Peds- ATI Practice Exam B 2019

Nurse is reviewing lab results of a school age child 1 week postop following an open fracture repair. Which findings should nurse ID as indication of potential complication? a. Erythrocyte sedimentation rate 18 mm/hr b. WBC count 6,200/mm3 c. C-reactive protein 1.4 mg/LRBC count 4.7 million/mm3 - a. Erythrocyte sedimentation rate 18 mm/hr Nurse planning care for school age child with tunneled CVA device. Which interventions should the nurse include in plan? a. Use sterile scissors to remove the dressing from the site. b. Irrigate each lumen weekly with 10 mL of 0.9% sodium chloride solution when not in use c. Access the site using a noncoring angled needle d. Use a semipermeable transparent dressing to cover the site - d. Use a semipermeable transparent dressing to cover the site Nurse is planning care to address nutritional needs for preschooler with cystic fibrosis. Which interventions should the nurse include in plans? a. Administer pancreatic enzymes 2 hr after meals. b. Discontinue the use of pancreatic enzymes if steatorrhea develops. c. Limit fluid intake to 750 mL per day. d. Increase fat content in the child's diet to 40% of total calories. - d. Increase fat content in the child's diet to 40% of total calories Nurse in ED auscultates lungs of adolescent experiencing dyspnea. Nurse should ID sound as what? a. Wheezes b. Crackles c. Pleural friction rub d. Rhonchi - a. Wheezes Nurse assesses school age child with infratentorial brain tumor. Which findings should the nurse ID as manifestation of IICP? a. Hypotension b. Reports insomnia c. Difficulty concentrating d. Tachycardia - c. Difficulty concentrating Nurse assesses infant with pneumonia. Which findings is priority for nurse to report to HCP? a. Nasal flaring b. WBC count 11,300/mm3 c. Diarrhea d. Abdominal distension - a. Nasal flaring Nurse in health department is caring for emancipated adolescent with STI and unaccompanied by guardian. Which actions should the nurse take? a. Have the adolescent sign a consent form for treatment. b. Instruct the adolescent to return with a guardian. c. Obtain consent from the adolescent's guardian over the phone d. Treat the adolescent without a consent form - a. Have the adolescent sign a consent form for treatment Nurse teaches adolescent about how to manage tinea pedis. Which statements by adolescent indicates understanding of teaching? a. "I should buy plastic shoes to wear at the swimming pool." b. "I should wear sandals as much as possible." c. "I should place the permethrin cream between my toes twice daily." d. "I should seal my nonwashable shoes in plastic bags for a couple of weeks." - b. "I should wear sandals as much as possible." Nurse assesses 8 y/o child with early indications of shock. After establishing airway and stabilizing child's resp, which actions should the nurse take next? a. Insert an indwelling urinary catheter. b. Measure weight and height. c. Initiate IV access. d. Maintain ECG monitoring. - c. Initiate IV access Charge nurse prepares to make room assignment for newly admitted school age child. Which considerations is the nurse's priority? a. Length of stay b. Treatment schedule c. Disease process d. Self-care ability - c. Disease process Nurse in ED assesses 3 month old infant with rotavirus and experiences acute vomiting and diarrhea. Which manifestations should nurse ID as indication that infant has moderate to severe dehydration? a. Heart rate 124/min b. Increased tear production c. Sunken anterior fontanel d. Cap refill 2 secs - c. Sunken anterior fontanel A nurse is preparing to administer ibuprofen 5mg/kg every 6 hours prn for temperatures above 38.0 C (100.5 F) to an infant that weighs 17.6 Lb. The infant has a temperate of 38.4 C (101.2 F). Available is ibuprofen liquid 100mg/5mL. How many mL should the nurse administer to the infant per dose? round to the nearest whole number. Use a leading 0 if it applies. - 2 mL Nurse provides dietary teaching to guardian of school age child with cystic fibrosis. Which statements should nurse make? a. "You should offer your child high-protein meals and snacks throughout the day." b. "You should decrease your child's dietary fat intake to less than 10% of their caloric intake." c. "You should restrict your child's calorie intake to 1,200 per day." d. "You should give your child a multivitamin once weekly." - a. "You should offer your