Video Library
ATI RN Pediatric Nursing 2023
Total Questions : 76
Showing 10 questions, Sign in for moreA nurse is caring for a 3-year-old child in the pediatric unit.
Based on the exhibits provided, which of the following findings are consistent with the child’s condition? Select all that apply.
The child is a 7-year-old male admitted with a history of chronic respiratory issues. The child presents with a persistent cough producing thick, greenish sputum. The mother reports that the child has had difficulty gaining weight despite a good appetite. The child appears fatigued and has been experiencing frequent respiratory infections. The child is currently on oxygen therapy at 2 liters per minute via nasal cannula. The mother also mentions that the child has large, greasy stools and frequent abdominal pain. The child is alert but appears tired and is cooperative during the examination.
The child has a barrel-shaped chest and clubbing of the fingers. Breath sounds are diminished bilaterally with crackles and wheezes noted throughout all lung fields. The abdomen is distended with hyperactive bowel sounds. The skin is dry with poor turgor, and there are multiple bruises on the lower extremities. The child has a thin, frail appearance with visible ribs and muscle wasting. The child’s lips are slightly cyanotic, and there is nasal flaring observed during respiration. The child’s extremities are cool to the touch.
- Temperature: 38.2°C (100.8°F)
- Heart rate: 110/min
- Respiratory rate: 32/min
- Blood pressure: 95/60 mm Hg
- Oxygen saturation: 92% on 2L O2 via nasal cannula
A nurse is caring for a school-age child in the pediatric unit.
A nurse is reviewing the child’s medical record. Based on the exhibits provided, which of the following is the most appropriate initial nursing action?
- 7-year-old client who weighs 18.1 kg (39.9 lb) admitted with a UTI.
- Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time.
- Child’s guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor.
- The child appears uncomfortable and is frequently shifting positions in bed.
- The client has been crying intermittently and is reluctant to drink fluids.
- The guardian mentions that the child has been more irritable and has a decreased appetite.
- The child has a history of recurrent UTIs, with the last episode occurring 6 months ago.
- Heart rate: 80/min
- Temperature: 38°C (100.4°F)
- Respiratory rate: 22/min
- Blood pressure: 106/65 mm Hg
A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI) in the pediatric unit.
For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
Explanation
- Advise child’s guardian about the use of sunscreen: This intervention is contraindicated as it is not relevant to the child’s current condition of a UTI.
- Educate the child about proper perineal hygiene: This intervention is anticipated as proper perineal hygiene is crucial in preventing recurrent UTIs.
- Administer salicylic acid for pain and fever: This intervention is contraindicated as salicylic acid is not typically used for pain and fever management in children with UTIs. Acetaminophen or ibuprofen is more appropriate.
- Ensure the child receives a maximum of 1,200 mL/day of fluid: This intervention is contraindicated as adequate fluid intake is essential for flushing out bacteria from the urinary tract. Restricting fluids is not appropriate.
- Administer sulfamethoxazole and trimethoprim: This intervention is anticipated as sulfamethoxazole and trimethoprim are commonly prescribed antibiotics for treating UTIs in children.
Received the child awake, alert, and crying. Parent states that the child was playing with a 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. Child is lying on the parent’s chest with eyes open and requesting a ‘sippy cup’.
Continues to have expiratory wheezing in bilateral upper lobes. Preparing the child for diagnostic testing.
- Heart rate: 90/min
- Blood pressure: 88/45 mm Hg
- Respiratory rate: 30/min
- Oxygen saturation: 96%
- Axillary temperature: 36.9° C (98.4° F)
X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies an object in the esophagus. No foreign objects visualized in the chest or abdomen.
- Keep the child NPO
- Prepare the child for flexible endoscopy
- Obtain informed consent from the parents
- Monitor the child closely for return of gag reflex
A nurse in the emergency department is caring for a toddler.
Complete the following sentence by using the list of options. The nurse should first:
The infant presents with tachypnea, moderate retractions, and nasal flaring. Auscultation reveals crackles in all lung fields, with no nasal drainage. The infant has a dry cough that occurs periodically. The skin appears pale, the scalp is diaphoretic, and the lower extremities are cool to the touch. The infant is tachycardic with a regular rhythm, and no murmur is heard. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. Mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The diaper remains dry. The abdomen is soft, full, and round, with active bowel sounds.
The infant was born at 38 weeks gestation via vaginal delivery with no complications. The infant has had no previous hospitalizations or surgeries. The infant has been exclusively breastfed and has had no known allergies. The mother reports that the infant has been feeding poorly for the past two days and has had decreased urine output. There is no family history of congenital heart disease or respiratory conditions.
- Chest X-ray: Mild left ventricular hypertrophy noted. Increased pulmonary vascular markings in all lobes.
