not recommended. Toddlers have different nutritional needs than adults, and some vitamins and minerals can be harmful in large amounts. It’s better to focus on providing a balanced diet.

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Question 9:

.A 2-year-old child admitted to a burn unit with second and third-degree burns is scheduled for another wound dressing change.
The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?

A. The child is suffering post-traumatic stress. B. The child is fearful of being separated from his/her parents. C. The child is fearful of permanent scarring. D. The child is worried about the pain associated with the procedure.

Answer and Explanation

Choice A:

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event. Symptoms may include flashbacks, nightmares, and severe anxiety. However, a 2-year-old child may not have the cognitive ability to develop PTSD as it requires a certain level of cognitive and psychological development.

Choice B:

While separation anxiety is a normal stage of development for infants and toddlers, a 2-year- old child in a burn unit is more likely to be afraid of the pain associated with wound dressing changes rather than being separated from his/her parents.

Choice C:

Fear of permanent scarring could be a concern for older children and adults who are more aware of their body image. A 2-year-old child may not have the cognitive ability to understand the concept of permanent scarring.

Choice D:

The child is likely worried about the pain associated with the procedure. Pain experienced by patients is likely to increase during procedures such as dressing changes. This is a common and immediate fear for children undergoing medical procedures, especially those associated with pain.

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Question 10:

.A nurse is reviewing the care plan with a school-aged child who has cystic fibrosis and a prescription to receive vest therapy to mobilize respiratory secretions.
Which of the following statements by the child indicates an understanding of the plan?

A. “I will administer tobramycin prior to vest therapy.”. B. “I will administer dornase alfa prior to vest therapy.”. C. “I will administer flutter valve therapy after vest therapy.”. D. “I will administer albuterol prior to vest therapy.”.

Answer and Explanation

Choice A:

Tobramycin is an antibiotic often used in people with cystic fibrosis to combat bacterial infections in the lungs. However, it is not typically administered prior to vest therapy.

Choice B:

Dornase alfa is a medication used to thin the thick, sticky mucus in the lungs of people with cystic fibrosis. While it can help improve lung function and reduce the risk of respiratory infections, it is not typically administered prior to vest therapy.

Choice C:

Flutter valve therapy is another method used to clear mucus from the lungs. It is not typically administered after vest therapy.

Choice D:

Albuterol is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. Administering albuterol prior to vest therapy can help open the airways and make the therapy more effective.

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Question 11:

A. “The medication is a bronchodilator, which opens airways.”. B. “The medication will thin the child’s mucus.”. C. “The medication will reduce wheezing.”. D. “The medication will help with coughing and shortness of breath.”. .

Answer and Explanation

Choice A:

Albuterol is a bronchodilator, which means it relaxes the muscles around the airways, allowing them to open up, or dilate. This makes it easier for air to get in and out of the lungs, and for mucus to be cleared out of the airways.

Choice B:

Albuterol does not thin the mucus. Other medications, such as hypertonic saline or dornase alfa, are used in cystic fibrosis to thin the mucus and make it easier to cough up.

Choice C:

By opening the airways, albuterol can help reduce wheezing, a high-pitched whistling sound that occurs when airways are narrowed.

Choice D:

Albuterol can help relieve symptoms of asthma, such as coughing and shortness of breath, by relaxing the muscles of the airways and increasing airflow.

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Question 12:

.The nurse is conducting physical assessments for a group of children at a local wellness clinic. Which child requires further evaluation?

A. An eight-year-old child who weighs 60 pounds, rides a bike without training wheels, and is an active swimmer. B. A three-year-old child who weighs 28 pounds, requires help with feeding, dislikes most foods, and refuses to drink milk. C. A six-month-old who weighs 16 pounds, continues to breastfeed, has started solid foods, and is beginning to crawl. D. A four-year-old child who weighs 40 pounds, eats from the same plate every meal, and is occasionally a picky eater.

Answer and Explanation

Choice A:

An eight-year-old child who weighs 60 pounds, rides a bike without training wheels, and is an active swimmer is showing appropriate developmental milestones for their age. Riding a bike and swimming are complex activities that require good motor coordination and balance. These activities also indicate that the child is physically active, which is beneficial for overall health.