child high-protein meals and snacks throughout the day." Nurse reviews dietary choices of adolescent with iron deficiency anemia. Nurse should ID which menu items has highest amount of nonheme iron? a. ½ cup whole milk b. 1 cup orange juice c. 1/2 cup raisins d. 1 cup raw carrots - c. The nurse should encourage the adolescent to eat raisins because they contain the highest amount of nonheme iron. Nurse provides discharge teaching to parents of 6 month old infant postop following hypospadias repair with stent placement. Which instructions should the nurse include in teaching? a. "You may bathe your infant in an infant bathtub when you go home." b. "Apply hydrocortisone cream to your infant's penis daily." c. "You should clamp your infant's stent twice daily." d. "Allow the stent to drain directly into your infant's diaper." - d. "Allow the stent to drain directly into your infant's diaper." Nurse in ED cares for school age child with epiglottis. Which actions should the nurse take? a. Obtain a throat culture from the child. b. Monitor the child's oxygen saturation. c. Put a warm mist humidifier in the child's room. d. Place the child in the supine position. - b. Monitor the child's oxygen saturation. Nurse in HCP office is caring for school age child with varicella. Parent asks nurse when their child will no longer be contagious. Which response should the nurse make? a. "When your 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, usually 6 days after they appear." d. "Two to three weeks, when your child's lesions completely disappear." - c. "When your child's lesions are crusted, usually 6 days after they appear." Nurse teaches family of school age child with juvenile idiotpathic arthritis. Which instructions should the nurse include in teaching? a. "Limit 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." - b. "Encourage the child to perform independent self-care." School nurse provides in service for faculty about improving education for students with ADHD. Which statements by faculty member indicates understanding of teaching? a. "I will plan to increase the amount of homework I assign to students who have ADHD." b. "I will give students who have ADHD the same amount of time as other students to complete tests." c. "I will allow students who have ADHD one rest break throughout the day." d. "I will teach challenging academic subjects to students who have ADHD in the morning." - d. "I will teach challenging academic subjects to students who have ADHD in the morning." Nurse is planning educational program to teach parents about protecting children from sunburns. Which instructions should the nurse plan to include? a. "Allow your child to play outside during the hours between 10:00 a.m. and 2:00 p.m." b. "Choose a waterproof sunscreen with a minimum SPF of 15." c. "Dress your child in loose weave polyester fabric prior to sun exposure." d. "Reapply sunscreen every 4 hours." - b. "Choose a waterproof sunscreen with a minimum SPF of 15." Nurse planning care for newly admitted school-age child with generalized seizure disorder. Which interventions should the nurse plan to include? a. Ensure that a padded tongue blade is at the child's bedside. b. Allow the child to play video games on a tablet computer. c. Allow the child to take a tub bath independently. d. Ensure the oxygen source is functioning in the child's room. - d. Ensure the oxygen source is functioning in the child's room. Nurse caring for newly admitted school age child with hypopituitarism. Which meds should the nurse expect the HCP to prescribe? a. Desmopressin b. Luteinizing hormone-releasing hormone c. Recombinant growth hormone d. Levothyroxine - c. Recombinant growth hormone Nurse creating POC (plan of care) for preschooler with Wilms' tumor and scheduled for surgery. Which 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 their pain will be managed after the surgery. - a. Avoid palpating the abdomen when bathing the child before surgery Nurse discussing organ donation with parents of school age child who has sustained brain death due to bicycle crash. Which actions should the nurse take first? a. Inform the parents that written consent is required prior to organ donation. b. Provide written information to the parents about organ donation. c. Ask the provider to explain misconceptions of organ donation to the parents. d. Explore the parents' feelings and wishes