ATI: RN Nursing Care of Children Online Practice 2016 A

A nurse is creating a plan of care for a toddler who has minimal change nephrotic syndrome and 3+ pitting edema. Which of the following interventions should the nurse include in the plan? A) Encourage an increased fluid intake for the toddler B) Place the child in an airbourne infection isolation room C) Increase toddlers dietary sodium intake D) Administer corticosteroids to the todd

A) INCORRECT: PO fluid restriction during edema phase B) INCORRECT: no isolation precautions required C) INCORRECT: low sodium diet during edema phase D) CORRECT: appropriate treatment

A nurse in a emergency department is preparing an in-service for a group of newly licensed nurses on the clinical manifestations of child maltreatment. Which of the following clinical manifestations should the nurse include as suggestive of potential physical abuse? A) Recurrent urinary tract infections B) Symmetric burns on the lower extremities C) Growth failure D) Lack of subcutaneous fat

A) INCORRECT: sexual abuse B) CORRECT: patterns are usually characteristics of the method or object used (cigar, cigarettes, an iron) C) INCORRECT: neglect (malnutrition) D) INCORRECT: physical neglect

A nurse at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the nurse recognize as a manifestation of pertussis? A) Inflamed throat with exudate B) Purulent eye drainage C) Dry hacking cough D) Koplik spots on buccal mucosa

A) INCORRECT: streptococcal pharyngitis B) INCORRECT: bacterial conjunctivitis C) CORRECT: becomes more severe at night D) INCORRECT: Rubeola (measles)

A nurse is teaching the parents of a school-age child who has a new diagnosis of osteomyelitis of the tibia. The nurse should identify that which of the following statements by the parents indicates and understanding of the teaching? A) My child will have a cast until healing is complete B) My child will receive antibiotics for several weeks C) My child can return to playing sports once he is discharged D) My child needs to be in contact isolation

A) INCORRECT: weight bearing must be avoided (position of comfort, not a cast) B) CORRECT: antibiotics for at least 4 weeks (surgery if antibx don't work) C) INCORRECT: no weight bearing D) INCORRECT: not a communicable disease

A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following findings indicates effectiveness of the medication? A) The adolescent reports an absence of nausea and vomiting B) The client experiences onset of loose stools within 15 min of administration C) The adolescents serum potassium level is 4.1 D) The adolescent has a BP of 86/52

A) INCORRECT: indicates effectiveness of antiemetic B) INCORRECT: this is an adverse effect of sodium polystyrene sulfonate C) CORRECT: tx hyperkalemia by exchanging sodium ions for potassium ions in the intesting D) INCORRECT: below expected range and is not an indication med is working

A nurse in a provider's office is caring for a school-age child who has varicella. The parent asks the nurse when her child will no longer be contagious. Which of the following responses should the nurse make? A) When you child no longer has an increased temperature B) Three days after you first noticed the rash appear on your child C) When your child's lesions are crusted, 6 days after they appear. D) Two to three weeks, when your child's lesions completely disappear

A) INCORRECT: no fever doesn't mean not contagious B) INCORRECT: still contagious after 3 days C) CORRECT: contagious 1 day prior to eruption and until crusted over (about 6 days) D) INCORRECT: incubation of varicella is 2 to 3 weeks (not associated with lesion appearance)

A nurse in an emergency department is performing a physical assessment on a 2 week old male infant. Which of the following manifestations in 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

A) INCORRECT: not the priority (skin issue) B) INCORRECT: not the priority (small vascular issue) C) INCORRECT: not the priority (dehydration) D) CORRECT: ABC's-->baby is having acute respiratory distress

A nurse is providing anticipatory guidance to the mother of a toddler. Which of the following expected behavior characteristics of toddlers should the nurse include in the teaching? A) Controls impulsive feelings B) Understands right from wrong C) Easily separates from parents for long periods of time D) Expresses likes and dislikes

A) INCORRECT: school aged children B) INCORRECT: preschooler C) INCORRECT: Toddlers have separation anxiety D) CORRECT: developing autonomy and self-concept (allow todd to have some control but also set limits to learn and control her actions)

A nurse is teaching the parent of a newborn about ways to prevent sudden infant death syndrome (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

A) INCORRECT: supine position B) INCORRECT: increases the risk of suffocation C) INCORRECT: use a firm mattress. Soft can lead to asphyxiation D) CORRECT: breastfeeding and the use of a pap while sleeping

A nurse in the emergency department is caring for a toddler who has partial-thickness burns on his 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

