ATI Practe test notes
What are normal adolescent creatine levels? What is a normal urinary amount for adolescents?
0.4 to 1.0 mg/d 33-62.5 ml/hr
pertussis
A Dry hacking cough that may be severe at night
What should a nurse expect to find for a paitent with ventricular septal defect?
A loud murmur
A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy. Which of the following findings should the nurse expect? (Select all the apply) a. negative Babinski reflex b. ankle clonus c. exaggerated stretch reflexesd. uncontrollable movements of the face e. contractures
ankle clonus exaggerated stretch contractures Positive Babinskin is a sign of spastic pyramidal
What should you do for a child with epidermal hematoma?
Position head slightly elevated in a midline position Perform NEURO check every 15 min ORAL SUCTION BUT NOT NASAL Implement seizure activities
Normal Children values? Potasium Sodium Urine Specif BUN
Potasium-4.1-5.3 Sodium-134-150 Urine Specif-1.005-1.03 BUN-5-18
Playing dress is up is good for? Playing patty cake? Playing push pull toy? Scrap Book?
Preschooler Infant Toddler School age
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 decrease the amount of fluids I drink when I am sick.
Puncture the sides to minimize pain and has more blood flow versus the pad He should eat 10 - 15 grange of carbs like OJ (4oz) or ice cream 1/2 cup Increase fluid intake
A client who is married but under 18 can sign their own consent forms true or false?
true
How to prepare an adolescent for a lumbar puncture
Give topical analgesic 1 hr prior Have patient lay down 12hrs past procedure to prevent postrocedural spinal headache Encourage extra fluid intake after procedure to replace fluid taken
Normal Children values? Hematocrit Hem WBC Platelet
Hamtocrit 32-44 Hemoglobins -9.5-14 WBC 5,000-10,000 Platelet-150,000-400,000
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 on a 0-10 pain scale b. petechiae on the lower extremities c. nuchal rigidity d. positive Kernig's sign
Headache, Nuchal rigidity and piste K sign, is expected for meninigits Petechia should be priority as it shows sepsis signs from mengioncocoal
A nurse is interviewing the parent of an 18 month old 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
18 month old is expected to say 10 words mild rasdoesnt effect hearing loss Moro, rooting or tonic neck are primitive reflexes and disappear at 5 months Tobramycin is a amino glycoside that can be an ototoxic side which can cause hearing loss mild or moderate
Which age can identify left hand to right hand? Which age child can spread butter on toast? Which age can child cut objects with scissors? Which age child can draw stick figure with 7 body parts?
6 6 4 5
A nurse is providing dietary teaching to the 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
Celiac disease require a gluten free diet White rice is gluten free * Say what*
How to care for partial thickness burn
Clean burn with soap and water Antimicrobial ointment
When should a patient be put in a positive pressure room?
When they have gone through a stem trransplant
Things to know about a Pavlik harness
It is warns continuously for about 6-12 weeks or hip is stable Dont adjust the harness Dont use lotions or powders to prevent skin breakdown Put diapers under harness
Infant care seat important facts
Keep at 45 deg angle Dont put any padding as it create space Harness should go at shoulder or just below shoulder height. Use anchor or tethers versus seat belts
A nurse is caring for a school-age child who is in Buck's traction following a leg fracture 24 hours ago. Which of the following actions should the nurse take? a. change the child's position every 2hrs b. clean the peripheral pin sites with chlorhexidine solution every 4 days c. assess peripheral pulses once every 4 hours d. ensure that the head of the bed is elevated to a 90 degree angle
Maintain patient in a supine postion prior to surgery.. dont move! Does not use pins Yes since its immobilized
Some important things to know about maintaining kids with allergies
Mop the floor with a wet mop sweep due to particles going in the air Don't use cough suppressants with kids who have asthma( they need to be able to cough up the mucus) Dehumidifiers should be used not humidifiers or heat because it can exacerbate the asthma Keep child away from known allergens
What us a manifestation of rubella or measles? Manifestation of bacterial conjunctivitis?