regarding organ donation. - d. Explore the parents' feelings and wishes regarding organ donation. Nurse planning developmental activities for newly admitted 10 y/o child with neutropenia. Which actions should the nurse plan to take? a. Provide the child with a book about adventure. b. Arrange frequent visits from family members and peers. c. Give the child a large-piece puzzle. d. Use puppets to entertain the child. - a. Provide the child with a book about adventure. Community health nurse assesses 18 month old toddler in community day care. Which findings should the nurse ID as potential indication of physical neglect? a. Resists having an axillary temperature taken. b. Exhibits withdrawal behaviors when their parent leaves. c. Has multiple bruises on their knees. d. Poor personal hygiene - d. Poor personal hygiene Nurse admitting a 4 month old infant with heart failure who is prescribed Digoxin 0.5 mcg PO Q12H Furosemide 20 mg PO Q12H. Which findings is the nurse's priority? a. Exhibits: Temperature 37.5° C (99.5° F), Heart rate 70/min, Respiratory rate 30/min b. Birth weight 3.2 kg (7 lb) Current weight 5.9 (13 lb) c. 3 episodes of vomiting 6 wet diapers in 24 hr d. Consumed 3 oz concentrated formula every 3 hr - c. Episodes of vomiting. Nurse teaches parents of preschooler with heart failure and new prescription for digoxin 2x daily. Which instructions should the nurse include in teaching? a. "Use a kitchen teaspoon to measure the medication." b. "Brush the child's teeth after giving the medication." c. "Double the next dose if the child misses a dose." d. "Repeat the dose if the child vomits." - b. "Brush the child's teeth after giving the medication." Nurse assesses pain level of 3 y/o toddler. Which pain assessments should the nurse use? a. FACES b. Numeric c. CRIES d. Visual analog - a. FACES Nurse teaches guardian of 6 month old infant about teething. Which statements should the nurse make? a. "Your baby might pull at their ears when they are teething." b. "Rub your baby's gums with an aspirin to decrease discomfort." c. "Place a beaded teething necklace around your baby's neck." d. "Your baby's upper middle teeth will erupt first." - a. "Your baby might pull at their ears when they are teething." Nurse performs hearing screenings for children at community health fair. Which children should the nurse refer to HCP for more extensive hearing evaluation? a. An 18-month-old toddler who has unintelligible speech b. A 3-month-old infant who has an exaggerated startle response c. A 4-year-old preschooler who prefers playing with others rather than alone d. An 8-month-old infant who is not yet making babbling sounds - d. An 8-monthold infant who is not yet making babbling sounds. Nurse teaching parents of toddler with cognitive impairment about toilet training. Which instructions should the nurse include in teaching? a. "Scold your child when they have a toileting accident." b. "Award your child with a sticker when they sit on the potty chair." c. "Play your child's favorite song while teaching them to use the potty chair." d. "Teach multiple steps of the skill at the same time." - b. "Award your child with a sticker when they sit on the potty chair." Nurse teaching school age child and parent about postop care following cardiac catheterization. Which instructions should the nurse include? a. "Stay home from school for 1 week following the procedure." b. "Follow a diet that is low in fiber for 1 week." c. "Wait 3 days before taking a tub bath." d. "Apply a pressure dressing to the site for 3 days."` - c. "Wait 3 days before taking a tub bath." Nurse caring for school age child with primary nephrotic syndrome and taking prednisone. Following 1 week of txt, which manifestations indicates to nurse that med is effective? a. Decreased edema b. Increased abdominal girth c. Decreased appetite d. Increased protein in the urine - a. Decreased edema Nurse receiving change of shift report for 4 children. Which children should the nurse assess first? a. A toddler 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 reports pain as 6 on a scale of 0 to 10. d. A school-age child who has acute glomerulonephritis and brown-colored urine. - a. A toddler who has a concussion and an episode of forceful vomiting. Nurse teaching group of parents about infectious mononucleosis. Which statements by parent indicates understanding of teaching? a. "Mononucleosis is