ATI PN Nursing Care of Children Online Practice 2020 B with NGN

A nurse is assisting with the care of the toddler 3 weeks following left nephrectomy due to Wilm's tumor. The nurse is reinforcing teaching about the adverse effects of chemotherapy with the toddlers parents. Which of the following statements by a parent indicates an understanding of the teaching?

"I should not pressure my child to eat while they have oral ulcers." The parent should not pressure their child to eat while they have oral ulcers. The parent should allow their child to consume foods of their choice to avoid anorexia, which can be caused by stomatitis related to chemotherapy.

(Maybe delete?) A nurse is reinforcing teaching about liquid oral iron supplements with the guardian of a school-age child who has iron deficiency anemia. Which of the following statements by the guardian indicates an understanding of the teaching?

"I will give this medication to my child with a straw"

A nurse is reinforcing teaching about home care with the guardian of a 14 month old toddler who has spastic cerebral palsy. Which of the following statements by the guardian indicates an understanding of the teaching?

"I will perform daily stretching exercises to my toddler's affected muscles" The nurse should reinforce that performing stretching exercises of the toddler's affected muscles will prevent muscle contractures.

A nurse is caring for a toddler who has terminal cancer and is receiving hospice care. The child's parent tells the nurse, "I'm a bad parent, and I can't deal with this." Which of the following responses should the nurse make?

"I'm not sure I follow you. Can you explain?" The nurse should use open-ended statements that will allow the parent to share their feelings and emotions. During times of grief, the parent needs to express emotions. The use of an open-ended statement relays the message that it is safe to do so with the nurse.

A nurse is reinforcing teaching regarding the immunization schedule with the parent of a 6-month-old infant during a well-baby visit. Which of the following statements by the parent indicates an understanding of the teaching?

"My baby will receive his 3rd DTaP vaccine today." The nurse should reinforce with the parent that the infant should receive his third diphtheria, tetanus, and pertussis (DTaP) immunization at 6 months of age.

A nurse in a provider's office is caring for a preschooler who has findings of croup. Which of the following statements by the parent requires immediate intervention by the nurse?

"My child has refused to drink any fluids for the past 8 hours." An inadequate fluid intake indicates the child is at greatest risk for dehydration and electrolyte imbalance. Therefore, this statement by the parent requires immediate intervention by the nurse.

A nurse is caring for a 3-year-old female child who is prescribed an indwelling urinary catheter. Which of the following actions should the nurse take when performing this procedure?

Apply 2% lidocaine lubricant into the urethral meatus. to assist in decreasing the discomfort the child might experience during catheterization.

A nurse is preparing to administer furosemide to a toddler who has a heart defect. Which of the following actions should the nurse take to identify the toddler?

Ask the guardian to verify the child's name Prior to administration of any medication, the nurse must correctly identify the toddler using two identifiers. The nurse should ask the guardian to verify the identity of the child and use the identification band as the second identifier.

A nurse is reinforcing dietary teaching with the parent of a child who has phenylketonuria. Which of the following foods should the nurse include the best recommendation for a low phenylalanine diet?

Banana The nurse should determine that foods such as a banana is the best food source to recommend because bananas contain low protein and low levels of phenylalanine. The nurse should also reinforce with the parent the importance of a low protein diet for their child.

A nurse is assisting with the care of an adolescent following a cardiac catherization. Which of the following is the priority finding the nurse should report to the provider?

Bleeding noted on the dressing is an indication that the client is at greatest risk for hemorrhage at the catherization site; therefore, the nurse should identify bleeding on the dressing as the priority finding. The nurse should apply continuous pressure 2.5 cm (1 in) above the site and notify the provider.

A nurse is collecting data from an 18-month-old toddler who has just presented to the urgent care clinic. Which of the following data should the nurse investigate further?

Blood pressure 120/80mm Hg is outside the expected reference range for an 18-month-old toddler and requires further investigation by the nurse.

A nurse is collecting data from a school-age child. The nurse should identify that which of the following findings is a manifestation of physical abuse?

Bruises at various stages of healing

A nurse is assisting with the care of a child who is receiving a blood transfusion. Which of the following findings indicates the child is having a hemolytic reaction?

