PEDS ATI A+B practice qs for exam2

A nurse is educating new parents about risk factors for sudden infant death syndrome (SIDS). Which of the following statements should indicate to the nurse the need for additional teaching? A: "Our baby will sleep in our bed because I am breastfeeding." B: "We will give my baby a pacifier during naps and at bedtime." C: "We will place my baby on her back when sleeping." D: "We will remove blankets and toys from the crib."

A: "Our baby will sleep in our bed because I am breastfeeding."

A nurse is caring for a newborn whose mother voices concerns about sudden infant death syndrome (SIDS). The nurse should include which of the following statements in a discussion with the mother? A: "Placing your child on her back when sleeping will decrease the risk of SIDS." B: "SIDS is directly correlated with the diphtheria, tetanus, and pertussis vaccines." C: "SIDS rates have been rising over the last 10 years." D: "Sleep apnea is the main cause of SIDS."

A: "Placing your child on her back when sleeping will decrease the risk of SIDS."

A nurse is providing health promotion teaching to the parents of an infant. Which of the following conditions should the nurse identify as the leading cause of death among this age group? A: Congenital anomalies B: Respiratory distress C: Low birth weight D: Sudden infant death syndrome

A: Congenital anomalies

A school nurse is caring for a child following a tonic clonic seizure. Which of the following actions should the nurse take first?

Check the child's respiratory rate When using the airway, breathing, and circulation approach to client care, the nurse should determine the priority action is to assess the child's respiratory rate. If the child is not breathing, the nurse should administer rescue breaths.

A nurse is teaching an assistive personnel to measure a newborn's respiratory rate. Which of the following statements indicates an understanding of why the respiratory rate should be counted for a complete minute? A: "Newborns are abdominal breathers." B: "Newborns do not expand their lungs fully with each respiration." C: "Activity will increase the respiratory rate." D: "The rate and rhythm of breath are irregular in newborns."

D: "The rate and rhythm of breath are irregular in newborns."

A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation? A: Uses a unidextrous grasp B: Has a fear of strangers C: Shows preferences towards foods D: Babbles one-syllable sounds

D: Babbles one-syllable sounds

A nurse is preparing to measure an infant's vital signs. The nurse should use which of the following sites to assess a heart rate? A: Carotid artery B: Apex of the heart C: Brachial artery D: Radial artery

B: Apex of the heart

A nurse is providing teaching to the parents of a preschooler who has heart failure and a new prescription for digoxin twice daily. Which of the following instructions should the nurse include in the teaching?

Brush the child's teeth after giving the medication The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comes as a sweetened liquid to enhance the taste.

A nurse is performing a pre-college physical assessment on an adolescent. Which of the following immunizations should the nurse anticipate administering? A: Pneumococcal polysaccharide vaccine B: Bacille Calmette-Guérin (BCG) vaccine C: Meningococcal polysaccharide vaccine D: Influenza vaccine

C: Meningococcal polysaccharide vaccine

A nurse is caring for a school-age child who has primary nephrotic syndrome and is taking prednisone. Following 1 week of treatment, which of the following manifestations indicates to the nurse that the medication is effective?

Decreased edema A child who has nephrotic syndrome can experience edema due to the increased glomerular permeability, which increases protein loss. Prednisone decreases glomerular permeability, which causes fluid to shift from the extracellular spaces, resulting in decreased edema.

A charge nurse is preparing to make a room assignment for a newly admitted school-age child. Which of the following considerations is the nurses's priority?

Disease process The transmission of infectious diseases is the greatest risk to this child and other children on the unit. Therefore, the child's disease process is the nurse's priority consideration.

A nurse is caring for a toddler who has acute otitis media and a temperature of 40 C (104 F). After administering acetaminophen, which of the following actions should the nurse plan to take to reduce the toddler's temperature?

Dress the toddler in minimal clothing The nurse should recognize that dressing the toddler in minimal clothing will expose the skin to air and maximize heat evaporation from the skin, thus reducing the toddler's temperature.

A nurse is admitting a 4 month old infant who has heart failure. Which of the following findings is the nurse's priority?

Episodes of vomiting When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is three episodes of vomiting. This can indicate digoxin toxicity, which requires immediate intervention. Therefore, this is the nurse's priority finding.

A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following expected behavior characteristics of toddlers should the nurse include?

Expresses likes and dislikes The nurse should include that expressing likes and dislikes is an expected behavior of toddlers. This is the time in life when a toddler is developing autonomy and self-concept. They will try to assert themselves and frequently refuse to comply. The parent should allow the child to have some control, but also set limits for them so they learn from their behavior and learn to control their actions.

A nurse is assessing the pain level of a 3 year old toddler. Which of the following pain assessment scales should the nurse use?

FACES The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale allows the toddler to point to the face that depicts their current level of pain. The nurse can then determine the need for pain management.