caused by an infection with the Epstein-Barr virus." b. "Mononucleosis is a bacterial infection requiring 14 days of antibiotics." c. "A Monospot is a throat culture used to diagnosis mononucleosis." d. "Children who get mononucleosis will need to refrain from sports for 6 months." - a. "Mononucleosis is caused by an infection with the Epstein-Barr virus." Nurse in ED is caring for school age child with sustained minor superficial burn from fireworks on forearm. Which actions should the nurse take? a. Administer the tetanus toxoid vaccine if more than 1 year since the prior dose. b. Apply an antimicrobial ointment to the affected area. c. Leave the burn area open to air. d. Place an ice pack on the affected area. - b. Apply an antimicrobial ointment to the affected area. School nurse is caring for child following tonic-clonic seizure. Which actions should the nurse take first? a. Check the child for a head injury. b. Observe for oral bleeding. c. Check the child's respiratory rate. d. Observe for extremity weakness. - c. Check the child's respiratory rate. Nurse caring for 1 month old infant who's breastfeeding and requires heel stick. Which actions should the nurse take to minimize infant's pain? a. Use a manual lancet to obtain the heel blood sample. b. Apply an ice pack to the infant's heel prior to obtaining the sample. c. Allow the mother to breastfeed while the sample is being obtained. d. Apply a topical lidocaine cream prior to obtaining the sample - c. Allow the mother to breastfeed while the sample is being obtained. Nurse creating POC for newly-admitted adolescent with bacterial meningitis. How long should the nurse plan to maintain adolescent in droplet precautions? a. Until the adolescent is afebrile. b. For 7 days following admission to the facility. c. Until the adolescent has a negative blood culture. d. For 24 hr following initiation of antimicrobial therapy - d. For 24 hr following initiation of antimicrobial therapy. Nurse is monitoring SpO2 level of an infant using pulse ox. Nurse should secure sensor to which areas on the infant? a. Wrist b. Great toe c. Index finger d. Heel - b. Great toe Nurse gives discharge teaching to guardians of toddler with lower leg cast applied 24 hrs ago. Nurse should instruct guardians to report which findings to HCP? a. Capillary refill time less than 2 seconds. b. Restricted ability to move the toes. c. Swelling of the casted foot when the leg is dependent. d. Pedal pulse +3 bilateral - b. Restricted ability to move the toes. Nurse caring for school age child with DM was admitted with Dx of diabetic ketoacidosis. When performing resp assessment, which findings should the nurse expect? a. Deep respirations of 32/min. b. Shallow respirations of 10/min. c. Paradoxic respirations of 26/min. d. Periods of apnea lasting for 20 second - a. Deep respirations of 32/min. Nurse gives discharge teaching to parent of school age child with moderate persistent asthma. Which instructions should the nurse include? a. "You should give your child their salmeterol inhaler every 4 hours when they are having an acute episode of wheezing." b. "You should monitor your child's weight weekly while they are receiving inhaled corticosteroid therapy." c. "Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy." d. "When using the peak expiratory flow meter, record your child's average of three readings." - c. "Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy." Nurse is caring for toddler with acute otitis media and temp of 40 C (104 F). After admin acetaminophen, which actions should the nurse plan to take to reduce toddler's temp? a. Apply a cooling blanket to the toddler. b. Dress the toddler in minimal clothing. c. Give the toddler a tepid bath. d. Administer diphenhydramine to the toddler. - b. Dress the toddler in minimal clothing. Nurse in ED assesses toddler with Kawasaki disease. Which findings should the nurse expect? (SATA) a. Increased temperature b. Gingival hyperplasia c. Xerophthalmia d. Bradycardia e. Cervical lymphadenopathy - a. Increased temperature is correct. c. Xerophthalmia is correct. e. Cervical lymphadenopathy is correct. Nurse assesses 6 month old during well-child visit. Which findings should the nurse report to HCP? a. Presence of a central incisor tooth. b. Presence of strabismus. c. Presence of an open anterior fontanel. d. Presence of external cerumen - b. Presence of strabismus.