Review ATI PN Paediatrics nursing 2023

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ATI PN Paediatrics nursing 2023

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Total Questions : 56

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Question 1:

A nurse is monitoring a 6-month-old infant 20 minutes after administering a hepatitis B immunization.
Which of the following findings is the nurse's priority?

A. Redness at the injection site. B. Temperature 37.7°C (99.9°F). C. Hives on the child's neck. D. Prolonged crying.

Answer and Explanation

Choice A:

Redness at the injection site is a common and expected local reaction following immunization. It typically resolves on its own without intervention. While it may cause some discomfort, it does not pose an immediate threat to the child's health and is not a priority over signs of a potential allergic reaction.

Choice B:

A temperature of 37.7°C (99.9°F) is a mild fever and a common response to immunizations as the body mounts an immune response. It is not usually cause for concern and can be managed with antipyretics if necessary. This mild fever does not indicate an urgent condition compared to the signs of an allergic reaction.

Choice C:

Hives on the child's neck is the priority finding because it can indicate an allergic reaction, which may progress to anaphylaxis. Anaphylaxis is a severe, life-threatening allergic reaction that requires immediate intervention. Hives are often the first sign of an allergic reaction and can quickly escalate to airway obstruction, difficulty breathing, and cardiovascular collapse. Early identification and treatment of an allergic reaction can prevent these severe complications. The nurse should be prepared to administer emergency medications, such as epinephrine, and provide respiratory support if needed.

Choice D:

Prolonged crying can be a sign of discomfort or pain following an immunization but is not necessarily indicative of a severe reaction. It is important to assess the child's overall condition and provide comfort measures. However, it does not take precedence over signs of an allergic reaction, which require immediate attention.

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Question 2:

A nurse is preparing to administer medications to a 5-month-old infant.
Tympanic temperature 39.2°C (102.6°F). Heart rate 84/min.
Respiratory rate 30/min.
Blood pressure 80/30 mmHg.
Oxygen saturation 96% on 0.5 L oxygen via nasal cannula.
Weight 7.2 kg (15.9 lb). The nurse should clarify the prescription for which medication?

A. Ibuprofen. B. Acetaminophen. C. Heart rate. D. Temperature.

Answer and Explanation

Choice A:

Ibuprofen should be clarified before administration to a 5-month-old infant. Ibuprofen is not recommended for infants younger than 6 months due to the risk of adverse effects on the kidneys and gastrointestinal tract. Infants have immature renal function, and administering ibuprofen can increase the risk of nephrotoxicity. Additionally, ibuprofen can cause gastric irritation and increase the risk of gastrointestinal bleeding. The nurse should verify the safety and appropriateness of this medication with the prescribing healthcare provider before administration.

Choice B:

Acetaminophen is generally considered safe for use in infants to reduce fever and alleviate pain. It is often the preferred antipyretic for infants younger than 6 months due to its favorable safety profile. Acetaminophen does not have the same risks of nephrotoxicity and gastrointestinal irritation as ibuprofen, making it a suitable choice for managing fever in this age group.

Choice C:

The heart rate of 84/min is within the normal range for a 5-month-old infant. Heart rate itself is not a medication and does not require clarification. Instead, it is a vital sign that should be monitored to assess the infant's overall condition and response to treatment.

Choice D:

Temperature itself is not a medication and does not require clarification. It is a vital sign that indicates the body's response to infection or inflammation. The nurse should monitor the infant's temperature and provide appropriate interventions, such as antipyretics like acetaminophen, to manage fever. .

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Question 3:

A nurse is assisting with the care of a school-age child who is terminally ill.
Which of the following interventions should the nurse perform?

A. Collect vital signs every 2 hours as the child's condition deteriorates. B. Reinforce with the family that they should avoid discussing death with the child. C. Encourage the family to involve siblings when caring for the child. D. Perform passive range of motion to the child's extremities every 4 hours.

Answer and Explanation

Choice A:

Collecting vital signs every 2 hours may not provide comfort and support to the child or family. Instead, it may contribute to unnecessary stress and anxiety for the child and family during this sensitive time. It is important to balance medical assessments with compassionate care.

Choice B:

Avoiding discussions about death may not be helpful for the child or family. Children, even those who are terminally ill, have the right to receive honest and age-appropriate information about their condition. Open communication helps them process their feelings and can provide a sense of closure.

Choice C:

Encouraging the family to involve siblings in caring for the terminally ill child can provide emotional support to both the ill child and the siblings. It fosters a sense of togetherness and helps siblings cope with the situation. It also allows siblings to express their love and support, which can be therapeutic for the entire family.

Choice D:

Performing passive range of motion to the child's extremities every 4 hours may be beneficial in maintaining joint flexibility and preventing contractures. However, it is not the primary focus in providing compassionate end-of-life care. Comfort measures and emotional support are more critical during this time.

