Peds ATI Practice

a nurse is providing immediate postoperative care for a preschooler who had a tonsillectomy. which of the following actions should the nurse take? A. offer ice cream or pudding when the child is fully awake B. eliminate the use of a straw when offering fluids C. apply a heating pad to the neck area D. instruct the child to blow his nose to clear bloody secretions

B. eliminate the use of a straw when offering fluids - straws can accidentally injure the surgical site and cause bleeding. their use should be avoided in the immediate postoperative period

a nurse is performing a well-child assessment on a 7 year old client who takes great pride in bringing school papers home. the nurse recognizes that this behavior demonstrates which of the following of erikson's stages of psychosocial development? A. initiative vs guilt B. industry vs inferiority C. identity vs role confusion D. autonomy vs shame and doubt

B. industry vs inferiority

a nurse on the pediatric unit is caring for a group of clients. which of the following findings should be the nurse's priority? A. a child who has asthma and a pulse ox of 94% B. a child who has nephrotic syndrome and 1+ protein on urine dipstick C. a child who has sickle cell anemia and a urine specific gravity of 1.030 D. a child who has insulin-dependent DM and a fingerstic glucose reading of 110mg/dL

C. a child who has sickle cell anemia and a urine specific gravity of 1.030 - a child who has sickle cella anemia must maintain adequate hydration because dehydration can cause sickle cell crisis that can occlude the child's circulation

a nurse is caring for a 12 month old infant following the surgical repair of a cleft palate. the nurse should plan to feed the infant usinng which of the following instruments? A. spoon B. straw C. firm nipple D. cup

D. cup - the infant should be fed clear liquids using a cup for 7 to 10 days following a cleft palate repair to prevent trauma and injury to the suture line

a nurse is reviewung laboratory findings of an adolescent who has acute renal failure. which of the following findings should the nurse expect? A. hypokalemia B. hypercalcemia C. decreased plasma creatinine D. metabilic acidosis

D. metabolic acidosis - acute renal failure: HYPERkalemia, HYPOcalcemia, and an elevated plasma creatinine

A nurse in an emergency department is caring for an 8 year old who is up to date with current immunization recommendations and has a deep puncture injury. which of the following should the nurse anticipate administering? A. diphtheria, tetanus, and acellular pertussis (DTaP) vaccine B. single injection of tetanus immune globulin (TIG) mixed with pediatric tetanus booster (DT) C. tetanus, diphtheria, and acellular pertussis (Tdap) vaccine D. adult tetanus booster (Td)

D. adult tetanus booster (Td) - Td is recommended for would prophylaxis in children 7 and older. Td is also recommended every 10 years after 18 years of age

A nurse is caring for a child who has epistaxis. which of the following actions should the nurse take? A. administer aspirin B. tilt the child's head back and apply pressure C. have the child lie down and rest D. apply pressure the the lower part of the child's nose

D. apply pressure the the lower part of the child's nose

A nurse is caring for a 7-year-old shild who is in skeletal traction following a complete fracture of the femur. Which of the following diversional activities should the nurse offer the child? A. puzzle with large pieces B. building blocks C. finger paints D. chapter books

D. chapter books

a nurse is caring for an 8 year old child who has acute glomerulonephritis. which of the following findings should the nurse expect? A. hypotension B. stomatitis C. bloody diarrhea D. periorbital edema

D. periorbital edema - glomerulonephritis causes high BP

a nurse is caring for a child with a vesicular rash that has been present for 6 days. the nurse should expect that the child has which of the following conditions? A. measles B. 5th disease C. tetanus D. varicella

D. varicella - children who have varicella may present first with a maculopapular rash that progress to vesicles on erythematous base which eventia;;y rupture and crust over

a nurse is performing a physical assessment on a 6 month old infant. which of the following reflexes should the nurse expect to fond? A. stepping B. babinski C. extrusion D. moro

B. babinski - the babinski reflex, which is elicited by stroking the bottom of the foot and causing the toes to fan and the big toe to dorsiflex, should be present until the age of 1 - stepping disappears at 4 months - moro should disapoear at 3-4 months

A nurse is caring for a child who has glomerulonephritis. which of the following actions should the nurse take? A. monitor the child's blood pressure twice per day B. maintain the child on bed rest for 3 days C. weigh the child once each day D. increase the child's daily intake of sodium

C. weigh the child once a day - monitor fluid balance

a nurse is assessing a 4 year old child for growth and developmental milestones during a well-child visit. which of the following findings suggests a possible delay in development? A. inability to tie shoes B. adding 3 parts to a stick figure C. speaking using only 2 or 3 word sentences D. inability to walk backward