Kopek spots on buccal mucosa Purulent eye drainage
Appendicitis. Which of the following locations should the nurse identify as McBurney's point?
his area of the right lower quadrant located about two-thirds of the way between the umbilicus and the client's anterosuperior iliac spine
scoliosos
lateral curvature of the spine Unilateral Rib hump with hip flexion S or C curve on thoracic spine
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 measles, mumps, and rubella (MMR) vaccine to the child c. screen the child's visitors for indications of infection d. infuse packed RBCs
medical asepses of washing hand is fine live vaccines are contraindicated for immunocompromised people Immune compromised people can't fight infectious diseases adequately packed RBC are for anemic patients Chemo need neutrophils
What is a manifestation of Meckel Diverticulum
Dark red stool with mucus
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
Allergic reaction Sign of RBC breakdown a hemolytic reaction Overload of fluid Electrolyte emabalnce All are adverse reactions of blood transfusion
What are steps to hydrotherapy for debriefment?
Apply angelic Apply antibiotic ointment Apply mesh gauze
Olgoric phase of acute kidney injury phase interventions include?
Complete a neurologic assessment and implement seizure precautions in order to maintain the child's safety Weigh child each day due to possible urinary output decrease and fluid retention Assess BP every 4 to 6 hrs due to risk of hypertensive ecnelotpahy. Dont give NSAIDS for fever due to the kidney status
What are sign of physical abuse on an adolescent?
Doesn't want to return home or fear of parent if story is vague or inconsistent with the wounds Blunted response to pain withdrawn behavior from peers
What physical assessments are abnormal in a 2 week old?
Excoriated scrotal area Multiple capillary hemangioma Depressed fontanel Substernal retractions * most important due to increased respiratory effort that can lead to respiratory failure
What are identifications of bacterial meningitis?
High Cererbal Fluid High WBC High Protein Low glucose
How to administer immunization to a 4 year old
Hold the patient sit upright as it decreases fear Use a 24 gage to limit pain do not aspirate and do it quickly to minimize pain Have parents stay so the child feels a sense of security
What are signs of peritonitis?
Hypoactive bowel sounds due to inflammation from fecal and bacteria from perforated appendix Abdominal distention - due to the inflammation of intestinal wall Chills, irritability and restlessness Tachycardia from infection and to hypovolemia from fluid shift to stomach Diarrhea and constipation
kyphosis
Increased curvature the thoracic spine caused by rickets Rounded smolders or slouching - if posture related
Osteomyelitis
Inflammation of bone and bone marrow Will receive antibiotics No need for cast as no weight baring should be done but support the limb No sports for several weeks or months until healed
how to give nystatin
No mixing into food due to asbospriton issues Dont rinse mouth but keep it in mouth as long as possible, swish and swallow Shake the bottle before administering it Not to use a straw but put it in directly in the mouth
Signs of early septic shock
Normal blood pressure (ex 10 yr old is 97-128/55-88 Elevated Temperature High heart rate (normal for 10 yr old is 60-100 awake and 50-90 sleeping) Normal urinary output ( 10 yr old is 33-58ml/hr)
When should you use droplet precautions? When should you use contact precautions?
Pertusis aka whooping cough, RSV ( make sure this room or patient has designated equipment like stethoscope or bp cuff in the room) Hep A or Retrovirus
What types of burns or wounds indicate child abuse?
Symmetric burns
How to stop/discontinue an Iv
Turn of the IV pump Occlude the IV tubing Remove the tape securing the catheter Apply pressure over the catheter insertion site.
What does a coartication of an aorta cause?
Weak femoral pulses Hypertension (aorta looks like its pinched)
Normal values for a 3 year old
Weight-32 is average eight BPn86-118/44-74 HR=80-120 RR-20-25
When should a patient be put in a negative pressure room?
When they have airborne infections like measles or vircella
lordosis
abnormal anterior curvature of the lumbar spine (sway-back condition)-common in toddlers or obese children or those with dislocated hips
A nurse in an emergency department is caring for a school-age child who has appendicitis and rates their pain as 7 on a 0-10 scale. Which of the following actions should the nurse take? a. instill a 500ml tap water enema b. give morphine 0.05mg/kg IV c. administer polyethylene glycol 1g/kg PO d. apply a heating pad to the child's abdomen
Enema will create bowel motility which can increaser chances of proliferated appendix Morphine yes for pain relief Polyethylenel Glycol is laxative that can increase chances of proliferated appendix Heat may cause a proliferated appendix
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
Increase in calcium, iron and Vitamin c lowers lead absorption Chelation therapy is for over 10 mcg lead or 45 mcg not high enough for services Schedule a yearly visits and educate them on how to lower the lead level