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Question 4:

A nurse is caring for a child and suspects the child has experienced physical maltreatment.
Which of the following statements should the nurse make?

A. "This should not have happened to you.”. B. "I promise I won't tell anyone about this.”. C. "It is not your fault that this happened.”. D. "You should have told someone about this sooner.”.

Answer and Explanation

Choice A:

Telling a child that "This should not have happened to you" acknowledges the injustice of the situation. While this statement can validate the child's feelings, it may not provide the necessary comfort and reassurance that the child needs in the moment.

Choice B:

Promising not to tell anyone about the abuse is inappropriate and unethical. As a mandated reporter, the nurse has a legal and ethical obligation to report suspected child abuse to the appropriate authorities. Making such a promise can hinder the necessary investigation and protection of the child.

Choice C:

Informing the child that "It is not your fault that this happened" is essential in alleviating feelings of guilt and shame that the child may have. It helps the child understand that they are not to blame for the abuse and that they are not responsible for the actions of the abuser. This reassurance is crucial for the child's emotional healing.

Choice D:

Telling the child "You should have told someone about this sooner" can place undue blame and guilt on the child. Children who experience abuse often feel fear, shame, and confusion, which can prevent them from disclosing the abuse. It is important to provide a supportive and non-judgmental environment to encourage the child to share their experiences.

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Question 5:

A nurse is collecting data from an infant.
Which of the following areas should the nurse palpate to check for an inguinal hernia?

A. Groin area. B. Abdomen. C. Lower back. D. Upper thigh.

Answer and Explanation

Choice A:

Palpating the groin area is the correct method to check for an inguinal hernia. An inguinal hernia occurs when a portion of the intestine protrudes through a weak spot in the abdominal muscles into the groin area. This area should be carefully examined to identify any bulges or abnormalities that indicate a hernia.

Choice B:

Palpating the abdomen may be useful for identifying other conditions, such as abdominal distension or masses. However, it is not the most appropriate site for detecting an inguinal hernia, which specifically involves the groin area.

Choice C:

Palpating the lower back is not relevant for detecting an inguinal hernia. The lower back is not a common site for hernias, and examining this area would not provide information about the presence of an inguinal hernia.

Choice D:

Palpating the upper thigh is not the correct method to check for an inguinal hernia. While the inguinal region is located near the upper thigh, the hernia itself protrudes into the groin area. The upper thigh does not provide the necessary information to identify an inguinal hernia.

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Question 6:

A nurse is preparing to administer cephalexin 50 mg/kg/day in divided doses every 8 hours to a child who weighs 33 lb. The amount available is cephalexin oral suspension 250 mg/5 mL.

How many mL 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: "5" mL

Explanation

Step 1 is: Convert the child's weight from pounds to kilograms: 33 lb ÷ 2.2 = 15 kg.

Step 2 is: Calculate the total daily dose: 50 mg/kg/day × 15 kg = 750 mg/day.

Step 3 is: Calculate the dose per administration (every 8 hours, which is 3 times a day): 750 mg/day ÷ 3 = 250 mg/dose.

Step 4 is: Determine the volume of medication to administer: 250 mg ÷ (250 mg/5 mL) = 5 mL.

Final calculated answer: 5 mL.

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Question 7:

A nurse is assisting with the care of a preschooler who is immediately postoperative following a tonsillectomy.
Which of the following actions should the nurse take?

A. Provide cherry fruit juice. B. Remind the child to cough and deep breathe. C. Encourage the child to use a straw. D. Apply an ice collar.

Answer and Explanation

Choice A:

Providing cherry fruit juice is not recommended for a child immediately postoperative following a tonsillectomy. Red-colored fluids can be mistaken for blood if the child vomits, making it difficult to assess for postoperative bleeding. Clear or light-colored fluids are preferred.

Choice B:

Reminding the child to cough and deep breathe is not appropriate immediately postoperative following a tonsillectomy. Coughing can dislodge clots and increase the risk of bleeding at the surgical site. Encouraging gentle breathing exercises may be more suitable.

Choice C:

Encouraging the child to use a straw is not advised following a tonsillectomy. The use of a straw can create negative pressure in the mouth and throat, which may disrupt the surgical site and increase the risk of bleeding. Sipping from a cup is preferred.

Choice D:

Applying an ice collar can help reduce pain and swelling in the throat area following a tonsillectomy. Cold therapy is effective in providing comfort and minimizing inflammation, making it a beneficial intervention for postoperative care. .

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Question 8:

A nurse is reinforcing teaching about bicycle safety with a school-age child.
Which of the following instructions should the nurse include?

A. Ensure the balls of your feet touch the ground when you are seated on the bicycle. B. Choose a helmet that is light in color and covers your ears. C. Ride instead of walk your bicycle through crosswalks and intersections. D. Ride against traffic to allow visibility to oncoming vehicles.

