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ATI RN Paediatrics 2023
Total Questions : 68
Showing 10 questions, Sign in for moreSchool-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K.
Barrel-shaped chest
Clubbing of the fingers bilaterally
Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough
A nurse is caring for a school-age child who has cystic fibrosis.
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.
- Diphenhydramine 10 mg PO 4 times per day
- Pimecrolimus 1% cream apply to skin lesions daily
A nurse in the emergency department is preparing to discharge a 3-year-old child.
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian?
Select all that apply.
0930: Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic.
0945: Notified provider of parent reports and child's fever. New prescriptions received.
1000: Urine sample obtained via sterile straight catheter.
A nurse in a provider's office is caring for a 1-year-old toddler.
Drag words from the choices below to fill in each blank in the following sentence.
The child is at risk for developing
and .Explanation
Given the clinical presentation and the context, the most appropriate words to fill in the blanks are "pyelonephritis" and "renal scarring."
So, the sentence should read: "The child is at risk for developing pyelonephritis and renal scarring."
Rationale for each choice:
1. Pyelonephritis: The child presents with a fever and lethargy, which are common signs of a urinary tract infection (UTI). The use of a sterile straight catheter to obtain a urine sample suggests that the healthcare provider is investigating a potential UTI, which in children can progress to pyelonephritis if not promptly treated. Pyelonephritis is an infection of the kidneys and is more severe than a simple bladder infection, requiring careful management to prevent complications.
2. Renal scarring: If pyelonephritis occurs, it can lead to renal scarring, especially in young children. Renal scarring is a long-term complication of recurrent or severe kidney infections, which can affect kidney function and lead to chronic kidney disease. Early diagnosis and treatment of UTIs are crucial to prevent renal scarring.
Rationale against other choices:
Nephrotic syndrome: This condition is characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and edema. While it is a serious kidney disorder, the child's symptoms (fever, lethargy, decreased appetite) are more indicative of an acute infection rather than nephrotic syndrome.
Acute glomerulonephritis: This condition typically presents with hematuria, proteinuria, hypertension, and edema. It is often a post-infectious condition (e.g., following a streptococcal infection) and less likely to present with just fever and lethargy in isolation. The current presentation suggests an acute infection rather than glomerulonephritis.
Polycystic kidney: This is a genetic disorder characterized by the growth of numerous cysts in the kidneys. It typically presents with signs of chronic kidney disease over time, rather than acute symptoms like fever and lethargy.
A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right- sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10.
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.
The nurse is planning care for the adolescent.
Select the 5 interventions the nurse should include.
0730: Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted.
0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, non-productive cough present.
A nurse is caring for a 3-year-old child.
For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process.
Explanation
Temperature: Acute laryngotracheobronchitis: ☑️ Pneumonia: ☑️
Both acute laryngotracheobronchitis and pneumonia can present with fever. While croup typically presents with a low-grade fever, pneumonia can also present with fever, though it can sometimes be higher.
Cough findings at 0800: Acute laryngotracheobronchitis: ☑️ Pneumonia: ☐
A "barking" non-productive cough is a classic symptom of acute laryngotracheobronchitis (croup). Pneumonia usually presents with a productive cough rather than a barking one, although it can sometimes be non-productive in children.
Irritability: Acute laryngotracheobronchitis: ☑️ Pneumonia: ☑️
Irritability can be seen in both conditions as a result of discomfort, fever, and difficulty breathing. It is a nonspecific symptom that can occur in many illnesses, including respiratory infections like croup and pneumonia.
Stridor: Acute laryngotracheobronchitis: ☑️ Pneumonia: ☐
Stridor, particularly inspiratory stridor, is a hallmark of acute laryngotracheobronchitis (croup), which involves inflammation of the upper airway causing a characteristic sound during breathing. Stridor is not typically associated with pneumonia, which usually affects the lower respiratory tract and may present with wheezing or crackles instead.
A nurse is preparing to administer an oral medication to a preschooler. Which of the following actions should the nurse take to encourage acceptance of the medication?
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