ATI Peds Adaptive Quiz with Rationales

1. A nurse is providing discharge teaching to parents whose infant had a ventriculoperitoneal shunt placement for the treatment of hydrocephalus. Which of the following statements by the parents indicates an understanding of the teaching? A. "We will chech his abdomen daily for signs of fluid accumulation." B. "We will notifiy the doctor right away if he has a fever." C. "We should keep a helmet on him when he's awake" D. "We can expect him to have occasional seizure episodes." - B. Rationale: Infection is a risk after ventriculoperitoneal shunt insertion, esp 1 to 2 months after placement. The parents should report fevers, vomiting, seizure activity, and decreased responsiveness, as these findings can indicate infections. 2. A nurse is providing teaching to the guardians of a 4 month old infant on how to play with the infant. Which of the following play activities should the nurse sugget for this infant? A. Show the infant a board book with large pictures. B. Imitate the sounds of different farm animals for the infant. C. Give the infant a large push-pull toy. D. Allow the infant to splash in the bathtub. - D. Rationale: Splashing is appropriate for the developmental age of the infant and provides tactile stimulation. However, the nurse shoud emphasize and teach bath safety to prevent injury. 3. A nurse is caring for a child with a vesicular rash that has been present for 6 days. The nurse should expect that the child has which of the followig conditions? A. Measles B. Fifth disease C. Tetanus D. Varicella - D. Rationale: Children who has varicella may present first with a maculopapular rash that progresses to vesicles on erythematous bases, which eventually rupture and crust over. 4. A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased urinary output and a blood pressure of 160/78 mmHg and is receiving hydralazine. Which of the following lunch choices should the nurse recommend? A. 1 hotdog, 22 potato chips, and 120 ml (4oz) of orange juice B. 1 sandwich with lettuce, tomato, and 4 slices of bacon; a small apple,; and 240 mL (8oz) of milk C. 3 oz grilled chicken, 1 cup of pear slices, and 120 mL (4oz) of apple juice. D. 1 cup of cottage cheese, a small banana, and 240 mL (8oz) of soda - C. Rationale: Children with glomerulonephritis has moderate sodium restriction, and further restriction is given to foods that are high in potassium for children who have decreased urinary output. These restrictions are because the kidneys of these children are not funtioning appropriately. This menu consist of 571 g of potassium and 268g of sodium. 5. A nurse is assessing a 6-year old child who began treatment for pneumococcal pnemonia 4 days ago. Which of the following findings should the nurse identify as an indication the treatment is effective? A. Dullness with chest percussion B. Heart rate 118/min C. Conjunctival discharge D. Respiratory rate 28/min - B. Rationale: Heart rate of 118/min is within the expected range for a 6-year-old child. A child who has an acute pneumococcal pneumonia infection will exhibit tachycardia. 6. A nurse is caring for a child who has exacerbation of cystic fibrosis. Which of the following laboratory findings should the nurse report to the provider immediately? A. Blood glucose 140 mg/dl B. Oxygen saturation 85% C. RBC 3.2 million/uL D. Serum sodium 156 mEq/L - B. Rationale: Apply ABC priority-setting framework 7. A nurse is assessing a 6 month-old infant during a well-child visit. Which of the following motor activities should the nurse expect the infant to have achieved? A. Sitting alone B. Attempting to stack objects C. Picking up small objects with a crude pincer grasp D. Turning from back to stomach - D. Rationale: A 6 month old infant should be able to turn over completely, sit momentarily without support, and reach to be picked up 8. A nurse in an acute pediatric unit is caring for a 2-year-old child who has separation anxiety when her parents leave for work. The nurse should identify which of the following behaviors as a manifestation of the stage of despair? A. The child tries to bite the nurse B. The child is withdrawn and refuses to talk C. The child attempts to run away to find her parents D. The child screams and cries loudly - B. Rationale: Separation anxiety manifests in 3 stages: protest, despair, and detatchment. Withdrawal and lack of communication are manifestations of the stage of despair. 9. A nurse is reviewing the medical record of a 2-month-old infant who has rotavirus. The nurse notes a hemoglobin level of 12g/dL and a hematocrit of 51%. Which of the following statements by the nurse indicates an understanding of the lab values? A. "The infant might be dehyrdated" B. "The infant might be anemic" C. "The infant might have received too much fluid" D. "The infant might have leukemia" - A. Rationale: An increased hematocrit level indicates dehydration. Hematocrit levels rise when blood volume is decreased during dehydration. 