ATI Peds Practice B Exam 2024 Graded A

A nurse is reviewing laboratory results of a school-age child who is 1 week postoperative following an open fracture repair. Which of the following values should the nurse identify as an indication of a potential complication A. Erythrocyte sedimentation rate 18 mm/hr B. WBC 6,200/mm3C. C-reactive protein 1.4 mg/L D. RBC 4.7 106/μL - A. Erythrocyte sedimentation rate 18 mm/hr The nurse should identify that an erythrocyte sedimentation rate of 18 mm/hr is above the expected reference range of up to 10 mm/hr and is an indication of osteomyelitis. A nurse is planning care for a school-age child who has a tunneled central venous access device. Which of the following interventions should the nurse include in the 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. The nurse should cover the site with a semipermeable transparent dressing to reduce the risk of infection. A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan? A. Administer pancreatic enzymes 2 hr after meals. B. Decrease 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. A child who has cystic fibrosis is unable to properly digest fats due to fibrosis of the pancreas and limited secretion of pancreatic enzymes. The nurse should increase the child's fat intake to 35% to 40% of total caloric intake. A nurse in an emergency department is auscultating the lungs of an adolescent who is experiencing dyspnea. The nurse should identify the sound as which of the following? A. Wheezes B. Crackles C. Pleural friction rub D. Rhonchi - A. Wheezes The nurse should identify the sound during auscultation as wheezes, which are high-pitched, musical or whistling-like sounds heard primarily on expiration as air passes through and vibrates narrowed airways. A nurse is assessing a school-age child who has an infratentorial brain tumor. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure? A. Hypotension B. Reports insomnia C. Difficulty concentrating D. Tachycardia - C. Difficulty concentrating The nurse should identify that irritability, inability to follow commands, and difficulty concentrating are manifestations of increased intracranial pressure due to decreased blood flow within the brain and pressure on the brainstem. A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report the provider? A. Nasal flaring B. WBC count 11,300/mm3 C. Diarrhea D. Abdominal distension - A. Nasal flaring When using the airway, breathing, and circulation approach to client care, the nurse should determine that the priority finding to report to the provider is nasal flaring. Nasal flaring indicates the infant is experiencing acute respiratory distress. A nurse in a health department is caring for an emancipated adolescent who has an STI and is unaccompanied by a guardian. Which of the following 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. The nurse should identify that an emancipated minor can sign the consent form for treatment of an STI or any other form of medical treatment requiring consent. A nurse is providing teaching to an adolescent about how to manage tinea pedis. Which of the following statements by the adolescent indicates an understanding of the 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." Sandals allow air to circulate around the feet, decreasing perspiration and eliminating the medium for bacteria and fungus to grow. The nurse should inform the adolescent that wearing sandals, open-toed, or well-ventilated shoes will promote healing of the fungal infection. A nurse is assessing an 8 year old child who has early indication of shock. After establishing an airway and stabilizing the child's respirations, which of the following 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. After establishing an airway and stabilizing the child's respirations, the next action the nurse should take when using the airway, breathing, and circulation approach to client care is to establish IV access to maintain the child's circulatory volume. A charge nurse is preparing to make a room assignment for a newly admitted school age child. Which of the following considerations is the nurse's priority? A. Length of stay B. Treatment schedule C. Disease process D. Self-care ability - C. Disease process The transmission of infectious diseases is the greatest risk to this child and other children on the unit. Therefore, the child's disease process is the nurse's priority consideration. A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is experiencing acute vomiting and diarrhea. Which of the following manifestations should the nurse identify as an indication that the infant has moderate to severe dehydration? A. Heart rate 124/min B. Increased tear production C. Sunken anterior fontanel D. Capillary refill 2 seconds - C. Sunken anterior fontanel The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe dehydration due to the acute loss of fluid. A nurse is providing dietary teaching to the guardian of a school age child who has cystic fibrosis. Which of the following statements should the 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." The nurse should instruct the guardian to provide a diet that is well-balanced and high in protein and calories. Children who have cystic fibrosis require a higher percentage of the recommended dietary allowances of all nutrients to meet their energy requirements. Children who have good nutritional intake have improved lung function and decreased risk of infection. A nurse is reviewing the dietary choices of an adolescent who has iron deficiency anemia. The nurse should identify that which of the following menu items has the highest amount of nonheme iron? A. ½ cup whole milk B. 1 cup orange juice C. ½ cup raisins D. 1 cup raw carrots - C. ½ cup raisins The nurse should encourage the adolescent to eat raisins because they contain the highest amount of nonheme iron. A nurse is providing discharge teaching to the parents of a 6 month old infant who is postoperative following hypospadias repair with a stent placement. Which of the following instructions should the nurse include in the 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." The nurse should instruct the parents to ensure that the stent drains directly into the infant's diaper to prevent kinking or twisting that can interfere with urine flow. A nurse in an emergency department is caring for a school age child who has epiglottitis. Which of the following 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. The nurse should monitor the child's oxygen saturation level because the child is experiencing acute respiratory distress and it is necessary to determine if the child is responding to treatment. A nurse in a provider's office is caring for a school age child who has varicella. The parent asks the nurse when their child will no longer be contagious. Which of the following responses 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 you 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 you child's lesions are crusted, usually 6 days after they appear." The nurse should inform the parent that the child is contagious 1 day prior to lesion eruption and until the vesicles have crusted over, which usually takes about 6 days. A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthrisis. Which of the following instructions should the nurse include in the 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." The nurse should teach the family the importance of encouraging the child to perform