4427 ATI review

ESR

10 mm/hr

Assessing pre-schooler with HIV. Which manifestation should the nurse expect? A. Generalized petechiae B. Jaundice C. Obesity D. Chronic Diarrhea

D

Nurse evaluating outcome of infant with bile duct obstruction after surgery. Which indicates success? A. Infants stool becomes fatty B. stool is yellowish brown C. infants direct bilirubin level has incerased D. palpable mass noted in RUQ.

D

Nurse teaching about immunizations for child with HIV (severe immunocompromised) Which should be included? A. Your child's immunizations today will be half doses B. the pneumococcal and influenza vaccines are recommended for your child C. Immunizations will be delayed until your child tests negative D. Your child will need to restart the immunization schedule once the lab values are in expected ranges

B

4 yo. ingested toilet bowl cleaner. Child has hemoptysis, is crying and states it burns. Which action should the nurse perform. A. Identify how much cleaner was in bottle B. admin activated charcoal C. perform immediate gastric lavage D. insert an IV for morphine administration E. apply a pulse oximeter

ADE - activated charcoal is contraindicated for treatment of poisoning of corrosive agent due to infiltration of burnt tissue by charcoal - lavage contradicted as this could expose upper GI to corrosive substance resulting in further injury

Maternal Risk factor for congenital heart disease

Alcohol consumption

Assessing visual acuity of school aged children. Which action should be taken?

Allow children to wear their glasses

Vigorous activity and diabetes injection sites

Always the hip

Cognitive Impairment toilet training.

Award child with sticker when they sit on the potty chair

9 m.o. during well child visit. Which indicates development delay? A. Creeping on hand/feet B. Inability to vocalize vowel sounds C. using crude pincer grasp D. Standing by holding onto a support

B

How to calculate BMI? 41 kg and 1.5 meters tall (example)

41 kg / (square of[2.25]) 1.5 --> 18.2 BMI

2 yo. nutrition? A. My child should consume 1000 cal./day B. My child should have 4 oz of protein per day C. I should vie my child 32 oz of milk/day D. I should feed my child 4 oz of veggies per day

A

Child has rheumatic fever. which statement indicates understanding? A. Child will take aspirin for joint pain B. child will need blood transfusion prior to discharge C. I will need to wear a gown when im in my Childs room I will apply lotion to my Childs peeling hands.

A

Child receiving treatment of DKA and has BG: 250mg/dL. Which action should be taken? A. admin 5% dextrose in 0.9% sodium chloride by continuous IV B Give potassium as rapid IV bolus C. Admin 3 U of ultralente insulin subcutaneously D. Obtain HbA1c Level stat

A

Which lab value is expected with acute lymphocytic leukemia. A. Plt: 500k B. RBCs: 2.5 mill. C. WBCs 4k D. Hot 60%

B

BMI of 21.2 is what? A. Underweight B. Healthy C. Overweight D. Obese

B

Lab report of a toddler receiving chemo for leukemia. Which lab value should be reported? A. Plt: 150K B Hgb 6g/dL C. WBC 6000 D Potassium 4.5 mEq/L

B

Nurse caring for a toddler who has gastroenteritis due to Salmonella. Which is priority? A. Weight the child B. Initiate contact precautions C. establish a skin care routine D. obtain recent food history

B

Nurse caring for infant with tracheoesophageal fistula. Which action should be taken? A. Place in lateral position B. Perform a oropharyngeal suctioning C. admin ranitidine orally D. thicken infant's formula

B

10 m.o. with suspected FTT. Which intervention should be included? (SATA) A. observe parents when feeding child B. Maintain detailed record of food/fluid intake C. follow Childs cues to time food and fluids D. Sit beside Childs high chair for feedings E. play music videos during scheduled feedings

AB

Which food is a choke risk? (SATA) A. Hot Dogs B. Grapes C. Bagels D. Marshmallows E. Graham Crackers

ABCD

Sickle Cells. What are manifestations of chronic vaso-occlusive crisis? (SATA) A. Enlarged Heart B. Enuresis C. Leg Ulcers D. Extrahepatic cholestasis E. Retinal detachment