Chills and flank pain Fndings that indicate an incompatibility of the transfused blood product with the child's blood. The nurse should identify this finding as an indication that the child is having a hemolytic reaction.

A nurse is caring for a toddler following a tonsillectomy . Which of the following is the priority finding that the nurse should report to the provider?

Continuous Swallowing When using the urgent vs. nonurgent approach to client care, the nurse should identify that continuous swallowing is a manifestation of hemorrhage. Therefore, this is the priority finding for the nurse to report to the provider.

A nurse is caring for an adolescent who has acne and a new prescription for isotretinoin. For which of the following adverse effects should the nurse monitor?

Depression; Clients taking isotretinoin can experience mental status changes, such as suicidal thoughts, aggression, emotional lability, and depression. The nurse should monitor the adolescent's mental status while taking isotretinoin

A nurse is assisting with the care of a 4-year old child who is prescribed an IV medication preoperatively. Which of the following techniques should the nurse use to assist the child to cope with this procedure? 1. Discuss benefits of the procedure. 2. Provide the child with a detailed explanation of the procedure. 3. Implement interactive sessions of 30 mins. 4. Give the child needleless IV supplies to play with. 5. Allow the child to perform the procedure with a doll.

Discuss the benefits of the procedure is correct. The nurse should discuss the benefits of the procedure with the child, because this action is an age-appropriate activity that will decrease the child's anxiety about the procedure. It will also provide an opportunity for the nurse to clarify any misconceptions the child might have about the procedure. Give the child needleless IV supplies to play with is correct. The nurse should allow the child to see, hold, and collect the supplies to familiarize the child with the potentially frightening aspects of the procedure, which will decrease the child's anxiety. Allow the child to perform the procedure with a doll is correct. The nurse should allow the child to mimic the procedure with a doll to alleviate anxiety. It will also provide an opportunity for the nurse to clarify any misconceptions the child might have about the procedure.

A nurse is assisting with the admission of a toddler who has bacterial meningitis caused by Haemophilus influenzae type B. Which of the following isolation guidelines should the nurse plan to initiate?

Droplet precautions The nurse should plan to initiate droplet precautions for this child, because bacterial meningitis caused by Haemophilus influenzae type B is transmitted through the air via large-particle droplets.

A nurse is contributing to the plan of care for a child who has type 1 diabetes mellitus and is experiencing an acute illness. Which of the following actions should the nurse include in the plan of care?

Encourage an increased fluid intake to flush out ketones and prevent dehydration; this can lead to Diabetic Ketoacidosis (DKA)

A nurse is assisting with the care of the toddler 3 weeks following left nephrectomy due to Wilms' tumor. A nurse in the outpatient clinic is assisting with the care of the toddler. Which of the following actions should the nurse take? (Select all that apply)

Encourage drinking fluids through a straw is correct. The nurse should encourage the toddler to drink through a straw because chemotherapy can cause stomatitis. Drinking through a straw allows oral fluids to bypass the mouth and increase comfort. Report platelet count to the provider is correct. The nurse should report the toddler's platelet count, which is below the expected reference range, and might need to be treated by the provider. Chemotherapy can cause bleeding and hemorrhaging. Offer the toddler oral nutritional supplements is correct. The nurse should offer the toddler oral nutritional supplements because the toddler might be at risk for decreased nutritional intake as a result of stomatitis and nausea related to chemotherapy.

The nurse is continuing to assist with the care of the toddler. The nurse should anticipate the providers prescription for ____________ due to ______________

Establishing IV access is correct. The nurse should anticipate a provider prescription to establish IV access. The toddler is scheduled for surgery and will require IV access for fluids and medications prior to, during, and after surgery. The need to administer fluids and medications is correct. The toddler is scheduled for surgery and might require IV fluids and medications during perioperative care for hydration, pain relief, and possibly antibiotics. Therefore, the nurse should anticipate a prescription for establishing IV access to help administer fluids and medications.

A nurse is caring for a child who has type 1 diabetes mellitus and has been receiving insulin via subcutaneous infusion pump. Which of the following laboratory tests would verify the average blood glucose level over the past 2 months?

