Video Library
ATI RN Pediatric Nursing 2023 Exam 3
Total Questions : 57
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
Temperature 38.4 C (101.1 F)
Heart rate 100/min
Respiratory rate 40/min
Blood pressure 100/57mm 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 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.
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
0730:
Tympanic temperature 38.1 C (100.6 F) Heart rate 95/min
Respiratory rate 20/min
Oxygen saturation 98% on room air 0800:
Tympanic temperature 38.2 C (100.6 F) Heart rate 95/min
Respiratory rate 20/min
Oxygen saturation 96% on room air
Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO
Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
A nurse is caring for a 3-year-old child.
For each of the flowing findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process
Explanation
Both acute laryngotracheobronchitis (croup) and pneumonia can cause irritability in a child due to discomfort from respiratory symptoms and fever.
The presence of a barking, non-productive cough at 0800 is consistent with acute laryngotracheobronchitis (croup), as it is a characteristic symptom. Pneumonia can also present with cough, but it is typically productive and associated with other respiratory symptoms such as dyspnea and crackles.
Stridor, an inspiratory wheezing sound, is a hallmark symptom of acute laryngotracheobronchitis (croup) due to inflammation and narrowing of the upper airway. It is not typically associated with pneumonia.
Fever can occur in both acute laryngotracheobronchitis (croup) and pneumonia. In this case, the tympanic temperatures of 38.1°C and 38.2°C are consistent with both conditions. However, pneumonia may present with higher fevers compared to croup.
0700:
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.
0700:
0715:
Temperature 38 C (100.4 F)
Heart rate 80/min
Respiratory rate 22/min
Blood pressure 106/65 mm Hg 0930:
Temperature 38.4 C (101.1 F)
Heart rate 90/min
Respiratory rate 23/min
Blood pressure 105/65 mm Hg
Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO
Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI)
The nurse is planning care for the client.
For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
Explanation
Proper perineal hygiene is essential in preventing recurrent urinary tract infections.
Teaching the child about proper hygiene practices is important for preventing future UTIs.
Sulfamethoxazole and trimethoprim are antibiotics commonly used to treat urinary tract infections. Administering the prescribed antibiotic is appropriate for treating the UTI.
Salicylic acid (aspirin) is contraindicated in children with viral infections due to the risk of Reye's syndrome, a rare but serious condition. Since the child has a fever, which is likely due to the UTI, salicylic acid should not be given.
Fluid intake should be encouraged to help flush out the bacteria causing the UTI. Restricting fluid intake is not appropriate in this situation.
Advising the child's guardian about the use of sunscreen is appropriate, especially if the child will be outdoors. This intervention is not directly related to the UTI but is generally important for the child's overall health and well-being.
0915
Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more 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
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 mmHg
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 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 the throat with no visual signs of foreign object in child’s nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation.
Abdomen soft and non-tender 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 plane radiographic study identifies object in esophagus
No foreign objects visualized in the chest or abdomen
A nurse in the emergency departments is caring for a toddler
Complete the following sentence by using the list of options.
The nurse should first
Explanation
Options 1:
A. Keeping the child NPO is crucial to prevent further ingestion or aspiration of the battery, which could lead to serious complications.
B. 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.
C. Obtaining an informed consent is not the priority in this scenario. It should be done after keeping the child NPO.
Options 2:
A. 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.
B. Preparing the child for flexible endoscopy is the second action to visualize and safely remove the battery from the esophagus.
C. Waiting for return of the gag reflex without taking immediate action could delay potentially life-saving interventions.
The 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.
A nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?
A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a nonpharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
A nurse is teaching the parent of an infant who has a new diagnosis of heart failure about nutrition. Which of the following instructions should the nurse include in the teaching?
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 client reports pain as 8 on a scale of 0-10
Client is tearful and grimacing during the examination.
Hct 28% (32% to 44%)
Hgb 6g/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)
Chest radiographic examination indicates cardiomegaly and systolic murmur
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.
Sign Up or Login to view all the 57 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