Answer and Explanation

Choice A:

Ensuring that the balls of your feet touch the ground when seated on the bicycle can actually indicate that the bicycle is too small. Proper bicycle fitting for children is essential for both comfort and safety. The balls of the feet should only touch the ground when the child is off the saddle, indicating that the seat height allows for proper leg extension while pedaling. This helps in efficient pedaling and reduces the risk of knee injuries.

Choice B:

Choosing a helmet that is light in color and covers your ears is important for bicycle safety. A light-colored helmet increases visibility to motorists, especially in low-light conditions, reducing the risk of accidents. Helmets should fit snugly and cover the forehead without obstructing the ears, ensuring they remain in place during a fall or collision. This protection is crucial to prevent head injuries, which can be severe and life-threatening in the event of an accident.

Choice C:

Riding a bicycle through crosswalks and intersections instead of walking it increases the risk of accidents. Pedestrians have the right of way in crosswalks, and riding through them can lead to collisions with both vehicles and pedestrians. Walking the bicycle allows the rider to better observe traffic signals, check for oncoming vehicles, and make safer decisions, thus significantly reducing the risk of accidents and ensuring the safety of all road users.

Choice D:

Riding against traffic to allow visibility to oncoming vehicles is extremely dangerous and against most traffic laws. Bicycle riders should ride with the flow of traffic to avoid head-on collisions and ensure predictability for other road users. Oncoming traffic may not expect a bicycle in their lane, increasing the risk of accidents. Riding with traffic helps to follow the same signals and signs as motor vehicles, ensuring better integration and safety on the road.

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Question 9:

A nurse is reinforcing dietary teaching with the guardians of a toddler.
Which of the following snack foods should the nurse recommend?

A. Grapes. B. Hard-boiled egg. C. Raw carrots. D. Popcorn.

Answer and Explanation

Choice A:

Grapes can pose a choking hazard to toddlers due to their size and shape. Young children have smaller airways, and whole grapes can easily become lodged in the throat. It is recommended to cut grapes into smaller pieces to minimize this risk, ensuring the safety of the child while still providing a nutritious snack rich in vitamins and antioxidants.

Choice B:

Hard-boiled eggs are an excellent snack for toddlers. They are soft, easy to chew, and packed with essential nutrients such as protein, healthy fats, vitamins, and minerals. Eggs support healthy growth and development in young children. Additionally, they are less likely to pose a choking hazard compared to harder or larger foods, making them a safer option for toddlers.

Choice C:

Raw carrots are not recommended for toddlers due to the high risk of choking. Toddlers have developing chewing skills and may not be able to properly break down hard, raw vegetables. This increases the danger of choking. Cooked or finely grated carrots are safer options that still provide the nutritional benefits without the associated risks.

Choice D:

Popcorn is not a safe snack for toddlers as it poses a significant choking hazard. The size and texture of popcorn make it difficult for young children to chew and swallow properly. The American Academy of Pediatrics recommends avoiding popcorn for children under four years old. Instead, opt for snacks that are soft and easy to manage for a toddler’s developing oral motor skills.

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Question 10:

A nurse is reinforcing teaching with a parent of a child who has gastroesophageal reflux disease and a new prescription for lansoprazole capsules.
Which of the following statements by the parent indicates an understanding of the teaching?

A. I will have my child chew the capsule completely. B. I should place the capsule under my child's tongue. C. I will administer this medication four times per day. D. I should administer this medication 30 minutes before breakfast.

Answer and Explanation

Choice A:

Chewing a lansoprazole capsule is not recommended. Lansoprazole is a proton pump inhibitor designed to reduce stomach acid. Chewing the capsule would destroy the enteric coating, which protects the medication from being broken down by stomach acid before it reaches the intestines, where it is absorbed. Proper administration is crucial for the medication's effectiveness in treating conditions like gastroesophageal reflux disease.

Choice B:

Placing a lansoprazole capsule under the tongue is not an appropriate method of administration. Lansoprazole capsules are meant to be swallowed whole so the medication can reach the stomach and intestines where it acts to reduce acid production. Sublingual administration would bypass the intended route, leading to reduced effectiveness and potential irritation or discomfort in the mouth.

Choice C:

Administering lansoprazole four times per day is incorrect for standard dosages. Lansoprazole is typically prescribed once or twice daily, depending on the severity of the condition and the patient’s specific needs. Overuse of this medication can lead to adverse effects, including nutrient deficiencies, increased risk of infections, and potential kidney issues. Following the prescribed dosage schedule is essential for safe and effective treatment.

Choice D:

Administering lansoprazole 30 minutes before breakfast is the correct method. Taking lansoprazole before meals ensures the medication is absorbed and activated in time to reduce stomach acid production during and after eating. This timing maximizes the effectiveness of the treatment for conditions like gastroesophageal reflux disease, providing symptom relief and promoting healing of the esophagus and stomach lining.

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Total Questions : 56

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ATI PN Paediatrics nursing 2023

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