Choice B:

A three-year-old child who weighs 28 pounds, requires help with feeding, dislikes most foods, and refuses to drink milk may be showing signs of a feeding disorder or picky eating, which can lead to nutritional deficiencies and impact growth and development. This child requires further evaluation to determine the cause of these feeding difficulties and to develop a plan to address them.

Choice C:

A six-month-old who weighs 16 pounds, continues to breastfeed, has started solid foods, and is beginning to crawl is showing appropriate developmental milestones for their age. The World Health Organization recommends exclusive breastfeeding for the first six months of life, followed by the introduction of appropriate complementary foods. Crawling is also a typical developmental milestone that usually appears between 6 and 10 months of age.

Choice D:

A four-year-old child who weighs 40 pounds, eats from the same plate every meal, and is occasionally a picky eater is within normal behavior for their age. It’s common for preschoolers to have food preferences and to want routines, such as using the same plate. Picky eating is also a common behavior at this age and usually isn’t a cause for concern unless it leads to nutritional deficiencies or other health problems.

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Question 13:

.The nurse is caring for a newborn infant with a cleft lip and palate.
Which of the following is the FIRST priority nursing goal when caring for this infant?

A. Positioning to prevent fluid accumulation in the middle ear which will result in infection. B. Facilitating immediate repair of the cleft palate to ease the feeding difficulties. C. Assisting the mother to bond with the baby by providing emotional support. D. Establishing adequate feeding and sucking to promote growth and development.

Answer and Explanation

Choice A:

While positioning to prevent fluid accumulation in the middle ear is important in the care of a newborn with a cleft lip and palate, it is not the first priority. Middle ear infections are common in children with cleft palate because the muscles that open the eustachian tubes (which drain fluid from the middle ear) may not work well. However, this is typically addressed after feeding issues are managed.

Choice B:

Facilitating immediate repair of the cleft palate to ease feeding difficulties is important, but it is not the first priority. Surgery to repair cleft palate is usually done when the child is older, between 6 and 12 months of age. The timing of surgery depends on the child’s overall health and the type and severity of the cleft.

Choice C:

Assisting the mother to bond with the baby by providing emotional support is an important aspect of care. However, it is not the first priority. The initial focus is on addressing the baby’s immediate physical needs, such as feeding and breathing.

Choice D:

Establishing adequate feeding and sucking is the first priority when caring for a newborn with a cleft lip and palate. Babies with a cleft palate may have difficulty creating enough suction to breastfeed or bottle-feed effectively. Special feeding techniques and equipment may be needed to help these babies get enough nutrition.

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Question 14:

.The nurse is caring for a newborn suspected to have esophageal atresia. Which of the following interventions must be the FIRST priority?

A. Place the child in low flow oxygen. B. Place the infant in an isolette or radiant warmer. C. Obtain a stat chest X-ray. D. Elevate the head of the bed 30 to 35 degrees.

Answer and Explanation

Choice A:

While providing oxygen can be important in the care of a newborn with esophageal atresia, it is not the first priority. These babies often have difficulty breathing, but this is usually due to the abnormal connection between the esophagus and the trachea (tracheoesophageal fistula), which allows stomach acid to enter the lungs. Oxygen therapy alone does not address this underlying problem.

Choice B:

Placing the infant in an isolette or radiant warmer is not the first priority. While maintaining the baby’s body temperature is important, it does not address the immediate risks associated with esophageal atresia.

Choice C:

Obtaining a stat chest X-ray can be part of the diagnostic process for esophageal atresia, but it is not the first priority. The diagnosis is usually suspected based on symptoms such as frothy bubbles in the mouth and nose, coughing or choking when feeding, and difficulty breathing.

Choice D:

Elevating the head of the bed 30 to 35 degrees is the first priority. This position helps to prevent aspiration of gastric contents into the lungs, which can occur due to the abnormal connection between the esophagus and the trachea (tracheoesophageal fistula) that is often present in babies with esophageal atresia.

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Question 15:

.The nurse is providing parents with suggestions about the appropriate actions to take when their toddler is having a temper tantrum.
Which statement by the parents indicates an understanding?