Glycosylated hemoglobin provides an accurate average of the client's blood glucose level over the past 120 days. This test can be used to determine the effectiveness of, or compliance with, a treatment plan. It can also be used to diagnose diabetes mellitus.

A nurse is collecting physical data from a 4-year-old child who has diarrhea and has been vomiting for 24 hr. Which of the following sites should the nurse grasp to determine the child's skin turgor?

The child's abdomen. The nurse should expect the child who has diarrhea and has been vomiting to exhibit a decrease in skin turgor. To check skin turgor, the nurse should grasp the skin on the child's abdomen, pull it taut, and release it quickly. A child who has been vomiting and had diarrhea for 24 hr will have a prolonged period of tenting.

A nurse is assisting with the development of a health promotion program for the guardians of adolescents. Which of the following information about adolescents should the nurse recommend to include in the program

The leading cause of death in adolescents is physical injury The nurse should recommend including this information, because injuries from motor-vehicle crashes are the leading cause of death in the adolescent population.

A nurse is collecting for an adolescent who has asthma and has received an albuterol nebulizer treatment. Which of the following findings indicates an improvement in the adolescent's condition

The nurse should recognize that a respiratory rate of 20/min is within the expected reference range and indicates an improvement in the adolescent's condition.

A nurse is collecting data from an 18-month old toddler. Which of the following is a deviation from expected growth and development that the nurse should report to the provider?

The toddler is unable to recognize familiar objects by name because this is a deviation from expected growth and development. The toddler should be able to accomplish this task by 12 months of age.

A nurse is reinforcing teaching with the parent of a school-age child who has lactose intolerance. Which of the following supplements should the nurse instruct the parent in the child's diet?

Vitamin D Lactose intolerance is managed by eliminating dairy products from the diet. However, this can result in a decrease in bone density because of the lack of calcium and vitamin D in the diet. The nurse should instruct the parent to administer a vitamin D supplement to the child to enhance the absorption of calcium from foods other than those containing lactose.

A nurse is assisting with the care of a school-age child following an appendectomy. Select the 3 findings that the nurse should identify as indications of a potential complication.

WBC count is correct. The child's WBC count has increased significantly following surgery. The nurse should identify that this is a potential indication of postoperative infection. Abdominal assessment is correct. The child's abdomen is rigid and distended, and they are reporting increased pain. The nurse should identify that this is a potential indication of postoperative infection. Temperature is correct. One day following surgery, the child's temperature has increased and is above the expected reference range. The nurse should identify that this is a potential indication of postoperative infection.

A nurse is reinforcing discharge teaching with the guardians of a 6 month old infant following a surgical procedure to repair a hypospadias. Which of the following instructions should the nurse include?

Wait 1 week before giving the infant a tub bath. The nurse should instruct the guardians to keep the infant's penis as dry as possible until the stent or catheter is removed. The parent should provide sponge-baths to the child until the stent or catheter is removed.

A nurse is screening a group of school age children for abuse. The nurse should identify that which of the following conditions places a child at risk for physical abuse?

A child who has ADHD: due to the increased emotional and physical demands the conditon can place of the child's parents

A nurse is caring for a group of children in an acute care setting. The nurse should identify that which of the following children is at risk for impaired elimination?

A child who has hyperglycemia A client who has hyperglycemia exhibits manifestations of polyuria, lethargy, confusion, thirst, nausea, vomiting, abdominal pain, signs of dehydration, rapid respiration, and fruity breath. A child who has hyperglycemia is at risk for dehydration

A nurse is preparing to leave the room after performing nasal suctioning for an infant who has respiratory syncytial virus (RSV). Identify the sequence in which the nurse should remove the following personal protective equipment (PPE).

1. Gloves 2. Goggles 3. Gown 4. Mask

A nurse on a pediatric unit is assisting with the care of a toddler. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the toddler.