A) INCORRECT: this is for major burn management B) INCORRECT: Prophylactic antibiotics are not recommended for burns C) CORRECT: used to remove any loose tissue D) INCORRECT: use antibiotic ointment to prevent infection

A nurse is assessing the vitals of a 10 yo following a burn injury. Which of the following clinical manifestations indicate early septic shock? A) BP 130/90 B) HR 60/min C) Temp 39.1 C D) UO 100 mL/hr

A) INCORRECT: above normal ( early shock doesn't affect BP) B) INCORRECT: below normal (early shock doesn't affect HR) C) CORRECT: fever and chills D) INCORRECT: above normal (early shock doesn't affect UO)

A nurse is auscultating the lung sounds of an adolescent who has asthma. The nurse should identify the sound as which of the following? A) Bio't respiration B) Cheyne-Stokes respiration C) Tachypnea D) Bradypnea

A) INCORRECT: apnea alternating with 2 to 3 shallow breaths B) INCORRECT: periods of apnea alternating periods of hyperventilation C) CORRECT: fast, reg pattern D) INCORRECT: slow, reg pattern

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 B) Sodium 140 C) USP 1.035 D) BUN 25

A) INCORRECT: below expected range and indicates hypokalemia B) CORRECT: within expected renage C) INCORRECT: above expected range and indicates concentrated urine D) INCORRECT: above expected range and indicates kidneys are not excreting BUN as they should

The nurse is preparing to collect a sample for 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

A) INCORRECT: collected to ID infectious organisms (kids with acute respiratory tract infections) B) INCORRECT: this determines adequate circulation by observing capillary refill before an arterial puncture. C) CORRECT: if the test is positive, hemoglobin electrophoresis is required to tell the difference between the genetic trait or the disease D) INCORRECT: collected to ID organisms or parasites that cause diarrhea or check for occult blood

A nurse is planning care for a toddler who has a serum lead level of 4 mcg. Which of the following actions should the nurse plan to take? A) Instruct the parents to decrease the calcium in their todd'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

A) INCORRECT: diet rich in calcium and vitamin C bcuz these decrease lead absorption B) INCORRECT: required for lead levels 45 mcg or greater (can be indicated for lead levels over 10 mcg) C) INCORRECT: not an indicator of child endangerment D) CORRECT: Teach family how to prevent exposure

A nurse is creating an educational plan to teach parents about protecting their children from sunburns. Which of the following instructions should the nurse plan to include? A) Choose a waterproof sunscreen with an SPF of at least 15 B) Apply sunscreen liberally to infants over 3 mo of age C) Dress children in a loose weave polyester fabric prior to sun exposure D) Reapply suncreen every 4 hours

A) CORRECT B) INCORRECT C) INCORRECT D) INCORRECT

A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to the provider? A) Nasal flaring B) WBC 11,300 C) Diarrhea D) Abdominal distention

A) CORRECT: ABC's acute respiratory distress B) INCORRECT: above expected range but A is priority C) INCORRECT: manifestation of pnemonia but A is priority D) INCORRECT: manifestation of pneumonia but A is the priority

A nurse is caring for a preschooler who has been receiving IV fluids via a peripheral IV. When preparing to discontinue the IV fluids and catheter, which of the following actions should the nurse plan to take? (place these in the right order) A) Remove the tape securing the catheter B) Apply pressure over the catheter insertion site C) Turn off the IV pump D) Occlude the IV tubing

C, D, A, B

A nurse is assessing a client who has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect? A) Steatorrhea B) Projectile vomiting C) Sunken abdomen D) Weight gain

A) CORRECT: damage to the cells in the bowel-->malabsorption-->steatorrhea and diarrhea B) INCORRECT: pyloric stenosis C) INCORRECT: distended abdomen D) INCORRECT: weight loss

A nurse is providing teaching to the family of a school age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include in the teaching? A) Limit the movement of the child's large joints B) Encourage the child to perform independent self-care C) Provide the child with a soft mattress for sleeping D) Schedule a 2 hour daily nap for the child in the afternoon

A) INCORRECT: exercise regularly to maintain mobility and strengthen muscles B) CORRECT: minimize pain and maximize mobility C) INCORRECT: can increase pressure on affected joints D) INCORRECT: stiffness occurs quickly and interferes with nighttime sleeping

A nurse is receiving change of shift report on four children. Which of the following children should the nurse assess first? A) A todd who has a concussion and an episode of forceful vomiting B) An adolescent who has infective endocarditis and reports having a headache C) An adolescent who was placed into halo traction 1 hr ago and rates his pain at a 6 D) A school-age child who has acute glomerulonephritis and brown colored urine