A. We frequently remind that only bad children have temper tantrums. B. We ignore the tantrum as long as there is no physical danger. C. We send our child to a quiet zone, for 10 minutes after each tantrum. D. We patiently reassure our child until the tantrum ends.

Answer and Explanation

Choice A:

Frequently reminding a child that only bad children have temper tantrums is not an effective strategy for managing tantrums. This approach can make the child feel bad about themselves and does not help them learn how to manage their emotions. It’s important to remember that tantrums are a normal part of toddler development and are not a sign that a child is bad.

Choice B:

Ignoring the tantrum as long as there is no physical danger is a recommended strategy for managing tantrums. By not giving attention to the tantrum, parents can avoid reinforcing the behavior. Once the tantrum is over, parents can give attention and praise to the child for calming down.

Choice C:

Sending a child to a quiet zone for 10 minutes after each tantrum can be an effective strategy for some children. However, this approach may not work for all children and is not typically the first strategy recommended by experts. It’s also important to note that the “quiet zone” should not be used as a punishment, but rather a place for the child to calm down.

Choice D:

Patiently reassuring a child until the tantrum ends is not typically recommended. This approach can actually prolong the tantrum by giving the child attention for the behavior. It’s generally more effective to ignore the tantrum and then give attention and praise once the child has calmed down.

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Question 16:

.Which child requires urgent care?

A. An 18-month-old who has high fever, coughs hard, and has a runny nose. B. A one-year-old who has a slight fever, a rash, and green secretions.

Answer and Explanation

Choice A:

An 18-month-old who has a high fever, coughs hard, and has a runny nose requires urgent care. High fever in a child can be a sign of a serious infection or other medical condition. The hard coughing could indicate a respiratory issue such as bronchitis or pneumonia, which can be serious in young children. The runny nose is another symptom of a possible respiratory infection.

Choice B:

A one-year-old who has a slight fever, a rash, and green secretions may not require urgent care but should still be seen by a healthcare provider. A slight fever can be a sign of a minor infection, which may resolve on its own or with over-the-counter remedies. However, a rash and green secretions could indicate a bacterial infection, which may require antibiotic treatment.

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Question 17:

.The nurse recognizes that which of the following is a key aspect of patient-centered care and the medical home model?

A. Providing interdisciplinary care that is comprehensive. B. Empowering families to make decisions. C. Offering supportive and holistic care approaches to treat the child. D. Taking responsibility for care when needed.

Answer and Explanation

Choice A:

Providing interdisciplinary care that is comprehensive is a key aspect of patient-centered care and the medical home model. This approach involves a team of healthcare professionals from various disciplines working together to provide comprehensive care. It ensures that all aspects of a patient’s health are considered and addressed, leading to more effective and efficient care.

Choice B:

Empowering families to make decisions is an important aspect of patient-centered care, but it is not the key aspect of the medical home model. While patient and family empowerment is crucial for ensuring that care aligns with the patient’s values and preferences, the medical home model’s primary focus is on providing comprehensive, coordinated care.

Choice C:

Offering supportive and holistic care approaches to treat the child is an important aspect of patient-centered care, but it is not the key aspect of the medical home model. While these approaches can enhance the quality of care and patient satisfaction, the medical home model’s main focus is on providing comprehensive, coordinated care.

Choice D:

Taking responsibility for care when needed is an important aspect of patient-centered care, but it is not the key aspect of the medical home model. While healthcare providers must be ready to take responsibility for care when necessary, the medical home model’s primary focus is on providing comprehensive, coordinated care.

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Question 18:

.When assisting in obtaining informed consent for a child, which of the following actions were taken? Select all that apply.

A. Providing a detailed technical explanation using medical terminology. B. Ensuring the parents were not pressured to give consent and the consent forms were provided. C. Explaining the potential adverse effects and benefits. D. Providing alternative options for treatment and explaining the possible risks of negative outcomes.

Answer and Explanation

Choice A:

Providing a detailed technical explanation using medical terminology is not an appropriate action when obtaining informed consent for a child. Medical terminology can be complex and difficult for non-medical professionals to understand. Therefore, it is important to explain the information in a way that is easy for the parents and the child (if appropriate) to understand.