C. speaking using only 2 or 3 word sentences - a 4 year old child should be speaking 4 to 5 word sentences. speaking in 2 to 3 word sentences is typical of a 2 year old child. - walking backward is a skill expected of a 5 year old child

a nurse is assessing an infant who develops respiratory distress, absence of breath sounds on one side, and deviation of the trachea away from the affected side. Based on these manifestations, which of the following conditions is the infant experiencing? A. tension pneumothorax B. flail chest C. pulmonary contusion D. fractured rib

A. tension pneumothorax

a nurse in a provider's office receives a phone call from the guardian of an infant who just vomited after the administration of digoxin. which of the following actions should the nurse take first? A. tell the guardian that a repeated dose of medication should not be given B. verify the prescribed medication regimen C. determine if the infant has been exposed to others who are ill D. ask the guardian about the infant's urinary output

A. tell the guardian that a repeat dose of medication should not be given - the greatest risk to this infant is an injury from digoxin toxicity

a nurse is assessing a 6 month olf infant who had a cardiac catheterization with right femoral entry to diagnose a possible congenital heart defect. which of the following findings should the nurse report to the provider? A. cool toes on the right foot B. weak pedal pulses on both feet C. positive babinski reflex on both feet D. erythema on the right foot

A. cool toes on the right foot - the nurse should monitor the temp of the infant's right extremity and report any indication of coolness distal to the entry site to the provider because this can indicate an obstruction of an artery

A nurse is caring for the family of a preschooler who has a terminal illness. The nurse should teach the family to expect the preschooler to have which of the following concepts of death? A. people can come back to life after they die B. death eventually occurs for all people C. death is a scary monster that causes people to die D. people are unable to be anything but alive

A. people are able to come back to life after they die

a nurse is providing dietary teaching to a parent of a toddler who has cystic fibrosis. which of the following instructions should the nurse include? A. provide a high-fat diet for the toddler B. limit the toddler's daily intake of sodium C. increase the toddler's intake of foods high in folic acid D. allow the toddler to skip meals when he is not hungry

A. provide a high-fat diet for the toddler - children who have CF have impaired intestinal absorption of fat. therefore, the toddler will require an increased intake of fat

a nurse is caring for a preschool age child who is dying. which of the following findings is an age appropriate reaction to death by the child? SATA A. the child views death as similar to sleep B. the child is interested in what happens to the body after death C. the child recognizes that death is permanent D. the child believes his thoughts can cause death E. the child thinks death is a punishment

A. the child views death as similar to sleep D. the child believes his thoughts can cause death E. the child thinks death is a punishment

a nurse on a pediatric unit is caring for a preschooler who is prescribed an iv medication. which of the following actions should the nurse take to prepare the child for the procedure? A. use role-play activities with the child B. provide the child with a detailed explanation of the procedure C. implement interactive sessions of 30 min each with the child D. give the child identical iv supplies to play with

A. use role-play activities with the child

a nurse is assessing a 2 month old infant who has a ventricular septal defect. which of the following findings should the nurse report to the provider? A. weight gain of 1.8kg (4lb) B. heart rate of 125/min C. soft, flat fontanel D. systemic murmur

A. weight gain of 1.8kg (4lb)

A nurse is discussing play activities with a group of parents of toddlers. Which of the following activities should the nurse recommend for this age group? A. Jumping rope B. Pushing a toy lawn mower C. Sorting colored marbles D. Playing a board game

B. Pushing a toy lawn mower - toddlers are developmentally ready for push-pull toys, and they enjoy play activities that allow imitation of adults.

a nurse is planning care for an infant who has heart failure. which of the following interventions should the nurse include in the plan to meet the nutritional needs of the infant? SATA A. offer the infant a feeding every 2 hr B. allow 30 min to complete each feeding C. gradually increase the caloric density of the formula D. position the infant semi-upright during feedings E. provide gavage feeding if respiratory rate exceeds 80/min

B. allow 30 min to complete each feeding C. gradually increase the caloric density of the formula D. position the infant semi-upright during feedings E. provide gavage feeding if respiratory rate exceeds 80/min

a nurse is assessing a child who has a ventricular septal defect. which of the following findings should the nurse expect? A. diastolic murmur B. murmur at the left sternal border C. cyanosis that increases with crying D. widened pulse pressure