Administer factor VIII is anticipated. The toddler is experiencing an acute episode of hemophilia due to a recent fall. During this acute episode, there is potential for internal bleeding into the joint spaces. The administration of factor VIII will control bleeding. Apply ice packs to affected joints is anticipated. The toddler is experiencing an acute episode of hemarthrosis due to a recent fall, as evidenced by the bruising and swelling of the knee joint. The application of ice will manage discomfort and decrease bleeding into the joint. Elevate affected joints is anticipated. The toddler is experiencing an acute episode of hemarthrosis due to a recent fall, as evidenced by the bruising and swelling of the knee joint. Elevation of the joint, along with the application of ice, will decrease bleeding and swelling in the joint. Perform passive range-of-motion (ROM) exercises during the first 12 hr following injury is contraindicated. The toddler is experiencing an acute episode of hemarthrosis. Passive ROM exercises can increase bleeding into the joint for the first 48 hr following injury. The toddler should be encouraged to exercise the joint as tolerated. Administer aspirin PRN pain is contraindicated. Aspirin and NSAIDs should be avoided because they inhibit platelet function and might increase bleeding

A nurse is collecting data from an infant during a well-child visit. Which of the following sites should the nurse use when obtaining the infant's heart rate?

Apical The nurse should use the apical pulse to obtain the infant's heart rate and count it for a full minute, because it gives a reliable rate and rhythm and provides accurate baseline assessment data. In an infant, the apical heart rate is auscultated at the fourth intercostal space lateral to the midclavicular line.

A nurse is assisting with the care of a newly admitted 2 year-old toddler. For each finding, click to specify if the finding is consistent with acute glomerulonephritis, iron deficiency anemia, or nephroblastoma (Wilms' tumor). Each finding may support more than one disease process

Hematuria is consistent with acute glomerulonephritis and nephroblastoma (Wilms' tumor). Acute glomerulonephritis can cause swelling within the glomeruli, which causes hematuria. With nephroblastoma (Wilms' tumor), there is a tumor within the kidney that affects the filtration of urine and causes hematuria. Hemoglobin level is consistent with iron deficiency anemia and nephroblastoma (Wilms' tumor). A lack of iron can lead to anemia, which is defined as decreased hemoglobin. Iron is required for production of hemoglobin. With nephroblastoma (Wilms' tumor), bleeding from the tumor can lead to decreased hemoglobin. Urine RBC casts is consistent with acute glomerulonephritis and nephroblastoma (Wilms' tumor). The presence of RBC casts in the child's urine is manifestation of acute glomerulonephritis and nephroblastoma. Blood pressure is consistent with acute glomerulonephritis and nephroblastoma (Wilms' tumor). With acute glomerulonephritis, hypertension is the result of excessive accumulation of water and retention of sodium. With nephroblastoma (Wilms' tumor), hypertension is caused by an increase in renin by the tumor. Skin assessment is consistent with acute glomerulonephritis, iron deficiency anemia, and nephroblastoma (Wilms' tumor). The child's skin assessment indicates skin pallor, which can be a result of decreased hemoglobin in all three disease processes.

A nurse is assisting with the care of a newly admitted 2-year old toddler. Select the 4 findings the nurse should report to the provider

Hemoglobin is correct. The toddler's hemoglobin level is below the expected reference range, which could indicate anemia. Therefore, the nurse should report this finding to the provider. Abdominal findings is correct. The toddler's abdominal assessment indicates tenderness with light palpation and abdominal swelling, which are unexpected findings. Therefore, the nurse should report these findings to the provider. Urine RBC casts is correct. The toddler's urine RBC casts is above the expected reference range. Therefore, the nurse should report this finding to the provider. Blood pressure is correct. The toddler's blood pressure is above the expected reference range, which is an unexpected finding. Therefore, the nurse should report this finding to the provide

A nurse is reviewing the laboratory values of a school-age child who has iron deficiency anemia. Which of the following findings should the nurse expect?

Hgb 9 g/dL

A nurse is caring for a school age child who has hypocalcemia. Which of the following manifestations should the nurse expect?

Hypotension

A nurse is reinforcing teaching about sudden infant death syndrome (SIDS) with the parent of a 1 month old infant. Which of the following statement by the parent indicates an understanding of the teaching?