ABCE

Nurse is providing teaching about baclofen. Which adverse effect should be included? A. Bradycardia B. Muscle Weakness C. Diarrhea D. Dry Skin

B

which is expected achievement for 3 YO. A. Walking backward while moving heel to toe B. standing on 1 ft. for several seconds C. Using scissors to cut out shapes D. Printing letters with a pencil

B

A nurse providing teaching to guardian of child with Kawasaki disease. Which of the following statements indicates understanding? (SATA) A. My child will likely be irritable for the next few weeks B. I will notify my child's doctor if the skin on her hands or feet begins to peel C. I will ensure my child does not receive any live vaccines for at least 18 months D. I will keep a record of my child's temperature until she has no fever for several days. E. My child will have joint stiffness primarily at the end of the day

ACD

Biliary Atresia. Which manifestation is expected? A. Yellow sclerae B. rapid weight gain C. tar-colored stools D. Abdominal distention E. dark urine

ADE

Newborn with spina bifida. Parents are upset by diagnosis. Which actions should nurse take? A. discuss placement options for newborn. B. Encourage parents to touch and care for newborn C. reassure the parents that everything will be fine D. Avoid talking about the newborn's defect until the parents bring up the subject

B - helps bonding

Assessing 6 y.o. who began treatment for pneumococcal pneumonia 4 days ago. Which indicates effective treatment?

B HR: 118 / min.

Nurse providing discharge to adolescent postop tonsillectomy Which manifestation should guardian report? A. Nasal secretions containing dark brown blood B. constant clearing of throat C. unpleasant odor from oral cavity D. temp at 100 48 hour after

B- manifestation of hemorrhage

Nurse providing treatment about disease management of 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.

Nurse providing information regarding MMR. Which indicates understanding? A. My child should not play with other children for 2 days B. I will need to return in 2 weeks for my child to receive the varicella immunization C. I will help my child to blow bubbles during the injection D. My child may have some drainage from the injection site

C- helps distract

6 mo. Which activity should it have achieved by now? A. sitting alone B. attempting to stack objects C. turning from back to stomach D. Picking up small objects with crude pincer grasp

C.

Infant with heart failure. Include which in plan to meet nutritional needs? (SATA) A. Offer infant 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.

BCDE

24 mo. well check. which is expected? (SATA) A. 8 deciduous teeth B. Ability to build tower of 6 blocks C. verb of 10-20 words D. Slightly bowed leg appearance E. Head circumference greater than chest

BD (should have vocal of 300 words, 2-3 word phrases)

18 m.o. with chronic otitis media. Nurse should recognize this will affect what? A. Olfaction B. Visual Acuity C. Speech Patterns D. Handeye coordination

C

A nurse in the emergency department is admitting a child who has full-thickness burns over 45% of his body. Which of the following actions should the nurse take first? A. Administer IV morphine B. Admin. topical Antimicrobial C. Admin IV fluid replacement D. Admin tetanus prophylaxis

C

A nurse is performing a nutritional screening for 12 Yo who weighs 90lb and 60 in. tall. What is BMI? A. 1.5 B. 3.6 C. 18.2 D. 27.3

C

Child with HIV> Which statement about immunizations is correct? A. Childs immunizations will be half doeses B. Pneumococcal and influenza vaccines are recommended C. Immunisations are delayed until your child tests negative D. Your child will need to restart to schedule once the lab values are within reference range

C

Creating care plan for 18 m.o. with CP. A. Use mobile walker for toddler B. discourage activities with repetitive joint movement C. Use manual jaw control when feeding D. discourage use of splints

C

Unrepaired myelomeningocele. Which of the following actions should the nurse take? A. Fasten diaper loosely B. Cleanse meningeal sac with povidone-iodine daily C. palpate abdomen for bladder distention D> Cover sac with dry sterile gauze dressing

C

Which indicates understanding about injury prevention? A. I should lightly shake talcum powder on my baby skin after each diaper change B. I should use a drop-side crib after rmy baby is 6 MO C. I should make sure my baby clothing doesn't have buttons D. I should ensure crib slats are no more than 3 inches apart.