- Complete Blood Count (CBC):
o White Blood Cells (WBC): 12,000/mm³ (4,500-11,000/mm³)
- Hemoglobin (Hgb): 11 g/dL (11-14 g/dL)
- Hematocrit (Hct): 33% (33-39%)
o Platelets: 250,000/mm³ (150,000-450,000/mm³)
-
- Electrolytes:
- Sodium (Na): 138 mEq/L (135-145 mEq/L)
- Potassium (K): 4.2 mEq/L (3.5-5.0 mEq/L)
- Chloride (Cl): 102 mEq/L (98-106 mEq/L)
- Bicarbonate (HCO3): 22 mEq/L (22-28 mEq/L)
- Electrolytes:
- Temperature: 37.7°C (99.9°F)
- Heart rate: 174/min while sleeping
- Respiratory rate: 72/min while sleeping
- Blood pressure in right upper extremity: 60/39 mm Hg
- Oxygen saturation: 90%
The infant is alert but irritable. The skin is pale with a diaphoretic scalp and cool lower extremities. The infant exhibits tachypnea with moderate retractions and nasal flaring. Crackles are heard in all lung fields upon auscultation. The heart rate is tachycardic with a regular rhythm, and no murmur is detected. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. The mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The abdomen is soft, full, and round, with active bowel sounds.
A nurse is caring for a 6-week-old infant in the pediatric unit.
Complete the diagram by dragging from the choices below to specify:
- What condition the client is most likely experiencing
- Two actions the nurse should take to address that condition
- Two parameters the nurse should monitor to assess the client’s progress
Explanation
Actions to Take:
-
Anticipate a prescription for digoxin:
- Digoxin is commonly used in pediatric heart failure cases to improve the strength of the heart’s contractions, helping to increase cardiac output and reduce symptoms of CHF. The nurse should anticipate its use to help manage the infant’s heart function.
-
Elevate the head of the bed to a 45° angle:
- This action helps reduce the work of breathing and decreases venous return to the heart, which can alleviate pulmonary congestion and improve respiratory function. Positioning the infant in a semi-upright position is crucial to relieve symptoms of CHF, especially when there’s evidence of respiratory distress.
Parameters to Monitor:
-
Peripheral pulses:
- Monitoring peripheral pulses is essential in assessing the effectiveness of the heart’s ability to pump blood. The weak pedal pulses and bounding upper extremity pulses noted earlier are significant findings that need to be monitored to gauge improvement in circulation as the infant’s condition is managed.
-
Respiratory status:
- Respiratory rate, effort (including retractions and nasal flaring), and oxygen saturation levels must be closely monitored to track the infant's progress. Improvement in respiratory status, along with reduced crackles, would indicate a reduction in pulmonary congestion.
- Three urinary tract infections over the past year treated with antibiotics.
- Diagnosed at 6 months old with vesicoureteral reflux.
- Heart rate: 128/min
- Temperature: 38.4°C (101.1°F)
- Respiratory rate: 28/min
- 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 hours.
- Child febrile and lethargic.
- Notified provider of parent reports and child’s fever.
- New prescriptions received.
- Urine sample obtained via sterile straight catheter.
- Urinalysis:
- Leukocyte esterase: positive (negative)
- Specific gravity: 1.035 (1.005 to 1.030)
- Appearance: cloudy and dark amber (clear)
- Nitrites: present (none)
- WBCs: 10 (0 to 4)
• Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter.
A nurse in a provider’s office is caring for a 1-year-old toddler.
The child is at risk for developing
Explanation
Choice A rationale: Pyelonephritis is a type of urinary tract infection (UTI) that affects the kidneys. It is a serious condition that can occur when bacteria from a lower urinary tract infection, such as a bladder infection, travel up to the kidneys. The toddler’s history of multiple UTIs and current symptoms, including fever and lethargy, suggest that the infection may have progressed to the kidneys. Pyelonephritis can cause significant kidney damage if not treated promptly.
Choice B rationale: Polycystic kidney disease is a genetic disorder characterized by the growth of numerous cysts in the kidneys. These cysts can lead to kidney enlargement and impaired kidney function over time. However, this condition is not typically associated with recurrent UTIs or vesicoureteral reflux. The toddler’s symptoms and medical history do not indicate the presence of polycystic kidney disease.
Choice C rationale: Renal scarring can occur as a result of recurrent UTIs and vesicoureteral reflux. When urine flows backward from the bladder into the ureters and kidneys, it can cause repeated infections and inflammation, leading to scarring of the kidney tissue. Renal scarring can impair kidney function and increase the risk of chronic kidney disease. The toddler’s history of UTIs and vesicoureteral reflux puts them at risk for developing renal scarring.
Choice D rationale: Nephrotic syndrome is a kidney disorder characterized by excessive protein loss in the urine, leading to low blood protein levels, swelling, and increased cholesterol levels. It is not typically associated with recurrent UTIs or vesicoureteral reflux. The toddler’s symptoms and medical history do not suggest nephrotic syndrome.
Choice E rationale: Acute glomerulonephritis is an inflammation of the glomeruli, the tiny filters in the kidneys. It can be caused by infections, autoimmune diseases, or other conditions. While it can lead to kidney damage, it is not typically associated with recurrent UTIs or vesicoureteral reflux. The toddler’s symptoms and medical history do not indicate acute glomerulonephritis.
The RN reviews therapeutic and nontherapeutic communication techniques with a group of nursing students. Which of the following demonstrates the use of therapeutic communication techniques?
Which of the following information is the priority for the nurse to include?
Sign Up or Login to view all the 76 Questions on this Exam
Join over 100,000+ nursing students using Naxlex’s science-backend flashcards, practice tests and expert solutions to improve their grades and reach their goals.
Sign Up Now
