NURS 3444. Exam 4 (Mid Semester ATI)

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

A nurse at a pediatric clinic is assessing a 5 month old infant At a well child visit which of the following findings should the nurse report to the provider? 1. head lags when pulled from in lying to a sitting position 2. absence of startle in crawl reflexes 3. inability to pick up a rattle after dropping it 4. rolls from Back to side

1. head lags when pulled from in lying to a sitting position

A nurse is teaching a parent of an infant about home safety . Which of the following information should the nurse include? Select all that apply 1. Use a wheeled infant Walker 2. place soft pillows around the edge of the infant crib 3. Position the car seat so that it is rear facing 4. Secure a safety gate at the bottom and top of the stairs 5. Maintain the water heater temperature at 49 degrees Celsius or 120 degrees Fahrenheit

3. Position the car seat so that it is rear facing 4. Secure a safety gate at the bottom and top of the stairs 5. Maintain the water heater temperature at 49 degrees Celsius or 120 degrees Fahrenheit

A nurse is talking with a parent of a preschooler. The parent reports that she struggles to get their child to go to bed at a consistent time. She explains that the child gets out of bed, enters his parents' room, and cries when they tell him to stay in his own bed. Which of the following instructions should the nurse give the parent? A. "Use a stable, relaxing routine like a bath and story time before bed" B. "Make sure the room is completely dark when placing your child in bed" C. "Let your child go to sleep in your lab and then put him in his bed" D. "Respond consistently if your child cries out for you after putting him to bed"

A. "Use a stable, relaxing routine like a bath and story time before bed"

A nurse is planning care for a 4 year old child who has nephrotic syndrome. Which of the following actions should the nurse take? A. Provided through skin care B. Test for blood type and cross match C. Allow ample hydrating fluid D. Maintain a low card diet

A. Provided through skin care

A nurse is reinforcing teaching with the guardian of an adolescent. The guardian reports that the adolescent sleeps for about 10 hours on weekend nights. Which of the following responses should the nurse make? A. "Your child should have a blood test to check for anemia." B. "Adolescents need more sleep due to rapid growth." C. "Your child should not be staying up so late at night." D. "If your child is eating properly, this should not happen."

B. "Adolescents need more sleep due to rapid growth."

A RN is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history from her parent, which of the following questions should the nurse ask? A. Does your child wear a hat outdoors in cold weather? B. Does anyone smoke around or in the same house of your child? C. Have you given your child any aspirin recently? D. Is your child's diet high in gluten?

B. Does anyone smoke around or in the same house of your child?

A nurse is providing immediate postoperative care for a child 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

A nurse on a pediatric unit is reviewing the health record of a child who is demonstrating increasing levels of stress after admission. The nurse should identify which of the following findings as a risk factor for a stress related reaction to hospitalization? A. Age 10 B. Frequent hospitalizations C. Parent bonding with child D. Calm, quiet demeanor

B. Frequent hospitalizations

A nurse is assessing a 12-year-old child during a well-child checkup. Which of the following physical findings should the nurse report to the provider? A. 5 cm (2 in) of growth in the past year B. Hyperopia C. Presence of pubic hair D. Weight gain of 3 kg (6.6 lb) in the last year

B. Hyperopia

A nurse is caring for a 3 year old child on the pediatric unit. The nurse should identify which of the following as an appropriate toy for the child? A. Jump rope B. coloring book and crayons C. checkers game D. jack-in-the-box

B. coloring book and crayons

A nurse is talking with the parent of a preschool-aged child who tells the nurse, "My child has suddenly become disinterested in certain foods." Which of the following statements should the nurse make? A. "During this phase, feed your child anything that she will eat." B. "Increase the amt of calories and water your child consumes." C. "Keep a diary of the foods your child eats each day." D. "Provide a large variety of fruit juices for your child to choose from."

C. "Keep a diary of the foods your child eats each day."

A nurse is teaching the guardian of a school-age child who has diabetes mellitus how to recognize diabetic ketoacidosis (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. Decreased urinary output

C. Deep, rapid respirations

A nurse is caring for a 2-year-old child who has cystic fibrosis. The nurse is planning to take the child to the playroom. Which of the following activities would be appropriate for the child? A. Cutting figures from colored paper B. Drawing stick figures using crayons C. Riding a tricycle D. Building towers of blocks