C

Nurse teaching school-age child who is to undergo a bone marrow aspiration. Which statement should be made? A. I will give you an antibiotic before the procedure B. I will place you on your side during the procedure C. You might have a headache following the procedure D. I will place a pressure dressing over the area following the procedure

D - antibiotic may screw results

Child with nephrotic syndrome. What is included in teaching? A. restrict Childs potassium intake B. Administer acetaminophen to child twice daily C. weight child once each week D. keep the child away from people who have an infection

D - increased risk for infection

Nurse planning care for an adolescent who has sickle cell anemia and is experiencing a vast-occlusive crisis. Which of the following interventions should the nurse include in the plan? A. Apply cold compresses to the child's extremities B. Admin. meperidine every 4 hr until the crisis has resolved C. maintain the child on bed rest D. decrease the child's fluid intake for 8 hr

C. maintain child on bed rest - sickle cell should minimize O2 needs

Care for 3 m.o. with ileostomy. which intervention should be included?

Check for stool every 4 hours.

6 m.o. who requires continuous pulse-ox. What intervention should be included? A. Reposition every 24hr B. Secure sensor to wrist C. Apply conduction gel to skin D. Cover ox. with clothing

D

Assessing 10 month old. what should be reported? A. Infant unable to walk independently? B. The infant's moro reflex is absent C. The infants anterior fontanel is open D. the infant needs assistance to sit-up

D

5 yo. immunization

DTaP

4 y.o. cognitive development should expect what?

Development of super-ego

9 m.o. sign of possible developmental delay?

Dropping cube when passing to other hand

School child with pediculosis. Which action is correct?

Dry clothing in heat for 20 minutes

How often to check ileostomy bag on 3 mo.?

Every 4 hours

2 mo. Which immunizations?

Hib and IPV

Methylphenidate SR tabs for ADHD. Which indicates understanding?

I should give this to my child and hour before breakfast (empty stomach)

Initial goal of DKA Therapy

Keep BG below 240 mg/dl - maintain regular insulin via continuous IV. Monitor hourly.

Newly diagnosed anorexia nervosa...

Lanugo over back due to impaired metabolic activity

Caring for child with hyperthermia. Which action should be taken?

Position child on cooling blanket and cover with sheet

Sodium Polystyrene Sulfonate used for what?

Potassium. 3.4-4.7 mEq/L for teens

Oral Nystatin for candidiasis>

SHAKE medication prior to admin

Ruptured appendix. Which Position should be assumed?

Semi Fowlers

Discontinuing IV fluids proper steps

1. turn off pump 2. Occlude tubing 3. remove tape 4. apply pressure over insertion site (stop bleeding)

Child with SCA admit for vaso-occlusive crisis. Which finding should be reported immediately? A. Slurred speech B. Hemoglobin level 9 g/dL C. Hematuria D. Pain level of 7 on FACES scale

A

Chronic diarrhea. Which condition is caused by malabsorption? A. Celiac B. Ulcerative Colitis C. Hirschsprung's disease D. Crohn's disease

A

Hgb: 12 g/dl, Hct: 51%. What statement indicates understanding? 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

Infant w/ untreated congenital hypothyroidism. Which manifestation should be expected? A. constipation B. Hyperreflexia C. Oily skin D. Hyperthermia

A

Nurse teaching about fiberglass cast. Which should be said? A. Monitor color fo toes every 4 hours for 24 hours B your child can scratch the inside of the cast with small wooden ruler C. Expect to stay damp for 72 hours D. Take child swimming and do baths as usual

A

Prolapsed rectum may be from: A. bulky stools B. weakened rectal sphincter C. elevated pancreatic enzymes D. Decreased Intra-abdominal pressure

A

Teaching parent of infant with HF and prescription for digoxin elixir. Which info should be included? A. Withhold if HR is less that 110/min B. Mix med. in 120mL of infant formula C. expect infant to vomit frequently while taking D. Double dose if infant has increased edema

A

What is expected of 4 YO? A. Child able to hop on 1 ft. B. Able to build tower of 6 blocks C. Name days of week D. Identify left and right

A

assess 3 y.o. which command should be expected to complete successfully. A. put your shoes on B. Name the days of the week C. cut out this picture with scissors D. balance on 1 ft with your eyes closed

A

After mono, what is there a risk of?