I will allow my baby to have a pacifier while sleeping-decreases the risk for SIDS

A nurse is assisting with the care of an 8-month old infant. Highlight the information in the Nurses' Notes that indicates the infant's condition is improving.

Infant is sleeping in parent's arms is correct. Restlessness and irritability are potential indications of hypoxia and impending airway obstruction. The infant was restless and irritable on admission, even when the parent was holding them. Therefore, this finding is an indication that the infant's condition has improved. Oxygen saturation is 96% on 100% cool mist oxygen via blow-by tubing is correct. A low oxygen saturation is an indication of hypoxia. The infant's oxygen saturation has increased from 89% to 96%, which is within the expected reference range. Therefore, this finding is an indication that the infant's condition has improved. Breath sounds are present and equal bilaterally in the lung bases is correct. This finding indicates increased air movement compared to the 0600 assessment. Therefore, this finding is an indication that the infant's condition has improved. Infant voided 34 mL is correct. The infant's parent reported on admission that the infant had not voided in over 12 hr. The infant's mucous membranes were noted on admission to be slightly dry, which is an indication of dehydration. Therefore, the infant voiding 34 mL is an indication that the infant's hydration status has improved.

A nurse is caring for a 1 month old infant who has a nasogastric tube in place for intermittent feedings. Which of the following actions should the nurse take?

Position the head of the crib at 30 angle between feedings (30-45 degrees to prevent aspiration)

A nurse is contributing to the plan of care for a child who is in Buck's traction. Which of the following interventions should the nurse include in the plan?

Maintain the leg in an extended position.This position decreases the risk for further injury to the extremity and minimizes the occurrence of muscle spasms.

A nurse in a pediatric clinic is talking on the telephone with the parent of a 6-month-old infant who has a urinary tract infection and started taking an oral antibiotic the day before. Listen to the audio clip and determine which of the following responses the nurse should take?

Mix the medicine with 1 teaspoon of applesauce before giving it to your baby.

A nurse is preparing a toddler for suturing of a minor facial laceration. The nurse should place the toddler in which of the following restraints?

Mummy restraint The nurse should use a mummy wrap when a short-term restraint is needed for treatment of the toddler that involves the head and neck. The nurse should always use the least amount of restraint necessary.

A nurse in a pediatric clinic is caring for an infant who has heart failure and a prescription for digoxin. Which of the following statements by the parent indicates desired therapeutic effect of the medication?

My baby is breathing easier than she used to Digoxin(increases cardiac output and decrease venous pressure and pulmonary edema, which will reduce respiratory demands

A nurse is reinforcing teaching with the guardian of a child who has a new diagnosis of rheumatic fever. Which of the following statements by the guardian indicates an understanding of the teaching?

My child might have a period of irregular movement of the extremities-chorea is temporary lack of coordination The nurse should instruct the guardian that the child might experience chorea weeks or months after the initial diagnosis. Chorea is a temporary lack of coordination and the presence of sudden, irregular movements or periods of clumsiness.

A nurse is providing care to parents immediately following their child;s unexpected death. Which of the following actions should the nurse take?

Offer the parents the opportunity to bathe and dress the child's body this can facilitate the grieving process and allow them to provide care for their child one last time

A nurse is assisting with the care of a school-age child The nurse should plan to first address the child's _____________, followed by the child's ________________________

Oxygen saturation is correct. When using the urgent vs. nonurgent approach to client care, the nurse should recognize that addressing the child's hypoxia is the priority intervention. The child's oxygen saturation is below the expected reference range. The nurse should take action to maintain the child's oxygen saturation above 95%. Pain is correct. When using the urgent vs. nonurgent approach to client care, the nurse should recognize that addressing the child's pain is the priority after addressing the child's hypoxia. The child reported a pain level of 8 on a scale of 0 to 10, which indicates severe pain. Vaso-occlusive crises can cause severe pain due to tissue ischemia from sickled cells obstructing blood flow.

A nurse is contributing to the plan of care for a 10mo old infant who is postoperative following a cleft palate repair. Which of the following actions should the nurse include in the plan of care

Place the infant in side-lying position to promote healing and prevent injury to the surgical site.

A nurse is reviewing the laboratory findings of a school-age child who reports feeling tired and being easily bruised. Which of the following laboratory values should the nurse report to the provider?

