PEDS ATI Practice A

A school nurse is assessing an adolescent who has scoliosis. Which of the following findings should the nurse expect? A. Increase in anterior convexity of the lumbar spine B. Increased curvature of the thoracic spine C. Lateral flexion of the neck D. A unilateral rib hump

D. A unilateral rib hump

A nurse is providing dietary teaching to a parent of a school-age child who has celiac disease. The nurse should recommend that the parent offer which of the following foods to the child? A. Wheat crackers B. Rye bread C. Barley soup D. White rice

D. White rice

A nurse is assessing a 4 yo child at a well-child visit. Which of the following developmental milestones should the nurse expect to observe? A. Identifies right from left hand B. Uses a utensil to spread butter C. Cuts an outlined shape using scissors D. Draws a stick figure with seven body parts

C. Cuts an outlined shape using scissors The nurse should recognize that an expected developmental milestone of a 4 yo child is using scissors to cut out a shape

A nurse is caring for a 15 yo child who is married and is scheduled for a surgical procedure. The client asks, "Who should sign my surgical consent?" Which of the following responses should the nurse make? A. "You can sign the consent from because you are married" B. "Your spouse should sign the consent form for you" C. "Your parent should sign the consent form for you" D. "You can appoint a legal guardian to sign the consent form"

A. "You can sign the consent form because you are married" The nurse should inform the adolescent that marriage gives adolescents the legal right to consent to surgical procedures and sign other legal documents

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the following to the affected area? A. Zinc oxide B. Antibiotic ointment C. Talcum power D. Antiseptic solution

A. Zinc oxide

A nurse is preparing to administer an immunization to a 4 yo child. Which of the following actions should the nurse plan to take? A. Place the child in a prone position for the immunization B. Request that the child's caregiver leave the room during the immunization C. Administer the immunization using a 24-gauge needle D. Inject the immunization slowly after aspirating for 3 seconds

C. Administer the immunization using a 24-gauge needle The nurse should administer an immunization for the 4 yo child using a 22-25 gauge needle to minimize the amount of pain the child experiences

A nurse is caring for a school-age child who is in Buck's traction following a leg fracture 24 hrs ago. Which of the following actions should the nurse take? A. Change the child's position every 2 hrs B. Clean the peripheral pin sites with chlorhexidine solution every 4 days C. Assess peripheral pulses once every 4 hrs D. Ensure that the head of the bed is elevated to a 90 degree angle

C. Assess peripheral pulses once every 4 hrs

A nurse in an emergency department is caring for a toddler who has partial-thickness burns on their right arm. Which of the following actions should the nurse take? A. Insert a nasogastric tube B. Initiate prophylactic antibiotic therapy C. Cleanse the affected area with mild soap and water D. Apply a topical corticosteroid to the affected area

C. Cleanse the affected area with mild soap and water The nurse should wash the affected area with mild soap and water to remove any loose tissue that could cause infection

A nurse is reviewing the lumbar puncture results of a school-age child who is suspected of having bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis? A. Decreased cerebrospinal fluid pressure B. Decreased WBC count C. Increased protein concentration D. Increased glucose level

C. Increased protein concentration

A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following actions should the nurse plan to take? A. Obtain a sputum specimen B. Perform an Allen test C. Perform a finger stick D. Obtain a stool specimen

C. Perform a finger stick

A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse see first? A. A school-age child who has sickle cell anemia and reports decreased vision in the left eye B. A school-age child who has cystic fibrosis and a frequent nonproductive cough C. A preschooler who has asthma and a peak flow reading in the green zone D. An adolescent who has meningitis and reports a sensitivity to light and noise

A. A school-age who has sickle cell anemia and reports decreased vision in the left eye. This finding indicates that the child is experiencing a vaso-occlusive crisis and should be reported to the provider immediately

A nurse is teaching the guardian of a 6mo infant about car seat use. Which of the following statements by the guardian indicates an understanding of the teaching? A. "I should secure the car seat using lower anchors and tethers instead of the seat belt" B. "I should position the car seat harness 1 inch above my baby's shoulders" C. "I will make sure that the car seat is placed at a 90 degree angle" D. "I will pad my baby's car seat with a blanket for traveling long distances"