D. Building towers of blocks

A nurse is providing education about the introduction of solid foods for the parent of an infant. Which of the following instructions should the nurse include? a. Begin after the extrusion reflex has diminished b. Introduce solids between 2 and 3 months of age c. Wait until the infant's first tooth erupts d. Add a sweetener such as light corn syrup to bland foods

a. Begin after the extrusion reflex has diminished

A nurse is reviewing the medical record of a 2-month-old infant who has rotavirus. The nurse notes a hemoglobin level of 12g/dL and a hematocrit of 51%. Which of the following statements by the nurse indicates an understanding of the laboratory values? a. The infant might be dehydrated b. The infant might be anemic c. The infant might have received too much fluid d. The infant might have leukemia

a. The infant might be dehydrated

A nurse is caring for a 10-year-old child who should reduce his fat intake. Which of the following menu choices should the nurse suggest? a. a hot dog on a whole-wheat bun b. 3 oz of baked chicken on a whole-wheat roll c. 1/2 cup of diced potatoes with scrambled eggs d. medium blueberry muffin

b. 3 oz of baked chicken on a whole-wheat roll

A nurse is assessing a 9-month-old infant during a well-child visit. Which of the following findings indicate that the infant has a developmental delay? a. Creeps on hands and knees b. Inability to vocalize vowel sounds c. Uses a crude pincer grasp d. Stands by holding onto support

b. Inability to vocalize vowel sounds

A nurse is caring for a 4-year-old child who has pneumonia. The child's mother left 2 hours ago, and he is currently experiencing the separation anxiety stage of despair. Which of the following findings should the nurse expect? a. Crying and screaming b. Inactivity and thumb sucking c. Showing interest in nearby toys d. Attempting to escape and find the parent

b. Inactivity and thumb sucking

A nurse is caring for a preschool-age child who has mucosal ulceration after receiving chemotherapy. Which of the following actions should the nurse take? a. Place viscous lidocaine on the child's oral lesions b. Instruct the child to use a soft-sponged toothbrush when brushing her teeth c. Encourage the child to rinse her mouth with hydrogen peroxide every 2-4 hr d. Give the child lemon glycerine swabs to use after each meal

b. Instruct the child to use a soft-sponged toothbrush when brushing her teeth

A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following laboratory findings should the nurse report to the provider immediately? a. Blood glucose 140 mg/dL b. Oxygen saturation 85% c. RBC 3.2 million/uL d. Serum sodium 156 mEq/L

b. Oxygen saturation 85%

a nurse is assessing the fine motor skills of a 4-year-old child. The nurse should expect the child to be able to perform which of the following activities? a. tying shoelaces into a bow b. coping a square c. Drawing a person with at least 8 parts D. Printing the letters of her name

b. coping a square

A nurse on the pediatric unit receives the laboratory results for several clients. Which of the following results should the nurse report to the provider? a. A client who has bacterial pneumonia and a WBC count of 15,800/mm^3 b. A client who has chronic kidney disease and a calcium level of 8.7 mg/dL c. A client who has diabetic ketoacidosis (DKA) and a blood glucose of 375 mg/dL d. A client who has leukemia and a hematocrit of 32%

c. A client who has diabetic ketoacidosis (DKA) and a blood glucose of 375 mg/dL

A nurse in an emergency department is caring for a toddler who is in acute respiratory distress. Which of the following findings should alert the nurse to the possibility of epiglottitis? a. Lethargy b. Spontaneous coughing c. Drooling d. Hoarseness

c. Drooling

A nurse is assessing the pain level of a 3-year-old who is postoperative following abdominal surgery. Which of the following pain scales should the nurse use? a. word graphic rating scale b. color tool c. FACES pain rating scale d. Numeric scale

c. FACES pain rating scale

A nurse is talking with the parent of a 4-month-old infant about growth and development. Which of the following statements indicates that the parent needs further teaching? a. I need to remind my older kids to keep small objects out of the baby's reach b. I let my baby play on her stomach when she is awake and I am watching c. My baby loves to play with the pillows in her crib d. I put my baby in a rear-facing car seat in the back seat of the care

c. My baby loves to play with the pillows in her crib

A nurse is caring for a toddler. Which of the following objects should the nurse select from the playroom for this child during hospitalization? a. Small plastic doll with clothes and accessories b. alphabet flash cards c. Handheld video game d. 10-piece wooden puzzle

d. 10-piece wooden puzzle

a nurse on a pediatric unit has just received reports for 4 newly admitted clients. for which of the following children should the nurse plan to initiate droplet precautions? a. A child who has Rocky Mountain spotted fever b. A child who has roseola c. A child who has Molluscum contagiosum d. A child who has pertussis

d. A child who has pertussis

A nurse is reinforcing preoperative teaching for a 5 year old child. What intervention should the nurse include? a. Explain the long-term benefits of the procedure b. Provide diagrams and pictures while explaining the procedure c. Use correct medical terminology during the teaching session d. Explain the procedure in terms of what the child will feel, see, hear, and taste

d. Explain the procedure in terms of what the child will feel, see, hear, and taste