A nurse is speaking with the mother of a 6-year-old child. Which of the following statements by the mother should concern the nurse? A: "The teacher says my child has to squint to see the board." B: "My child has recently lost both front top teeth." C: "My child often cheats when we play board games." D: "Sometimes my child acts bossy with his friends."

A: "The teacher says my child has to squint to see the board."

A nurse is providing teaching to the parents of a newborn. Which of the following information should the nurse include? A: "Your baby will receive a hepatitis B vaccine prior to discharge." B: "Your baby should receive the pneumococcal conjugate vaccine on his first birthday." C: "Your baby should receive the measles, mumps, rubella vaccine at 6 months." D: "Your baby will receive the first diphtheria, tetanus, pertussis vaccine at the 2 week well-baby visit."

A: "Your baby will receive a hepatitis B vaccine prior to discharge."

A nurse is reviewing data for four children. Which of the following children should the nurse assess first? A: A 10-year-old child who has sickle cell anemia who reports severe chest pain B: A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 C: A 1-year-old toddler who has roseola and a temperature of 39° C (102.2° F) D: A 4-year-old child who has asthma and a PCO2 of 37 mm Hg

A: A 10-year-old child who has sickle cell anemia who reports severe chest pain

A nurse is planning care for a 4-year-old child who requires airborne precautions. Which of the following activities should the nurse plan for child? A: Putting a large-piece puzzle together B: Watching a video game in the playroom C: Pulling a wagon with toys in the hallway D: Constructing a model airplane

A: Putting a large-piece puzzle together

A nurse is providing discharge teaching to the parents of a 6 month old infant who is postoperative following hypospadias repair with a stent placement. Which of the following instructions should the nurse include in the teaching?

Allow the stent to drain directly into your infant's diaper The nurse should instruct the parents to ensure that the stent drains directly into the infant's diaper to prevent kinking or twisting that can interfere with urine flow.

A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation?

An 8 month old infant who is not yet making babbling sounds The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a more extensive evaluation of hearing.

A nurse is creating a plan of care for a newly-admitted adolescent who has bacterial meningitis. How long should the nurse plan to maintain the adolescent in droplet precautions?

For 24 hr following initiation of antimicrobial therapy The nurse should plan to maintain the adolescent on droplet precautions for at least 24 hr following initiation of antimicrobial therapy. This practice will ensure that the adolescent is no longer contagious, which protects family members and the personnel caring for the client. Prophylactic antibiotics might be prescribed to individuals who were in close contact with the adolescent.

A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant?

Great toe The nurse should secure the sensor to the great toe of the infant and then place a snug-fitting sock on the foot to hold the sensor in place. The nurse should also check the skin under the sensor site frequently for temperature, color, and the presence of a pulse.

A nurse is providing discharge teaching to the guardian of a school-age child who has undergone a tonsilectomy. Which of the following statements by the guardian indicates an understanding the teaching?

I will notify the doctor if I notice that my child is swallowing frequently The nurse should instruct the parent that frequent swallowing is an indication of bleeding and, if it is observed, to notify the provider immediately.

A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan?

Increase fat content in the child's diet to 40% of total calories A child who has cystic fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limited secretion of pancreatic enzymes. The nurse should increase the child's fat intake to 35% to 40% of total caloric intake.

A nurse in an emergency department is assessing a toddler who has Kawasaki disease. Which of the following findings should the nurse expect? SATA

Increased temperature Kawasaki disease is an acute illness associated with a fever that is unresponsive to antipyretics or antibiotics. Xerophthalmia Ophthalmic manifestations of Kawasaki disease include reddening of the conjunctiva and dryness of the eyes, or xerophthalmia. Cervical lymphadenopathy A child who has Kawasaki disease can develop enlarged cervical nodes on one side of the neck that are nontender and greater than 1.5 cm in size.

A nurse is assessing an 8 year old child who has early indications of shock. After establishing an airway and stabilizing the child's respirations, which of the following actions should the nurse take next?

Initiate IV access After establishing an airway and stabilizing the child's respirations, the next action the nurse should take when using the airway, breathing, and circulation approach to client care is to establish IV access to maintain the child's circulatory volume.

A nurse is creating a plan of care for a child who has varicella. Which of the following interventions should the nurse include?

Initiate airborne precautions for the child The nurse should initiate airborne precautions for a child who has varicella because it is spread through droplets in the air. The incubation period for varicella is 2 to 3 weeks, and the child is contagious even before lesions appear.

A nurse in an emergency department is caring for a school-age child who has epiglottitis. Which of the following actions should the nurse take?

Monitor the child's oxygen saturation. The nurse should monitor the child's oxygen saturation level because the child is experiencing acute respiratory distress and it is necessary to determine if the child is responding to treatment.

A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to the provider?

Nasal flaring When using the airway, breathing, and circulation approach to client care, the nurse should determine that the priority finding to report to the provider is nasal flaring. Nasal flaring indicates the infant is experiencing acute respiratory distress.