B. murmur at the left sternal border - a ventricular septal defect (a hole in the sternal wall between the ventricles) is an ACYANOTIC heart defect. the sound is transmitted in the direction of blood flow, so any backflow of blood from the left to the right ventricle through the septal defect is best hears in this area

a school nurse is assessing a child who has been stung by a bee. the child's hand is swelling, and the nurse notes that the child is allergic to insect stings. which of the following findings should the nurse expect if the child develops anaphylaxis? SATA A. bradycardia B. nausea C. hypertension D. urticaria E. stridor

B. nausea D. Urticaria E. stridor - a common gastrointestinal responde to excessive histamine release is nausea. a common skin manifestation of excessive histamine release is hives (urticaria). a serious life threatening response is airway narrowing (dyspnea and stridor)

The nurse is preparing to administer an oral medication to an 8-month-old infant. Which of the following actions should the nurse take? A. mix the medication with 1 tsp of honey to sweeten the taste for the infant B. use an oral syringe to place the medication alongside the infants tongue C. add the medication to the infants bottle of formula D. place the infant in a supine position to administer the medication

B. use an oral syringe to place the medication alongside the infant's tongue

a nurse is caring for a toddler. which of the following laboratory findings should the nurse report to the provider? A. BUN 8 mg/dl B. uric acid 3.0 mg/dl C. creatinine 0.9 mg/dl D. urine specific gravity 1.010

C. creatinine 0.9 mg/dl - the expected reference range for a toddler is a creatinine level of 0.3-0.7 - BUN 5-18 - uric acid 2.0 to 5.5 - urine specific gravity 1.01 to 1.030

a nurse is teaching the guardian of a school-age child who has DM how to recognize DKA. which of the following findings should the nurse identify as a manifestation of this complication? A. slow heart rate B. protruding eyeballs C. deep, rapid respirations D. decrease urinary output

C. deep, rapid respirations - kussmaul respirations are a manifestation of DKA. body is attempting to rid itself of the excess carbon dioxide that results from the presence of ketones.

a nurse is caring for an adolescent who has end stage renal disease and is schedules for peritoneal dialysis. which of the following actions should the nurse take? A. position the adolescent supine during the procedure B. have the adolescent drink 240 mL (8oz) of fluid prior to the procedure C. obtain the adolescent's weight prior to the procedure D. monitor the adolescent's vital signs every 4 hours during the procedure

C. obtain the adolescent's weight prior to the procedure

a nurse is assessing a preschooler who has HIV. which of the following manifestations should the nurse expect" A. generalized petechiae B. jaundice C. obesity D. chronic diarrhea

D. chronic diarrhea

a nurse is assessing an adolescent who is receiving fentanyl via epidural. which of the following assessments should the nurse identify as the priority? A. skin around the catheter site B. blood pressure C. pain level D. oxygen saturation

D. oxygen saturation - ABC

a nurse is preparing to administer recommended vaccinations to a 2 month old infant. which of the following immunizations should the nurse plan to administer? A. human papillomavirus (HPV) and hep a B. measles, mumps, and rubella (MMR) and TDaP C. haemophilus influenzae type b (Hib) and inactivated polio virus (IPV) D. varicella (VAR) and live attenuated influenza vaccine(LAIV)

C. haemophilus influenzae type b and inactivated polio virus - the HOV immunization series starts at 11 years old and hep A starts at 12 months - the first dose of the MMR vaccine is administered at 12-15 months and TdaP is at 11-12 years old - varicella is not administered to children younger than 12 months and LAIV is not administered to children under 2

a nurse is planning care fir an infant with an unrepaired myelomeningocele. which of the following actions should the nurse take? A. fasten the diaper loosely B. cleanse the meningeal sac with povidone-iodine daily C. palpate the abdomen for bladder distension D. cover the sac with a dry, sterile gauze dressing

C. palpate the abdomen for bladder distension - a neurogenic bladder is a common complication of a myelomeningocele. even if the infant is having wet diapers, the nurse should assess for bladder distension due to the possibility of incomplete emptying of the bladder

A nurse is planning to use guided imagery for an early school aged child who continues to have mild discomfort following the administration of an analgesic. Which of the following techniques should the nurse plan to use? A. give the child a kaleidoscope and ask the child to find different designs B. encourage the child to take a deep breath and let the body go limp on the exhale C. teach the child to picture a stop sign whenever the pain begins D. encourage the child to focus on a recent pleasurable experience

D. Encourage the child to focus on a recent pleasurable experience - guided imagery: this technique encourages the child to focus on the pleasurable experience rather than the sensation of pain.

a nurse is teaching the parents of a child who has rheumatic fever. which of the following statements by a parent indicates an understanding of the teaching? A. "my child may take aspirin for his joints" B. "my child will need a blood transfusion prior to discharge" C. "i will wear a gown when i am in my child's room" D. "i will apply lotion to the child's peeling skin"