A nurse is caring for a school age child who has acute poststreptococcal glomerulonephritis. Which of the following manifestation should the nurse expect? a. Hypotension b. Elevated serum lipid levels c. Decreased serum potassium levels d. Hematuria

d. Hematuria

A nurse is teaching a group of parents of toddlers about growth and development. A parent asks, "Why does my child's abdomen stick out?" Which of the following statements should the nurse make? a. You should give your child a stool softener daily b. Toddlers gain weight at a rapid pace c. You should have your child assessed for a spinal deformity d. Toddlers do not have well-developed abdominal muscles

d. Toddlers do not have well-developed abdominal muscles

A nurse is contributing to the preoperative teaching plan for a preschooler who is scheduled for a tonsillectomy. Which of the following interventions should the nurse plan to include? A. Encourage the preschooler to bring a favorite toy to the hospital B. Spend 30 minutes teaching the preschooler about what to expect C. Schedule the teaching session for the morning of the preschooler's procedure D. Reassure the preschooler that medicine will prevent pain after the procedure

A. Encourage the preschooler to bring a favorite toy to the hospital

A nurse is caring for an infant who is experiencing dehydration. Which of the following assessments is the nurse's priority? A. Measure the client's weight daily B. Check for tears C. Palpate the fontanel D. Assess skin turgor

A. Measure the client's weight daily

A nurse is providing teaching about home safety to the parent of a 2-month-old infant. Which of the following information should the nurse include? A. Remove bibs before the infant goes to sleep B. Cover the infant with a lightweight blanket at bedtime C. Place the infant in direct sunlight for at least 10 minutes each day D. Set the hot water heater to 60°C (140°F)

A. Remove bibs before the infant goes to sleep

A nurse is caring for a toddler who is postoperative following a cleft palate repair. Which of the following actions should the nurse take? A. Restrain the toddler's arms at the elbows B. Feed the toddler with a spoon C. Monitor the toddler's oral temperature D. Weigh the toddler every 48 hours

A. Restrain the toddler's arms at the elbows

A nurse is caring for an infant who has gastroenteritis and is dehydrated. which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client ? A. Less extracellular fluid B. reduce body surface C. Longer intestinal tract D. decrease rate of metabolism

C. Longer intestinal tract

a nurse is teaching the guardian of a preschooler. the guardian states that the preschooler has had an imaginary playmate for about 3 mo. which of the following pieces of information should the nurse give the guardian? A: children commonly begin having imaginary friends when they reach school age. B: Notify your provider if the imaginary friend persists longer than 6 months C: have your child take responsibility for actions if he tries to blame the imaginary friend D: set limits by not allowing your child to have the imaginary friend present during family meals

C: have your child take responsibility for actions if he tries to blame the imaginary friend

The nurse is assessing the fine motor skills of a 3 year old preschooler. Which of the following findings should the nurse expect? A. The preschooler can draw a stick figure that has 7 parts B. The preschooler can print her first name C. the preschooler can cut out pictures using scissors D. The preschooler builds a tower of 9 cubes

D. The preschooler builds a tower of 9 cubes

A nurse is caring for an infant following surgical repair of a cleft lip and palate. Which of the following actions should the nurse take? a. Keep the infant's mouth open by using a tongue blade for 4 hr following surgery. b. Use a suction catheter to gently remove the infant's oral secretions PRN c. Place the infant in prone position. d. Clean the infant's incision with chlorhexidine.

b. Use a suction catheter to gently remove the infant's oral secretions PRN

A nurse is observing an 8 month old infant and parent playing peek a boo. The parent asks the nurses if this game has any developmental significance. The nurse should indicate to the parents that playing peek a boo will develop which of the following concepts? a. Hand-eye coordination b. Sense of trust c. Object permanence d. Egocentrism

c. Object permanence

A nurse is caring for a 6-month-old infant who has intussusception. Which of the following actions should the nurse take? a. Prepare to administer high-dose steroids b. Give the child magnesium hydroxide PO c. Prepare the child for a barium enema d. Inform the parents that the child will need a colostomy

c. Prepare the child for a barium enema