Choice B:

Ensuring the parents were not pressured to give consent and the consent forms were provided is an appropriate action when obtaining informed consent for a child. It is important that the decision to consent is made freely and without coercion.

Choice C:

Explaining the potential adverse effects and benefits is an appropriate action when obtaining informed consent for a child. Parents must be fully informed about the potential risks and benefits of a procedure or treatment to make an informed decision.

Choice D:

Providing alternative options for treatment and explaining the possible risks of negative outcomes is an appropriate action when obtaining informed consent for a child. Parents should be aware of all available treatment options and their potential outcomes to make an informed decision.

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Question 19:

.The nurse is providing education about age-appropriate activities to the parents of a 7-year-old child. Which of the following statements indicates a need for further teaching?

A. We will work on catching a bounced ball. B. We will purchase a jumping rope. C. We will encourage him to ride his tricycle. D. Running is a great activity, we can play chase.

Answer and Explanation

Choice A:

Working on catching a bounced ball is an age-appropriate activity for a 7-year-old child. This activity helps develop motor skills and hand-eye coordination.

Choice B:

Purchasing a jumping rope is an age-appropriate activity for a 7-year-old child. Jumping rope helps improve physical fitness, coordination, and timing.

Choice C:

Encouraging a 7-year-old child to ride his tricycle indicates a need for further teaching. At this age, most children have the balance and coordination necessary to ride a two-wheeler bike. Continuing to ride a tricycle may limit the development of these skills.

Choice D:

Running is a great activity for a 7-year-old child. It helps improve cardiovascular fitness and physical strength. Playing chase adds an element of fun and can also help develop social skills.

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Question 20:

.The nurse is teaching an adolescent girl about appropriate food choices.

Which of the following best explains how to answer Questions based on cognitive development?

A. Adolescents are capable of abstract thinking and can participate in planning. B. Adolescents cannot perceive quantity of mass if you change the shape. C. Adolescents are not capable of thinking critically about food choices. D. Adolescents are only capable of understanding in very concrete terms.

Answer and Explanation

Choice A:

Adolescents are capable of abstract thinking and can participate in planning. This cognitive development allows them to understand the long-term consequences of their food choices and participate in planning their meals.

Choice B:

Adolescents are capable of understanding quantity of mass even if you change the shape. This is a cognitive ability typically developed during the concrete operational stage of cognitive development, which occurs between the ages of 7 and 1189.

Choice C:

Adolescents are capable of thinking critically about food choices. With the right guidance and information, they can make informed decisions about their diet.

Choice D:

Adolescents are capable of understanding in abstract terms, not just concrete terms. They can understand complex concepts and hypothetical scenarios, which can help them make informed decisions about their food choices.

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Question 21:

.Which child requires urgent emergency medical intervention?

A. A 6-month-old who has a high fever, dysphagia, stridor, and a muffled cry. B. A 13-year-old who has a high fever, stridor, and purulent secretions. C. A 2-year-old who has a barky cough, is afebrile, and has mild intercostal retractions. D. A 5-year-old who has an abrupt onset of moderate respiratory distress, a mild fever, and a barky cough.

Answer and Explanation

Choice A:

A2.

Choice B:

A 13-year-old who has a high fever, stridor, and purulent secretions. While these symptoms are concerning and require medical attention, they are not as immediately life-threatening as the symptoms presented in

Choice C:

A 2-year-old who has a barky cough, is afebrile, and has mild intercostal retractions. These symptoms suggest croup, a common childhood condition that causes a barky cough and mild breathing difficulties. While croup can be distressing, it is usually not life-threatening and can often be managed at home with supportive care.

Choice D:

A 5-year-old who has an abrupt onset of moderate respiratory distress, a mild fever, and a barky cough. These symptoms also suggest croup. While this child is experiencing moderate respiratory distress, which requires medical attention, it is not as immediately life-threatening as the symptoms presented in

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Question 22:

.The parents of a 7-year-old recently diagnosed with cystic fibrosis have received discharge instructions for chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine.
Which of the following statements by the parents indicates understanding of the discharge instructions?

