ATI RN Pediatric Nursing at International University Miami
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Free ATI RN Pediatric Nursing at International University Miami Questions
Which medication is administered to premature infants to reduce the severity of symptoms associated with respiratory syncytial virus (RSV) infection?
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Respaire.
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Singulair.
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Menomune.
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Synagis.
Explanation
Correct Answer: Synagis.
Explanation:
Synagis (palivizumab) is a monoclonal antibody administered to high-risk infants, particularly premature infants or those with certain heart or lung conditions, to help reduce the severity of symptoms associated with respiratory syncytial virus (RSV) infection. It is not a vaccine, but rather a preventive treatment to help boost the infant’s immune defense against RSV, which can lead to serious respiratory complications in premature or high-risk infants.
Why Other Options Are Wrong:
Respaire: There is no medication called "Respaire" that is associated with RSV or respiratory treatments.
Singulair: Singulair (montelukast) is a leukotriene receptor antagonist used to treat allergies and asthma, not RSV. It is not effective for treating or preventing RSV infections.
Menomune: Menomune is a meningococcal vaccine and is not related to the treatment or prevention of RSV.
Conclusion:
Synagis (palivizumab) is the correct medication to administer to high-risk premature infants to reduce the severity of symptoms associated with RSV infection.
A nurse is preparing to administer ampicillin 50 mg/kg/day divided equally every 6 hours to a child who weighs 30 kg (66 lb). Available is ampicillin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- 6 mL
- 9 mL
- 12 mL
- 15 mL
Explanation
The total daily dose of ampicillin is 50 mg/kg/day × 30 kg = 1500 mg/day. Dividing this into 4 doses (since it's every 6 hours), the dose per administration is 1500 mg ÷ 4 = 375 mg per dose. The available concentration is 125 mg/5 mL, which equals 25 mg/mL. To administer 375 mg, divide 375 mg by 25 mg/mL, resulting in 15 mL per dose. Therefore, the nurse should administer 15 mL per dose.
Correct Answer Is:
D. 15 mL
A nurse is planning care for a child who is experiencing sickle cell crisis. Which of the following interventions should the nurse include in the plan of care?
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Administer meperidine as needed for pain
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Initiate bed rest
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Limit fluid intake
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Apply cold compresses to affected joints
Explanation
Correct Answer: Initiate bed rest
Sickle cell crisis involves severe pain, often triggered by blocked blood flow and reduced oxygenation in various parts of the body. The goal of nursing care is to alleviate pain, prevent complications, and support the body during this critical period. Bed rest is recommended during a sickle cell crisis to minimize physical exertion, which could exacerbate the condition and further reduce blood flow. Rest helps conserve energy and supports the body in managing the increased metabolic demand caused by the crisis. The reduced movement can also help prevent further strain on the affected organs and tissues.
Why Other Options are Wrong:
Administer meperidine as needed for pain:
Meperidine (Demerol) is not recommended for pain management in children with sickle cell crisis due to the risk of causing seizures and other adverse effects. Opioids like morphine or hydromorphone are preferred for pain relief during a sickle cell crisis as they are safer and more effective in managing severe pain.
Limit fluid intake:
Limiting fluid intake is contraindicated during a sickle cell crisis. The child is at risk of dehydration, which can increase the likelihood of sickle cell sickling and worsen the crisis. Adequate hydration helps to keep the blood vessels open, reducing the chance of sickle cells sticking together and forming clots. Therefore, the nurse should encourage increased fluid intake.
Apply cold compresses to affected joints:
Cold compresses should be avoided during a sickle cell crisis, as they can cause vasoconstriction, which may exacerbate the blockage of blood flow and worsen the pain. Warm compresses are recommended instead because they help dilate blood vessels, improving circulation and pain relief.
Summary:
In the plan of care for a child experiencing a sickle cell crisis, the nurse should initiate bed rest to minimize physical exertion and conserve energy. Other interventions, such as administering meperidine for pain, limiting fluid intake, and applying cold compresses, are inappropriate and may worsen the crisis or hinder recovery.
Upon inspection, a nurse visualizes a blade of grass clipping stuck under the right upper eyelid of a teenage client complaining of eye pain, increased tear production, and redden sclera. What should the nurse use to remove the grass clipping?
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Moist gauze pad.
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Dry cotton swab.