A. "my child may take aspirin for his joint pain"

a nurse is providing teaching to a 12 year old client who is recovering from an acute episode of hemophilia A. which of the following statements should the nurse include in the teaching? A. "have your parent stretch and move your legs for you" B. "apply heat to joints that become painful, stiff, and swollen" C. "take aspirin at the first sign of a headache" D. "you will be able to participate in physical exercise

D. you will be able to participate in physical exercise" - physical exercise is important for the maintenance of joint mobility and muscle strengthening.

a nurse is providing teaching to the parent of a 2 year old toddler about nutrition. which of the following statements by the parent indicates an understanding of the teaching? A. "my child should consume 1,000 calories per day B. "my child should have 4 oz of protein per day" C. "i should give my child 32oz (4 cups) of milk per day" D. "i should feed my child 4 oz (1/2 cup) of vegetables per day"

A. "my child should consume 1000 calories per day"

A nurse is assessing a toddler who has measles (rubeola). which of the following findings should the nurse expect? A. koplik spots B. parotitis C. strawberry tongue D. paroxysmal coughing

A. Koplik spots - swollen parotid glands are an expected finding in a child with mumps. Strawberry tongue is an expected finding in a child who has scarlet fever. paroxysmal coughing is an expected finding in a while who has pertussis

a nurse is providing teaching about disease management to the parent of a preschooler who has a new diagnosis of asthma. which of the following parent statements indicates an understanding of the teaching? A. "my child should not receive live virus vaccines" B. "i will encourage my child to participate in sports" C. "i will give my child aspirin when she has a fever" D. "my child will outgrow asthma by adulthood"

B. "i will encourage my child to participate in sports"

a nurse is caring for a toddler who has asthma. the parents are concerned about the toddlers reaction to the hospitalization. which of the following actions should the nurse take to decrease the child's anxiety? A. provide privacy B. give the child a thorough explanation before providing care C. encourage rooming-in D. tell the child you will help fix her

C. encourage rooming in - rooming-in is the most effective means of providing emotional support for a toddler. the family's presence provides a sense of security that increases the child's ability to cope with an unfamiliar environment

a nurse at a community health department is discussing the nutritional needs of children with a group of parents and guardians. which of the following pieces of information should the nurse include? A. infants should be transitioned to low-calorie milk at 12 months B. preschoolers need 10 - 12g of protein per day C. toddlers can be given up to 120-180 mL (4-6 oz) of juice per day D. school-age children should be encouraged to avoid afternoon snacks

C. toddlers can be given up to 120-180mL (4-6 oz) of juice per day

A nurse is admitting a child who has a UTI and a history of myelomeningocele. after completing the admission history, which of the following actions should the nurse plan to take? A. attach a latex allergy alert identification band B. initiate contact precautions C. post signs in the client's bathroom to strain the client's urine D. administer folic acid with meals

A. attach a latex allergy alert identification band - myelomeningocel, a serious complication of spina bifida, is a neural tube defect in which the spinal cord and meninges are in the CSF filled sac at birth. clients who have neural tube defects are at risk of latex allergy; therefore, the nurse should avoid the use of common medical products containing latex.

a nurse is planning to collect the specimen from a male infant using a urine collection bag. which of the following actions should the nurse take? A. wash and dry the infant's genitalia and perineum thoroughly B. apply a small coating of water-soluble lubricant to the skin of the infant's perineal area C. avoid placing the scrotum inside the collection bag D. wait several hours after positioning the device before checking it

A. wash and dry the infant's genitalia and perineum thoroughly - the skin should be washed and dried to promote the application of the adhesive of the collection device

a nurse is providing teaching to a 13 year old who has type 1 DM. which of the following client statements indicates an understanding of DM management? A. "i will need to avoid snacks between meals" B. "i should check my blood glucose levels more often when i am sick" C. "i will need to limit my exercise to 1 hr per day" D. "i should consume 30g of simple carbohydrates if i feel shaky"

B. "i should check my blood glucose levels more often when i am sick" - blood glucose levels should be checked every 3 hours during illness for a client with type 1 DM because hyperglycemia often occurs with an infection, requiring additional doses of insulin

a nurse is providing teaching about foods high in fiber to the guardian of a child who has chronic constipation. which of the following foods should the nurse recommend? A. 1/2 cup whole milk B. 1/2 cup cooked pinto beans C. 1 cup green leaf lettuce D. 1 cup apple juice

B. 1/2 cup cooked pinto beans