A. These therapies will decrease our child’s resistance to respiratory infections. B. These therapies will only be done when our child is showing signs of illness. C. These therapies will help to loosen our child’s secretions and allow for better expectoration. D. These therapies will allow for the removal of mucus from our child’s GI tract that blocks digestion.

Answer and Explanation

Choice A:

These therapies will decrease our child’s resistance to respiratory infections. This statement is incorrect. The therapies mentioned - chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine - do not directly decrease a child’s resistance to respiratory infections. Instead, they help manage the symptoms of cystic fibrosis by helping to clear mucus from the lungs, which can improve lung function and reduce the risk of lung infections.

Choice B:

These therapies will only be done when our child is showing signs of illness. This statement is incorrect. These therapies are part of the daily management of cystic fibrosis and are typically done regularly, not just when the child is showing signs of illness.

Choice C:

These therapies will help to loosen our child’s secretions and allow for better expectoration. This statement is correct. The goal of these therapies is to help clear thick, sticky mucus from the lungs, which can improve breathing and reduce the risk of lung infections.

Choice D:

These therapies will allow for the removal of mucus from our child’s GI tract that blocks digestion. This statement is incorrect. While cystic fibrosis can affect the digestive system by causing thick mucus to block the tubes that carry digestive enzymes from your pancreas to your small intestine, the therapies mentioned are primarily used to help clear mucus from the lungs.

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Question 23:

.The parents of a 7-year-old recently diagnosed with cystic fibrosis have received discharge instructions for chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine.

Which of the following statements made by the parents indicates an understanding of the discharge instructions?

Answer and Explanation

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Question 24:

.The nurse is providing education about age-appropriate activities to the parents of a 1-year-old child. Which of the following statements indicates a need for further teaching?

A. We will work on catching a bounced ball. B. We will purchase a jumping rope. C. We will encourage him to ride his tricycle. D. Running is a great activity, we can play chase.

Answer and Explanation

Choice A:

Catching a bounced ball is a skill that typically develops around the age of 21. However, it’s not uncommon for 1-year-olds to start practicing this skill, especially if they show interest and are physically ready.

Choice B:

Jumping rope is a complex activity that requires advanced motor skills, coordination, and timing. These skills are usually not fully developed in a 1-year-old child. Therefore, purchasing a jumping rope for a 1-year-old child indicates a need for further teaching as it is not an age- appropriate activity.

Choice C:

Riding a tricycle is a skill that children typically start to develop around the age of 31. However, there are tricycles designed for younger children that come with push handles for parents. If the parents are referring to this type of tricycle and they are always present to supervise and assist, it could be an appropriate activity.

Choice D:

Running and playing chase can be great activities for a 1-year-old child. Around this age, many children start to walk independently and may even start to run. Playing chase can help them develop their gross motor skills and is a fun way for them to stay active.

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Question 25:

.What instructions must the nurse include in the post-operative discharge instruction for a 6-year-old who just had a tonsillectomy? (Select All That Apply).

A. Pain needs to be controlled, children will not eat or drink when in pain and can quickly become dehydrated. B. Report mild ear pain or foul breath after surgery. C. Your child may eat soft foods, no crunchy foods for the first few days. D. Your child will form scabs on their tonsils as they heal, there is no need to worry during this healing period.

Answer and Explanation

Choice A:

After a tonsillectomy, it’s crucial to manage the child’s pain effectively. Pain can deter children from eating or drinking, which can lead to dehydration. Therefore, ensuring that the child’s pain is well managed is an essential part of post-operative care.

Choice B:

Mild ear pain or foul breath after surgery are common symptoms following a tonsillectomy. These symptoms do not necessarily indicate a problem, but they should be monitored. If these symptoms persist or worsen, it may be necessary to seek medical attention.

Choice C:

After a tonsillectomy, it’s recommended that the child eat soft foods for the first few days. Crunchy foods can irritate the throat and delay healing. Therefore, avoiding crunchy foods initially is an important part of post-operative care.

Choice D:

Following a tonsillectomy, it’s normal for the child to form scabs on their tonsils as they heal. This is a normal part of the healing process and is not a cause for concern.

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ATI Pediatrics Exam NURS 243 Spring 2014

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