A. "I should secure the car seat using lower anchors and tethers instead of the seat belt"

A nurse is providing teaching to the parent of a school-age child who has a new prescription for oral nystatin for the treatment of oral candidiasis. Which of the following instructions should the nurse include? A. "Shake the medication prior to administration" B. "Provide the medication through a straw" C. "Rinse the child's mouth with water immediately after giving the medication" D. "Mix the medication with applesauce if the child dislikes the taste"

A. "Shake the medication prior to administration" The nurse should instruct the parent to shake the medication prior to administration to disperse the medication evenly within the suspension

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan? A. Administer ibuprofen to the child for a temperature greater than 38 C B. Assess the child's blood pressure every 8 hrs C. Weigh the child weekly at various times of the day D. Initiate seizure precautions for the child

D. Initiate seizure precautions for the child A sodium level of 129 mEq/L indicates hyponatremia and places the child at increased risk for neurological deficits and seizure activity

A hospice nurse is caring for a preschooler who has a terminal illness. One of the preschooler's parents tells the nurse that they cannot cope anymore and are thinking about moving out of the house. Which of the following statements should the nurse make? A. "It is important that you provide emotional support for your family at this time" B. "You have to do what you feel is best. Everything will turn out fine" C. "I know how you feel. This is an extremely stressful time for your family" D. "Let's talk about some of the ways you have handled previous stressors in your life"

D. "Let's talk about some of the ways you have handled previous stressors in your life"

A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching? A. "I will puncture the pad of my finger when I am testing my blood glucose" B. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast C. "I will eat a snack of 5 grams of carbohydrates if my blood glucose is low D. "I will decreased the amount of fluids I drink when I am sick

B. "I will give myself a shot of regular insulin 30 minutes before I eat breakfast The child should administer regular insulin 30 min before meals so that the onset coincides with food intake

A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy. Which of the following findings should the nurse expect? (SATA) A. Negative Babinski reflex B. Ankle clonus C. Exaggerate stretch reflexes D. Uncontrollable movements of the face E. Contractures

B. Ankle clonus C. Exaggerated stretch reflexes E. Contracture

A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first? A. Prednisone B. Epinephrine C. Diphenhydramine D. Albuterol

B. Epinephrine

A nurse is caring for a preschooler who has been receiving IV fluids via a peripheral IV catheter. When preparing to discontinue the IV fluids and catheter, which of the following actions should the nurse plan to take

First, the nurse should turn off the IV pump. Next the nurse should occlude the IV tubing, and then remove the tape securing the catheter. Last, the nurse should apply pressure over the catheter insertion site

A nurse is caring for a school-age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction? A. Laryngeal edema B. Flank pain C. Distended neck veins D. Muscular weakness

B. Flank pain The nurse should recognize that flank pain is caused by the breakdown of RBCs and is an indication of a hemolytic reaction the blood transfusion

A nurse is assessing a school-age child who has meningitis. Which of the following findings is the priority for the nurse to report to the provider? A. Reports a headache as 6/10 pain score B. Petechiae on the lower extremities C. Nuchal rigidity D. Positive Kernig's sign

B. Petechia on the lower extremities The presence of a petechial or purpuric rash on a child who is ill can indicate the presence of meningococcemia.

A nurse is assessing a 3 yo toddler at a well-child visit. Which of the following manifestations should the nurse report to the provider? A. Blood pressure 90/50 mm Hg B. Respiratory rate 45/min C. Weight 14.5 kg (32 lb) D. Heart rate 110/min

B. Respiratory rate 45/min Above expected reference range of 20-25/min for a 3-year old

A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings should the nurse identify as an indication the adolescent is rejecting the kidney? A. Negative leukocyte esterase B. Serum creatinine 3.0 mg/dL C. Negative urine protein D. Urine output 40 mL/hr

B. Serum creatinine 3.0 mg/dL

A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The nurse should identify that which of the following laboratory values indicates effectiveness of the current treatment? A. Potassium 2.9 mEq/L B. Sodium 140 mEq/L C. Urine specific gravity 1.035 D. BUN 25 mg/dL

B. Sodium 140 mEq/L

A nurse is providing discharge teaching to the parent of a child who is 1 week postoperative following a cleft palate repair. For which of the following members of the inter-professional team should the nurse initiate a referral A. Occupation therapist B. Speech therapist C. Respirator therapist D. Physical therapist

B. Speech therapist

A nurse in a provider's office is preparing to administer immunizations to a toddler with a neomycin allergy during a well-child visit. Which of the following actions should the nurse plan to take? A. Withhold the MMR vaccine B. Withhold the DTaP vaccine C. Withhold the influenza vaccine D. Withhold the tuberculin skin test

