ATI Paediatrics Practice Exam A

A nurse is a providers office is preparing to administer vaccinations to a toddler during a well-child visit. Which of the actions should the nurse plan to take? (kid has increased RR & HR; allergy to Neomycin) A. Withhold the measles, mumps, and rubella (MMR) vaccine. B. Withhold the diphtheria, tetanus, and pertussis (DTaP) vaccine. C. Withhold the influenza vaccine. D. Withhold the tuberculin skin test (TST). - A. Withhold the measles, mumps, and rubella (MMR) vaccine. Rationale: The nurse should recognize that an allergy to neomycin with an anaphylactic reaction is a contraindication for receiving the MMR vaccine. Clients who have a severe allergy to eggs or gelatin should not receive this vaccine. A nurse is providing teaching to the parent of a school-aged child who has a new prescription for oral nystatin for the treatment of oral candidacies. 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." Rationale: The nurse should instruct the parent to shake the medication prior to administration to disperse the medication evenly within the suspension. A nurse is reviewing the lumbar puncture results of a school-aged child who has suspected bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis? A. Decreased cerebrospinal fluid pressureB. Decreased WBC count C. Increased protein concentration D. Increased glucose level - C. Increased protein concentration Rationale: The nurse should identify that an increased protein concentration in the spinal fluid is a finding that can indicate bacterial meningitis. A nurse is caring for a preschooler whose father is going home 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 p.m." B. "Your daddy will be back after you eat." C. "Your daddy will be back in the morning." D."Your daddy will be back after he takes care of your brother." - B. "Your daddy will be back after you eat." Rationale: Preschoolers make sense of time best when they can associate it with an expected daily routine, such as meals and bedtime. Therefore, the child comprehends time best when it is explained to them in relation to an event they are familiar with, such as eating. A nurse is reviewing the laboratory report of a school-aged child who is experiencing fatigue. Which of the following findings should the nurse recognize 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% Rationale: The nurse should recognize that this hematocrit level is below the expected reference range of 32% to 44% for a school-age child. The child canexhibit fatigue, lightheadedness, tachycardia, dyspnea, and pallor due to the decreased oxygen-carrying capacity. A nurse is reviewing the laboratory results of an infant who is receiving treatment for severe dehydration. The nurse should identify which of the following lab values indicates that the treatment is working? 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 Rationale: The nurse should identify that a sodium level of 140 mEq/L is within the expected reference range of 134 to 150 mEq/L and indicates the current treatment regimen the infant is receiving for dehydration is effective. A nurse is reviewing the laboratory report of a 7-year-old child who is going through chemotherapy. which of the following lab 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 Rationale: A child receiving chemotherapy is at risk for anemia due to the chemotherapy effects on the blood-forming cells of the bone marrow. The development of anemia is diagnosed through laboratory testing of hemoglobin and hematocrit levels. The nurse should recognize that a hemoglobin level of 8.5 g/dL is below the expected reference range of 10 to 15.5 g/dL for a 7-year-old child and should be reported to the provider. A nurse is teaching the parents of an infant 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." - D. "Give the infant a pacifier at bedtime." Rationale: The nurse should inform the parent that protective factors against SIDS include breastfeeding and the use of a pacifier when the infant is sleeping. 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? (place in order) Remove the tape securing the catheter Turn off the IV pump Occlude the IV tubing Apply pressure over the catheter insertion site - 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 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 possible indication 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. Describes strong relationships with peers - C. Denies discomfort during assessment of injuries Rationale: 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 teaching the parent of an infant who has the Palvik Harness for the treatment of developmental dysplasia of the hip. The nurse should identify that which of the following statements made by the parents 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 powder to my infant's skin twice daily." D. "I will place my infant' - D. "I will place my infant's diapers under the harness straps." Rationale: To prevent soiling of the harness, the parent should apply the infant's diaper under the straps.