independent self-care. This will minimize the child's pain while maximizing mobility. Encouraging and praising the child's efforts for independence will also increase their self-esteem. A school nurse is providing an in service for faculty about improving education for students who have ADHD. Which of the following statements by a faculty member indicates an understanding of the 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." Faculty should plan to teach challenging academic subjects in the morning when students who have ADHD are most able to focus and their medication is most likely to be effective. A nurse is planning an educational program to teach parents about protecting their children from sunburns. Which of the following 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." The nurse should instruct parents to apply a waterproof sunscreen with a minimum SPF of 15 for children. The parents should apply the sunscreen prior to sun exposure to reduce the risk of sunburn. A nurse is planning care for a newly admitted school age child who has generalized seizure disorder. Which of the following 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. The nurse should recognize that maintaining the child's airway is important during a seizure. The nurse should ensure that the oxygen source is functioning because the child might require supplemental oxygen following a seizure. A nurse is caring for a newly admitted school age child who has hypopituitarism. Which of the following medications should the nurse expect the provider to prescribe? A. Desmopressin B. Luteinizing hormone-releasing hormone C. Recombinant growth hormone D. Levothyroxine - C. Recombinant growth hormone Recombinant growth hormone injections are used to treat hypopituitarism, which inhibits cell growth and results in growth failure. The nurse should expect the provider to prescribe this treatment. 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 their pain will be managed after the surgery. - A. Avoid palpating the abdomen when bathing the child before surgery. The nurse should avoid palpating the abdomen when bathing the child before surgery because movement of the tumor can cause cancer cells to disseminate to other sites, adjacent and distant to the tumor site. A nurse is discussing organ donation with the parents of a school age child who has sustained brain death due to a bicycle crash. Which of the following 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. The first action the nurse should take when using the nursing process is assessment. The nurse should first explore the parents' feelings and wishes regarding organ donation to assist in determining if organ donation is the right choice for the family. A nurse is planning developmental activities for a newly admitted 10 year old child who has neutropenia. Which of the following 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. - B. Arrange frequent visits from family members and peers. The nurse should provide a school-age child with a book about adventure as a developmental activity because children are expanding their knowledge and imagination during this age. Through reading, school-age children can feel powerful and skillful as they imagine themselves in the stories they read. A community health nurse is assessing an 18 month old toddler in a community day care. Which of the following findings should a nurse identify as a 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 A toddler who has poor personal hygiene can be a potential indication of physical neglect. Because toddlers are still dependent on their parents or guardians for help with hygiene needs, poor personal hygiene can indicate a lack of supervision. A nurse is admitting a 4-month-old infant who has heart failure. Which of the following findings is the nurse's priority? A. Episodes of vomiting B. Formula consumption C. Weight D. Temperature - A. Episodes of vomiting When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is three episodes of vomiting. This can indicate digoxin toxicity, which requires immediate intervention. Therefore, this is the nurse's priority finding. A nurse is providing teaching to the parents of a preschooler who has heart failure and a new prescription for digoxin twice daily. Which of the following instructions should the nurse include in the 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." The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comes as a sweetened liquid to enhance the taste. A nurse is assessing the pain level of a 3 year old toddler. Which of the following assessment scales should the nurse use? A. FACES B. Numeric C. CRIES D. Visual analog - A. FACES The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale allows the toddler to point to the face that depicts their current level of pain. The nurse can then determine the need for pain management. A nurse is teaching the guardian of a 6 month old infant about teething. Which of the following 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." The nurse should inform the guardian that teething can result in discomfort for the infant. Therefore, the guardian should look for indications such as pulling on the ears, difficulty sleeping, increased drooling, or increased fussiness. 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. 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- month-old infant who is not yet making babbling sounds The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a more extensive evaluation of hearing. A nurse is teaching the parents of a toddler who has a cognitive impairment about toilet training. Which of the following instructions should the nurse include in the 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." A child who has a cognitive impairment learns through shaping behaviors. The parents should reward the child for sitting on the potty chair as a reinforcement of the desired behavior of continence. As the child repeats this action, the parents can gradually decrease this reward and then give rewards for the next step in the task, such as voiding while sitting on the potty chair. A nurse is teaching a school age child and their parent about postoperative care following cardiac catheterization. Which of the following 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." The child should keep the site clean and dry for at least 3 days to reduce the risk of infection. Tub baths should be avoided for 3 days to avoid immersion of the incision in water. A nurse is caring for a school age child who has primary nephrotic syndrome and is taking prednisone. Following 1 week of treatment, which of the following manifestations indicates to the nurse that the medication is effective? A. Decreased edema B. Increased abdominal girth C. Decreased appetite D. Increased protein in the urine - A. Decreased edema A child who has nephrotic syndrome can experience edema due to the increased glomerular permeability, which increases protein loss. Prednisone decreases glomerular permeability, which causes fluid to shift from the extracellular spaces, resulting in decreased edema. A nurse is receiving change of shift report for four children. Which of the following 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 When using the urgent vs. nonurgent approach to client care, the nurse should assess this child first. An episode of forceful vomiting is an indication of increased intracranial pressure in a toddler who has a concussion.