A. Withhold the MMR vaccine The nurse should recognize that an allergy to neomycin allergy is CI for receiving the MMR vaccine. Clients who have a severe allergy to eggs or gelatin should also not receive this vaccine

A nurse is caring for an infant who has respiratory syncytial virus (RSV). Which of the following actions should the nurse implement for infection control> A. Have a designated stethoscope in the infant's room B. Place the infant in a room equipped with negative airflow C. Administer palivizumab as prescribed for the infant D. Remove gloves after leaving the infant's room

A. Have a designated stethoscope in the infant's room Droplet precautions should be initiated.

A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the following findings should the nurse recognized as an indication of anemia A. Hematocrit 28% B. Hemoglobin 13.5 g/dL C. WBC count 8,000/mm3 D. Platelets 250,000/mm3

A. Hematocrit 28% Below expected reference range of 32-44% for school-age child

A nurse is reviewing the laboratory report of a 7 yo child who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider? A. Hgb 8.5 g/dL B. WBC count 9,500/mm3 C. Prealbumin 18 mg/dL D. Platelets 300,000/mm3

A. Hgb 8.5 g/dL A child receiving chemotherapy is at risk for anemia due to the chemotherapy effects on the blood-forming cells of the bone marrow. This is below ERR of 10-15.5 g/dL

A nurse is caring for a school-age child who has experienced a tonic-clonic seizure. Which of the following actions should the nurse take during the immediate postictal period? A. Place the child in a side-lying position B. Delay documentation until the child is fully alert C. Give the child a high-carbohydrate snack D. Administer an oral sedative to the child

A. Place the child in a side-lying position The nurse should place the child in a side-lying position to prevent aspiration

A nurse is creating a plan of car for a school-age child who has heart disease and has developed heart failure. Which of the following interventions should the nurse include in the plan? A. Provide small, frequent meals for the child B. Schedule time in the play room for the child C. Weigh the child weekly D. Maintain the child in a supine position

A. Provide small, frequent meals for the child The metabolic rate of a child who has heart failure is high because of poor cardiac function. Therefore the nurse should provide small, frequent meals for the child because it helps conserve energy

A nurse in an emergency department is caring for a school-age child who has appendicitis and rates their abdominal pain as 7 on a scale of 0-10. Which of the following actions should the nurse take? A. Instill a 500 mL tap water enema B. Give morphine 0.05 mg/kg IV C. Administer polyethylene glycol 1g/kg PO D. Apply a heating pad to the child's abdomen

B. Give morphine 0.05 mg/kg IV

A charge nurse in an ED is preparing an in-service for a group of newly licensed nurses about the manifestations of child maltreatment. Which of the following manifestations should the charge nurse include as a potential indication of physical abuse? A. Recurrent urinary tract infections B. Symmetric burns of the lower extremities C. Failure to thrive D. Lack of subcutaneous fat

B. Symmetric burns of the lower extremities The patterns are usually characteristic of the method or object used, such as cigar or cigarette burns, or burns in the shape of an iron

A nurse is assessing a toddler who has gastroenteritis and is exhibiting manifestations of dehydration. Which of the following findings is the nurse's priority? A. Skin breakdown B. Hypotension C. Hyperpyrexia D. Tachypnea

D. Tachypnea

A nurse is interviewing the parent of an 18mo toddler during a well-child visit. The nurse should identify that which of the following findings indicates a need to assess the toddler for hearing loss? A. The toddler has a vocabulary of 25 words B. The toddler developed a mild rash following a recent varicella immunization C. The toddler's Moro reflex is absent D. The toddler received tobramycin during a hospitalization 2 weeks ago

D. The toddler receiving tobramycin during a hospitalization 2 weeks ago

A school nurse is assessing an adolescent who has multiple burns in various stages of healing. Which of the following behaviors should the nurse identify as a possible indications of physical abuse? A. Expresses a reluctance to leave home B. Provides a detailed description of how the burns occurred C. Denies discomfort during assessment of injuries D. Describe strong relationship with peers

C. Denies discomfort during assessment of injuries The nurse should suspect child maltreatment in the form of physical abuse if the adolescent has a blunted response to painful stimuli or injury