10. A nurse is planning to implement relaxation strategies with a young child prior to a painful procedure. Which of the following actions should the nurse take? A. Ask the child to hold a breath and blow it out slowly B. Ask the child to describe a pleasurable event C. Bounce the child gently while holding him upright D. Rock the child using long, rhythmic movements. - D. Rationale: The nurse can implement relaxation strategies by sitting with the child in a well-supported position such as against the chest and rocking or swaying back and forth in long, wide movements. 11. A nurse is planning preoperative teaching for a school-age child who is scheduled for cardiac surgery. Which of the following actions should the nurse plan to take when teaching the child? A. Limit teaching sessions to 10 min B. Use simple, concrete terms when giving explanations C. Use photographs to help explain the procedure D. Conduct the teaching session 2 days before the procedure - C. Rationale: The nurse should recognize the school-age child's increased language ability and desire for knowledge. The nurse should use photographs and simple diagrams to explain the procedure in an interesting and concrete way that the child can understand. 12. A nurse is performing a developmental assessment on a 3-year-old child. Which of the following commands should the nurse expect the child to complete successfully? A. "Put your shoes on" B."Name the days of the week" C. "Cut out this picture with a pair of scissors" D. "Balance on 1 foot with your eyes closed" - A. Rationale: Children should be able to pull their shoes when they are 3 years old. They typically cannot tie their shoes until they are 5 years of age. 13. A nurse is preparing to assess a 2-year-old toddler. Which of the following behaviors should the nurse expect during the examination? A. The child prefers to sit on the parent's lap during the examination B. The child is interested in how the examination equipment works C. The child asks specific questions about body functions D. The child questions how her development compares to other children at the same age - A. Rationale: Toddlers and infant who are able to sit typically prefer to sit in their parent's lap throughout the exam. 14. A nurse is caring for a toddler who has gastroenteritis caused by Salmonella. Which of the following is the priority action for the nurse? A. Weigh the child B. Initiate contact precautions C. Establish a skin care routine D. Obtain a recent food history - B. Rationale: Salmonella is a type of bacteria that is transmitted via contaminated feces, making contact precautions essential for preventing transmission. This client is at greatest risk for transmission of Salmonella to others; therefore, contact precautions are the nurse's priority. 15. A nurse is caring for an infant who has billiary atresia. Which of the following manifestations should the nurse expect? (Select all that apply) A. Yellow sclerae B. Rapid weight gain C. Tar-colored stools D. Abdominal distention E. Dark urine - A, D, E Rationale: Biliary atresia is a progressive process that leads to the destruction of the biliary tree. Yellow sclerae are an early manifestation of biliary atresia caused by obstruction of the biliary tree, resulting in cholestasis. Abdominal distention is a clinical manifestation of bilary atresia due to hepatomegaly. Dark urine is a clinical manifestation of biliary atresia due to conjugated bilirubin escaping from the liver and being excreted in the urine. 16. A nurse is providing nutritional teaching to an adolescent child who has celiac disease. Which of the following breakfast foods should the nurse recommend? A. Plain flour pastry B. Wheat cereal C. Scrambled eggs D. Rye toast - C. Rationale: A client who has celiac disease should be on a gluten-free diet and should avoid foods containing barley, oat, rye,a nd wheat; therefore, scrambled eggs are appropriate breakfast item for the nurse to recommend for the client 17. A charge nurse is reviewing the expected growth and development of school-age children with a group of staff nurses. Which of the following statements should the nurse include? A. A 7 year-old child prefers to play with children of a different gender B. A 6-year old child should understand the concept of casue and effect C. A 6-year old child should be able to count to 13 coins D. An 8-year old child should be able to wash his or her own hair independently. - C. Rationale: A 6-year old child should be able to count 13 coins, identify morning and afternoon, and be able to identify right and left hands.