A) CORRECT: increased intracranial pressure with a concussion B) INCORRECT: non-urgent C) INCORRECT: non-urgent D) INCORRECT: non-urgent

A nurse is creating a plan of care for a preschooler who has Wilms' tumor and is scheduled for surgery. Which of the following interventions should the nurse include? A) Avoid palpating the abdomen when bathing the child before surgery. B) Refrain from auscultating the child's bowel sounds during the postoperative assessment C) Encourage the child to play with other children on the unit prior to surgery D) Explain to the child that his pain will be managed after the surgery

A) CORRECT: movement of tumor can cause cancer cells to disseminate to other sites B) INCORRECT: important part of post op assessment C) INCORRECT: risk of injury increases with physical activity D) INCORRECT: pain prior with increase fear and anxiety

A nurse in an ED is assessing a 3 month old who has rotavirus and is experiencing acute vomiting and diarrhea. Which s/s should the nurse identify as an indication that they have moderate to severe dehydration? A) HR 124/min B) Increased tear production C) Sunken anterior fontanel D) Capillary refill 2 seconds

A) INCORRECT: 106-186/min for 3-5 mo old infant B) INCORRECT: more likely to have absence of tears C) CORRECT: acute loss of fluid D) INCORRECT: normal for infant (greater than 2 seconds is an s/s of dehydreation)

A nurse is providing discharge teaching to the parent of an 18 mo old toddler who has dehydration as a result of acute diarrhea. Which of the following statements by the parent indicates an understanding of the teaching? A) I will offer my child small amounts of fruit juice frequently B) I will avoid giving my child solid foods until his diarrhea has stopped C) I will monitor my child's number of wet diapers D)I will give my child polyethylene glycol daily for 7 days

A) INCORRECT: Fruit juice is high in carbs and low in electrolytes B) INCORRECT: Encourage solid foods with diarrhea C) CORRECT: best way to monitor adequate output and hydration status D) INCORRECT: this will pull fluid into the bowel and increase diarrhea and dehydration. Your baby be dead!

A nurse is caring for a 15 year old client following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing syndrome of inappropriate antidiuretic hormone secretion (SIADH)? A) Sodium 148 B) Urine specific gravity 1.020 C) Mental confusion D) Weak peripheral pulses

A) INCORRECT: Sodium normal for 15 yo. SIADH causes a decrease in sodium B) INCORRECT: 1.015-1.030 SIADH will have concentrated urine and high specific gravity C) CORRECT: altered pituitary function (also causes decreased UO, Na+, and hypo-osmolarity due to over-hydration D) INCORRECT: More likely to have fluid overload (bounding pulses, high BP and HR

A nurse is providing teaching to the parents of a preschooler who has heart failure and who is to begin taking digoxin twice daily. Which of the following instructions should the nurse include in the teaching? A) Use a kitchen tablespoon to measure the medication B) Brush the child's teeth after giving the medication C) Double the next dose if child misses a dose D) Repeat the dose if the child vomits

A) INCORRECT: duh...use accurate measurements B) CORRECT: prevent tooth decay (med comes in a sweetened liquid to enhance taste) C) INCORRECT: No, no, no...never do that. Ever! D) INCORRECT: n/v is a s/s of Dig toxicity...sooo don't give another dose if your pt has Dig toxicity

A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation? A) A toddler who is 18 months old and has unintelligible speech B) An infant who is 3 months old and has an exaggerated startle response C) A preschooler who is 4 years old and prefers playing with others rather than alone D) An infant who is 8 months old and is not yet making babbling sounds

A) INCORRECT: toddlers who do not possess intelligible speech by 24 months should be referred B) INCORRECT: under 4 months and LACK a startle response should be referred C) INCORRECT: preschooler who prefers playing alone and avoids interaction should be referred D) CORRECT: not making babbling sounds by 7 months should be referred

A nurse is caring for a preschooler who is sceduled for hydrotherapy treatment for wound debridement following a burn injury. Which of the following actions should the nurse take prior to the procedure? A) Apply topical antimicrobial ointment to the child's wound B) Place a mesh gauze dressing over the child's wound C) Administer and analgesic to the child D) Initiate prophylactic antibiotic therapy for the child

A) INCORRECT: you should do that after B) INCORRECT: you should do that after C) CORRECT: this is a very painful procedure D) INCORRECT: not recommended in children with burns