ATI Ch. 17-20 Questions

A nurse is reviewing the diagnostic findings for a preschool age child who is suspected of having cystic fibrosis. Which of the following findings should the nurse identify as an indication of cystic fibrosis? A. Sweat chloride content 85 mEq/L B. Increased blood levels of fat-soluble vitamins C. 72 hr stool analysis sample indicating hard, packed stools D. Chest x-ray negative for atelectasis

A

A nurse is performing an admission assessment for a child who has cystic fibrosis. Which of the following findings should the nurse expect? (Select all that apply.) A. Wheezing B. Clubbing of fingers and toes C. Barrel-shaped chest D. Thin, watery mucus E. Rapid growth spurts

A, B, C

A nurse is discussing risk factors for asthma with a group of newly licensed nurses. Which of the following risk factors should the nurse include in the teaching? (Select all that apply.) A. Family history of asthma B. Family history of allergies C. Exposure to smoke D. Low birth weight E. Being underweight​​​​​​​

A, B, C, D

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Decreased blood pressure in lower extremities

A, B, E

A nurse is teaching a child who has asthma how to use a peak flow meter. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Zero the meter before each use. B. Record the average of the attempts. C. Perform three attempts. D. Deliver a long, slow breath into the meter. E. Sit in a chair with feet on the floor.

A, C

A nurse is admitting a child who has cystic fibrosis. Which of the following medications should the nurse expect to include in the plan of care? Select all that apply. A. Tobramycin B. Loperamide C. Vitamins A, D, E, K D. Albuterol E. Dornase alfa

A, C, D, E

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (Select all that apply.) A. Erythema marginatum (rash) B. Continuous joint pain of the fingers C. Tender, subcutaneous nodules D. Decreased erythrocyte sedimentation rate E. Elevated C-reactive protein

A, E

A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A. Place on NPO status for 12 hr prior to the procedure. B. Check for iodine or shellfish allergies prior to the procedure. C. Elevate the affected extremity following the procedure. D. Limit fluid intake following the procedure

B

A nurse is caring for an infant who has the following clinical manifestations: systolic murmur, wide pulse pressure, bounding pulses, and rales when auscultating the lungs. Which of the following congenital heart conditions should the nurse suspect? A. Tetralogy of Fallot B. Patent ductus arteriosus C. Ventricular septal defect D. Pulmonary stenosis

B

A nurse is providing discharge teaching for a child who has cystic fibrosis. Which of the following instructions should the nurse include? A. Provide a low-calorie, low-protein diet. B. Administer pancreatic enzymes with meals and snacks. C. Implement a fluid restriction during times of infection. D. Restrict physical activity.

B

A nurse is providing education to the parent of a child who has infective endocarditis. Which of the following statements by the parent indicates understanding of the teaching? A. "My child will need IV antibiotics for the next 7 days." B. "I will need to let our dentist know about my child's diagnosis." C. "My child will need to avoid high altitudes until the infection is gone." D. "Some children with this diagnosis eventually require a lung transplant."

B

The nurse in this scenario is caring for a school-aged child who had a cardiac catheterization using the femoral vein one hour ago. Which of the following actions should the nurse take? A. Remove pressure dressing from the insertion site. B. Palpate pulses distal to the insertion site. C. Place the child in a semi-fowlers position. D. Maintain the child on NPO status.

B

The nurse in this scenario is providing discharge teaching to the child's mother. Which of the following instructions should the nurse include in the teaching? A. "Your child may resume their normal level of activity in 24 hours." B. "You should administer acetaminophen to your child for discomfort at the insertion site." C. "Drainage and swelling are expected at the insertion site for the first week after the procedure." D. "It is expected for the extremity that was used for the procedure to be cool to the touch."

B

A nurse is planning care for a child who has an exacerbation of asthma. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Perform chest percussion. B. Place the child in an upright position. C. Monitor oxygen saturation. D. Administer bronchodilators. E. Administer dornase alfa daily.

B, C, D

A nurse is assessing a child who has an acute exacerbation of asthma. Which of the following findings should the nurse expect? (Select all that apply.) A. Oxygen saturation 96% B. Wheezing C. Retraction of sternal muscles D. Bronchovesicular breath sounds E. Cough

B, C, E

A nurse is assessing an infant who has heart failure. Which of the following manifestations should the nurse expect to find? (Select all that apply.) A. Bradycardia B. Cool extremities C. Peripheral edema D. Increased urinary output E. Nasal flaring

B, C, E

A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? (Select all that apply.) A. Hoarseness and difficulty speaking B. Difficulty swallowing C. Low-grade fever D. Drooling E. Dry, barking cough F. Stridor

B, D, F

A nurse is caring for a child who has bronchiolitis. Which of the following actions should the nurse take? (Select all that apply.) A. Initiate airborne precautions B. Initiate chest percussion and postural drainage C. Administer humidified oxygen D. Suction the nasopharynx as needed E. Administer oral penicillin

C, D

A nurse is teaching a group of caregivers about influenza. Which of the following information should the nurse include in the teaching? A. "Amantadine will prevent the illness." B. "Children who are 3 months or older should receive the inactivated influenza vaccine." C. "Zanamivir can be given to children 1 year and older." D. "Oseltamivir should be given within 48 hours of onset of manifestations."

D

A nurse is teaching an adolescent about the correct use of their asthma medications. Which of the following medications should the nurse instruct the adolescent to use before exercise? A. Fluticasone/salmeterol B. Montelukast C. Prednisone D. Albuterol

D

Sort the following postoperative nursing actions for the child who has had a tonsillectomy into the indicated or contraindicate category. A. administer codeine as prescribed B. administer pain medications on a regular schedule C. elevate the head of the bed D. encourage turning, coughing, and deep breathing E. monitor for frequent swallowing F. provide ice chips G. provide straws for liquids

Indicated: B, C, E, F Contraindicated: A, D, G

A nurse is caring for a school-aged child who has heart failure. The nurse has assessed the child and found the clinical manifestations listed below. Sort the clinical manifestations into the systems category in which they belong. Drag the manifestations from the left column to the appropriate category in the right column. 1. Tachycardia 2. Retractions 3. Ascites 4. Pallor 5. Tachypnea 6. Hepatomegaly 7. Weak pulses 8. Orthopnea 9. Weight gain 10. Nasal flaring Myocardial, Pulmonary, Vascular

Myocardial: 1, 4, 7 Pulmonary: 2, 5, 8, 10 Vascular: 3, 6, 9

Review the nursing interventions and medications. Drag each intervention/medication to the body system the intervention/medication is intended to treat. 1. Chest physiotherapy 2. Pancreatic enzymes 3. Insulin 4. Positive expiratory therapy 5. Vitamins A, D, E, and K 6. Increase fluid intake 7. Monitor blood glucose levels 8. Albuterol Pulmonary, GI, Endocrine

Pulmonary: 1, 4, 8 GI: 2, 5, 6 Endocrine: 3, 7