A nurse is caring for a school-age child who has peripheral edema. The nurse should identify that which of the following assessments should be performed to confirm peripheral edema?

Palpate the dorsum of the child's feet The nurse should palpate the dorsum of the feet by pressing the fingertip against a bony prominence for 5 seconds to assess for peripheral edema.

A nurse is caring for an infant who is receiving IV fluids for the treatment of Tetralogy of Fallot and begins to have a hypercyanotic spell. Which of the following actions should the nurse take?

Place the infant in a knee- chest position The nurse should place the infant in a knee-chest position during a hypercyanotic spell to decrease the return of desaturated venous blood from the legs and to direct more blood into the pulmonary artery by increasing systemic vascular resistance.

A nurse is caring for a preschooler who has congestive heart failure. The nurse observes wide QRS complexes and peaked T waves on the cardiac monitor. Which of the following prescriptions should the nurse clarify with the provider?

Potassium chloride The nurse should identify that a child who has congestive heart failure can develop electrolyte imbalances, such as hyperkalemia or hypokalemia. The nurse should identify that the child is exhibiting manifestations of hyperkalemia and contact the provider about the administration of potassium chloride, which can increase the severity of hyperkalemia.

A nurse is assessing a 6 month old infant during a well-child visit. Which of the following findings should the nurse report to the provider?

Presence of strabismus Strabismus, or crossing of the eyes, typically disappears at 3 to 4 months of age. If not corrected early, this can lead to blindness. Therefore, the nurse should report this finding to the provider.

A nurse is planning developmental activities for a newly admitted 10 year old child who has neutropenia. Which of the following actions should the nurse plan to take?

Provide the child with a book about adventure The nurse should provide a school-age child with a book about adventure as a developmental activity because children are expanding their knowledge and imagination during this age. Through reading, school-age children can feel powerful and skillful as they imagine themselves in the stories they read.

A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy. The nurse should inform the parent that their child will need pulmonary function tests every 12 to 24 months to evaluate the presence of lung disease and how the child is responding to the current treatment regimen. As children grow, sometimes their manifestations can improve or decline, and treatment needs to change accordingly.

A nurse is planning care for a school-age child who has a tunneled central venous access device. Which of the following interventions should the nurse include in the plan?

Use a semipermeable transparent dressing to cover the site The nurse should cover the site with a semipermeable transparent dressing to reduce the risk of infection.d

A nurse is teaching a school-age child and their parent about postoperative care following cardiac catheterization. Which of the following instructions should the nurse include?

Wait 3 days before taking a tub bath The child should keep the site clean and dry for at least 3 days to reduce the risk of infection. Tub baths should be avoided for 3 days to avoid immersion of the incision in water.

A nurse in an emergency department is auscultating the lungs of an adolescent who is experiencing dyspnea. The nurse should identify the sound as which of the following?

Wheezes The nurse should identify the sound during auscultation as wheezes, which are high-pitched, musical or whistling-like sounds heard primarily on expiration as air passes through and vibrates narrowed airways.

A nurse is receiving change of shift report for four children. Which of the following children should the nurse assess first?

A toddler who has a concussion and an episode of forceful vomiting When using the urgent vs. nonurgent approach to client care, the nurse should assess this child first. An episode of forceful vomiting is an indication of increased intracranial pressure in a toddler who has a concussion.

A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is experiencing acute vomiting diarrhea. Which of the following manifestations should the nurse identify as an indication that the infant has moderate to sever dehydration?

Sunken anterior fontanel The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe dehydration due to the acute loss of fluid.

A nurse is preparing to administer ibuprofen 5 mg/kg every 6 hr PRN for a temperatures above 38.0 C (100.5 F) to an infant who weighs 17.6 Ib. Available is ibuprofen oral suspension 100 mg/5 mL. How many mL should the nurse administer to the infant per dose?

2 mL

A nurse in a provider's office is caring for a school-age child who has varicella. The parent asks the nurse when their child will no longer be contagious. Which of the following responses should the nurse make?

When your child's lesions are crusted, usually 6 days after they appear The nurse should inform the parent that the child is contagious 1 day prior to lesion eruption and until the vesicles have crusted over, which usually takes about 6 days.

A nurse is providing dietary teaching to the guardian of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make?

You should offer your child high-protein meals and snacks throughout the day The nurse should instruct the guardian to provide a diet that is well-balanced and high in protein and calories. Children who have cystic fibrosis require a higher percentage of the recommended dietary allowances of all nutrients to meet their energy requirements. Children who have good nutritional intake have improved lung function and decreased risk of infection.

A nurse is reviewing the dietary choices an adolescent who has iron deficiency anemia. The nurse should identify that which of the following menu items has the highest amount of nonheme iron?

half cup raisins The nurse should encourage the adolescent to eat raisins because they contain the highest amount of nonheme iron.