Abdominal trauma due to the persistence of splenomegaly and lymphadenopathy

8 YO up to date on immunizations comes in with deep puncture injury. Administer what?

Adult tetanus booster

Varicella

Airborne precautions

Lumbar Puncture, which action should be taken?

- Apply topical analgesic 1 hr prior to procedure - Prone for 12 hours following - encourage extra fluids following procedure

Bacterial meningitis indication?

- Increased CSF pressure - Increased WBC - Increase protein Concentration - Decreased glucose

Ventricular septal defect. What should be expected?

- Loud harsh murmor -

School age child with meningitis. Which is priority to report?

- Petechiae on lower extremities - may indicate greatest risk of serious rapid complications from sepsis

3 yo. at well-child. Which manifestation should be reported?

- Resp. rate of 45/min. - RR should be 20-25/min

Extravasation. Whats the order of interventions?

1. stop infusion 2. elevate extremity 3. notify provider 4. remove IV line

Group of infants with congenital heart defects. Which should illicit cyanosis? A. Transposition of great arteries B. Ventricular Septal Defect C. Coarctation of the Aorta D. Patent ductus arteriosus

A - reversal of aorta and pulmonary artery allow venous blood to enter systemic circulation without oxygenation

Dietary recommendation for parent of child with CF? A. increase protein B decrease calories C. increase fiber D. Decrease salt

A = require up to 150% of normal requirements

6 yo. at well child. Which finding requires further assessment? A. Presence of sparse, fine pubic hair B. decreased head circumference compared to full height C. increased leg length in relation to height D. presence of loose central incisor

A - indicates precocious puberty

Visual acuity screening for school age. Which action should be taken? A. 5 ft from chart B. wear glasses during screening C. Observe for pupillary constriction while shining light D. Instruct child to point direction letters face

B

6 mo. with intussusception. Which action should be taken? A. Prep. to admin high dose steroids B. Give child mag. hydroxide PO C. prep for barium enema D. Inform parents child will need colostomy

C - may force bowel to resume a normal configuration

Which requires further assessment in 30 m.o.? A. Primary dentition complete B. unable to hop on 1 foot C. birth weight tripled D. able to state first and last name

C - should be quadrupled

Acute nephrotic syndrome. What should be reported? A. Sodium 142 mEq/L B. Potassium 4 mEq/L C. WBC count 3,000/mm^3 D. PLT 298,000/mm^3

C Corticosteroids used in treatment cause immunosuppression. This is very low

6 mo. with acute renal failure. Which finding is expected? A. BUN 5 mg/dL B. Creatinine 0.2 mg/dL C. Sodium 125 mEq/L D. Potassium 4.2 mEq/L

C This is hyponatremic for the age

18 mo. post op. Which pain scale? A. FACES B. CRIES C. FLACC D. PIPP

C. FACES is for 3 +

Nurse providing discharge for child with nephrotic syndrome. Which instructions should the nurse include in teaching? A. Restrict potassium intake B. Administer acetaminophen to child twice daily C. Weight child once each week D. keep child away from people with an infection

D

What is expected for fine motor skills fo 3 y.o. A. preschooler can draw stick figure w/ 7 parts B. can print her first name C. can cut out picture with scissors D. builds tower of 9 cubes

D

Which activity is the strategy of thought-stopping? A. Assemble a puzzle B. Discuss a pleasurable event C. Tighten and then relax each body part D. Repeat memorized facts about the painful event

D - like repeating in head "I'll be home by this time tomorrow" or other facts that help mitigate the pain

Adolescent receiving fentanyl via epidural. Which is priority? A. Skin around site B. BP C. Pain D. O2 sat.

D.

Nurse assessing child with acute glomerulonephritis. Which manifestation is expected? A. hypokalemia B. decrease BP C. Increased urine volume D. Periorbital edema

D

When does tongue extrusion reflex diminish?

after 4 months

How long tympanovstomy tubes stay in place?

Until they fall out on their own

Nurse should take to prepare preschooler for IV med?

Use role-play method

18 mo.

Vocal of 10 or more words

aplastic anemia

failure of blood cell production in the bone marrow RBCs, Platelets, AND WBCs