Platelets 85,000/mm3 This value is below the expected reference range for a school-age child and should be reported to the provider.

A nurse is assisting with planning dietary needs for a toddler. Which of the following interventions should the nurse include in the plan of care?

Provide 1 Tbsp (15 g) of solid food for each year of age.

A nurse in a care provider's office is preparing to administer scheduled vaccines to an infant. The infant's parent refuses to allow the nurse to administer the vaccines. Which of the following actions should the nurse take?

Provide the parent with a vaccine information sheet (VIS) to ensure the parent has the most current information regarding the benefits and risks of the vaccines.

During a well-child visit, the parent of a toddler expresses concern to the nurse that the toddler takes several hours to fall asleep at night. Which of the following recommendations should the nurse make?

Provide the toddler with a favorite toy at bedtime.

A nurse is reinforcing teaching with the parents of a 2-year-old toddler at a well child visit. Which of the following should the nurse recommend as an age appropriate activity for the toddler?

Putting together a large piece puzzle Puzzles provide the child an opportunity to develop fine motor skills. Other fine motor skill activities include finger painting and coloring with thick crayons.

A nurse is reinforcing teaching with the parents of preschoolers regarding the use of booster seats in a motor vehicle. Which of the following instructions should the nurse include in the teaching?

Secure the child in the booster seat using the motor vehicle's shoulder-lap seat belt.

A nurse is collecting data from a 10-month-old infant. Which of the following findings should the nurse report to the provider?

Sits with support by leaning on hands The nurse should identify that sitting with support can indicate a developmental delay, because an infant should be able to sit unsupported by 8 months of age. Therefore, the nurse should report this finding to the provider.

A nurse is contributing to the plan of care for an infant who has bronchiolitis and is tachypneic. Which of the following actions should the nurse include in the plan of care?

Suction nasal passages with a bulb syringe. The nurse should suction the infant's nasal passages using a bulb syringe to clear the nasal passages and decrease respiratory effort.

A nurse is assisting with the care of a newly admitted 2 year-old toddler the nurse should first address the child's ___________ followed by the child's ___________.

Temperature When using the evidence-based practice approach to client care, the nurse should first address the toddler's temperature because it is above the expected reference range. Fever is the priority concern because it can lead to seizure activity. The nurse should then also address the toddler's hemoglobin level and hematuria because these are unexpected findings that require further assessment. Abdominal Pain When using the evidence-based practice approach to client care, the nurse should next address the toddler's abdominal pain. During the assessment, the nurse noted abdominal tenderness and a FLACC scale rating of 6 out of 10. These findings require the nurse to use evidenced-based methods to relieve the toddler's pain. The nurse should also address the toddler's serum RBC count and blood pressure because they are above the expected reference ranges.

A nurse is preparing to administer phenobarbital to a toddler who has a seizure disorder and weighs 10kg (22lbs). The prescription reads phenobarbital sodium 2.5mg/kg PO BID. Available is phenobarbital 20mg/5ml. How many mL should the nurse administer with each dose?

X = Dose per kg × Client's weight in kg X mg = 2.5 mg/kg × 10 kg X mg = 25 mg 20mg/5mL = 25mg/XmL (25 x 5/20) XmL = 6.25 mL Use the "Desired over Have" Method of calculation

A nurse is reinforcing teaching with the family of an adolescent client who was recently diagnosed with celiac disease. Which of the following foods should the nurse recommend?

Yellow corn An adolescent who has celiac disease is unable to process gluten, a protein found in wheat, barley, rye, and oats. The nurse should instruct the family that the adolescent's diet is restricted to foods that are free of gluten, such as corn, rice, and millet.

A nurse is preparing to obtain a peak expiratory flow rate from an adolescent. Which of the following actions should the nurse take?

have the client stand during the procedure ; allows to get an accurate reading

A nurse is assisting in the care of a male child who has acute poststreptococcal glomerulonephritis. (APSG) For which of the following manifestations should the nurse monitor?

oliguria; Due to the decreased glomerular filtration rate and retention of sodium and water associated with the disease process.