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ATI RN Paediatrics nursing 2023
Total Questions : 70
Showing 10 questions, Sign in for moreThe child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis.
Diphenhydramine 10 mg PO 4 times per day
Pimecrolimus 1% cream apply to skin lesions daily
Child is alert and responsive.
Respiratory rate even and nonlabored at rate of 24/min. No adventitious sounds auscultated.
Heart rate 108/min
Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities.
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.
0915:
Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent heard the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual and witnessed them gagging periodically.
0930:
Child is lying on parent's chest with eyes open and requesting 'sippy cup.' Continues to have expiratory wheezing in bilateral upper lobes. Preparing child for diagnostic testing.
0915:
Blood pressure 88/45 mm Hg
Heart rate 90/min
Respiratory rate 30/min
Axillary temperature 36.9° C (98.4° F)
Oxygen saturation 96%
0930:
Blood pressure 86/46 mm Hg
Heart rate 88/min
Respiratory rate 28/min
Axillary temperature 36.9° C (98.4° F)
Oxygen saturation 95%
0915:
Child awake and sobbing, asking parent for 'sippy cup' with excessive drooling and occasionally gagging. Breath sounds with small expiratory wheezing noted in bilateral upper lobes; respirations slightly elevated as child continues to cry and sob. Oxygen saturation 96% on room air. Penlight used to inspect throat with no visual signs of foreign object; no visual objects in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation.
Abdomen soft and nontender with active bowel sounds in all four quadrants. Skin warm, pink, and smooth. Yellow urine noted in child's diaper. Provider notified of assessment findings.
0930:
X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies object in esophagus.
No foreign objects visualized in the chest or abdomen.
A nurse in the emergency department is caring for a toddler.
Explanation
The nurse should first keep the child NPO followed by prepare the child for flexible endoscopy.
Rationale:
Keeping the child NPO is crucial to prevent further ingestion or aspiration of the battery, which could lead to serious complications. Preparing the child for flexible endoscopy is the second action to visualize and safely remove the battery from the esophagus. Teaching the child's parents the importance of inspecting the child's play area is important for future prevention but is not the immediate priority in this acute situation. Obtaining an informed consent is not the priority in this scenario. It should be done after keeping the child NPO. Encouraging parents to inspect toys for easily removable parts is important for prevention but is not the immediate priority when dealing with a child who has already ingested a foreign object. Waiting for return of the gag reflex without taking immediate action could delay potentially life-saving interventions.
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.
Temperature 37.8° C (100° F)
Heart rate 100/min
Blood pressure 110/72 mm Hg Respiratory rate 20/min
Oxygen saturation 95% on room air
Awake, alert, and oriented x 3
Yellow sclera of eyes noted bilaterally
Right upper quadrant tender to palpation
Hands painful to touch and swollen bilaterally
Right knee is swollen, warm to palpation, and the client reports
pain as 8 on a scale of 0 to 10.
Client is tearful and grimacing during the examination.
Hct 28% (32% to 44%)
Hgb 6 g/dL (10 to 15.5 g/dL)
WBC count 20,000/mm3 (6,200 to 17,000/mm3)
ALT 50 units/L (4 to 36 units/L)
AST 62 units/L (10 to 40 units/L)
Total bilirubin 3.0 mg/dL (0.3 to 1.0 mg/dL)
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.
School-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
Temperature 38.4° C (101.1° F)
Heart rate 100/min
Respiratory rate 40/min
Blood pressure 100/57 mm Hg
Sputum culture positive for Pseudomonas aeruginosa Stool analysis positive for presence of fat and enzymes Chest x-ray indicates obstructive emphysema WBC count 20,000/mm3 (5,000 to 10,000/mm3)
A nurse is caring for a school-age child who has cystic fibrosis.
A nurse is teaching the guardian of a newborn about how to prepare their 3-year-old child to meet their new sibling. Which of the following statements should the nurse make?
A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take?
A nurse is caring for a 5-year-old child who has acute poststreptococcal glomerulonephritis. Which of the following findings should indicate to the nurse that treatment has been effective?
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a non-pharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
A nurse is assessing a school-age child who is receiving prednisolone. For which of the following adverse effects should the nurse monitor?
A nurse is preparing a child for a lumbar puncture. In which of the following positions should the child be placed for the procedure?
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