A nurse is caring for a school-age child who is receiving chemotherapy and is severely immunocompromised. Which of the following actions should the nurse take? A. Use surgical asepsis when providing routine care for the child B. Administer the MMR vaccine to the child C. Screen the child's visitors for indications of infection D. Infuse packed RBCs

C. Screen the child's visitors for indications of infection A child who is severely immunocompromised is unable to adequately respond to infectious organisms, resulting in the potential for overwhelming infection

A nurse is assessing the vital signs of a 10 yo child following a burn injury. The nurse should identify that which of the following findings is an indication of early septic shock? A. Blood pressure 130/90 mm Hg B. Heart rate 60/min C. Temperature 39.1 C (102.4 F) D. Urinary output 100 mL/hr

C. Temperature 39.1 C (102 F) The nurse should identify that this temperature is above the expected reference range of 37-37.5 C (98.6-99.5F) for a 10 yo child

A nurse is teaching the parent of an infant who has a Pavlik harness for the treatment of developmental dysplasia of the hip. The nurse should identify that which of the following statements by the parent indicates an understanding of the teaching? A. "I should remove the harness at night to allow my infant to stretch her legs" B. "I will need to adjust the straps on the harness once each week" C. "I should apply baby power to my infant's skin twice daily" D. "I will place my infant's diapers under the harness straps"

D. "I will place my infant's diapers under the harness straps

A nurse is caring for a preschooler whose father is going home for a few hours while another relative stays with the child. Which of the following statements should the nurse make to explain to the child when their father will return? A. "Your daddy will be back at 7 pm" B. "Your daddy will be back after he takes care of your brother" C. "Your daddy will be back in the morning" D. "Your daddy will be back after you eat"

D. "Your daddy will be back after you eat" The child comprehends time best when it is explained to them in relation to an event they are familiar/have routine around, such as eating

A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse? A. Elevate the head of the child's bed B. Insert a large bore IV catheter for the child C. Determine the allergen that caused the child's reaction D. Administer epinephrine IM to the child

D. Administer epinephrine IM to the child

A nurse is teaching the parent of an infant about ways to prevent SIDS. Which of the following instructions should the nurse include? A. "Place the infant in a prone position to sleep" B. "Allow the infant to sleep on a large pillow" C. "Use a soft mattress in the infant's crib" D. Give the infant a pacifier at bedtime"

D. Give the infant a pacifier at bedtime"

A nurse is creating a plan of care for an infant who has an epidural hematoma from a head injury. Which of the following interventions should the nurse include in the plan? A. Position the infant side-lying with their head at a 0-5 degree angle B. Perform a neurological assessment every 4 hrs C. Suction the infant's nares to remove secretions D. Implement seizure precautions for the infant

D. Implement seizure precautions for the infant An infant who has an epidural hematoma is at great risk for seizure activity

A nurse is admitting a school-age child who has pertussis. Which of the following actions should the nurse take? A. Place the child in a room with positive-pressure airflow B. Place the child in a room with negative-pressure airflow C. Initiate contact precautions for the child D. Initiate droplet precautions for the child

D. Initiate droplet precautions for the child

A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. Which of the following nutritional items should the nurse offer to the toddler? A. Apple juice B. Peanut butter C. Chicken broth D. Oral rehydration solution

D. Oral rehydration solution A toddler who has acute diarrhea should consume an oral rehydration solution to replace electrolytes and water by promoting the reabsorption of water and sodium

A nurse is providing teaching about play activities for social development to the parents of a preschooler. Which of the following play activities should the nurse recommend for the child? A. Playing pat-a-cake B. Using a push-pull toy C. Creating a scrapbook D. Playing dress-up

D. Playing dress-up

A nurse is planning care for a toddler who has a serum lead level of 4 mcg/dL. Which of the following actions should the nurse plan to take? A. Instruct the parents to decrease the calcium in their toddler's diet B. Prepare the toddler for chelation therapy C. Refer the family to Child Protective Services D. Schedule the toddler for a yearly rescreening

D. Schedule the toddler for a yearly rescreening The nurse should schedule the toddler for a lead level rescreening in 1 year and educate the family on ways to prevent exposure

A nurse in an emergency department is performing a physical assessment of a 2-week-old male newborn. Which of the following findings is the priority for the nurse to report to the provider? A. Excoriated scrotal area B. Multiple capillary hemangiomas C. Depressed posterior fontanel D. Substernal retractions

D. Substernal retractions