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Plastic tweezer.
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Irrigation solution.
Explanation
Correct Answer: Irrigation solution
Explanation:
When a foreign object such as a grass clipping is stuck in the eye, the first step is typically to irrigate the eye to flush out the object. Using an irrigation solution, such as saline, helps to remove the debris gently without causing additional trauma to the eye. The irrigation solution helps dislodge the grass clipping, reducing discomfort and preventing further injury.
Why Other Options are Wrong:
Moist gauze pad
A moist gauze pad could potentially cause more irritation by pressing the foreign body further into the eye, especially if the clipping is stuck beneath the eyelid. It would not be effective in flushing the object out of the eye.
Dry cotton swab
A dry cotton swab might be used to gently remove the foreign body in some cases, but using it could risk pushing the object further into the eye, especially if the grass clipping is not easily accessible. This method is not as effective or safe as irrigation.
Plastic tweezer
Using a plastic tweezer could potentially harm the eye, especially if the grass clipping is deep in the eyelid. Tweezer use increases the risk of injury, scratching the cornea, or causing more discomfort during removal. It should only be used by healthcare professionals if the object is accessible and easily removed.
- Facial twitching
- Kyphosis
- Enuresis
- Constipation
Explanation
A nurse is taking care of a preschooler who has neutropenia. Which of the following interventions should the nurse include in the plan?
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Avoid raw fruits and vegetables in the child's diet.
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Administer vaccines prior to discharge.
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Bathe the child every other day.
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Obtain the child's rectal temperature once daily.
Explanation
The correct answer is: Avoid raw fruits and vegetables in the child's diet.
Explanation
Neutropenia and Risk of Infection: Neutropenia is a condition characterized by a low level of neutrophils, a type of white blood cell critical for fighting infections. Raw fruits and vegetables can harbor bacteria, fungi, or other pathogens that could pose a significant infection risk to a child with neutropenia. Cooking food thoroughly reduces this risk.
Why the Other Interventions Are Incorrect:
"Administer vaccines prior to discharge."
Live vaccines (e.g., measles, mumps, rubella) are contraindicated in immunocompromised patients, such as those with neutropenia, because their weakened immune system may not effectively handle the live attenuated pathogens. Vaccines should be administered based on provider recommendations and the child’s immune recovery status.
"Bathe the child every other day."
Good hygiene is crucial to prevent infection in a neutropenic child. Daily bathing is generally recommended to reduce the risk of skin infections and maintain cleanliness.
"Obtain the child's rectal temperature once daily."
Rectal temperatures are avoided in neutropenic patients because they can cause mucosal injury, increasing the risk of introducing pathogens and leading to infection. Axillary or oral temperature measurement is safer in this population.
Summary:
The primary goal for neutropenic patients is to minimize exposure to infection. Avoiding raw fruits and vegetables, maintaining daily hygiene, and choosing safe temperature measurement methods are critical components of care.
A child falls on the playground and is brought to the school nurse with a small laceration on the forearm. Which action should the nurse implement first?
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Slowly pour hydrogen peroxide over the open wound.
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Apply ice to the area before rinsing with cold water.
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Wash the wound gently with mild soap and water.
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Gently cleanse with a sterile pad using povidone-iodine.
Explanation
Correct Answer: Wash the wound gently with mild soap and water.
The first step in treating a minor wound like a small laceration is to clean the wound to prevent infection. Washing the area gently with mild soap and water is the best approach to remove dirt, debris, and bacteria from the wound. This is a basic, effective first-aid measure to clean the wound before further care is provided.
Why Other Options Are Wrong:
Slowly pour hydrogen peroxide over the open wound:
Hydrogen peroxide is no longer recommended for cleaning open wounds because it can damage healthy tissue and delay the healing process. It may cause further irritation and disrupt wound healing.
Apply ice to the area before rinsing with cold water:
Ice may be useful for reducing swelling, but the priority should be to clean the wound first. Ice should be applied later if necessary, but cleaning the wound is the first priority.
Gently cleanse with a sterile pad using povidone-iodine:
While povidone-iodine is an antiseptic, it is not the first step in wound care. Rinsing the wound with water and mild soap should be done first to cleanse it before applying antiseptic solutions.
Conclusion:
The most important initial step in caring for a minor laceration is to wash the wound gently with soap and water to ensure it is clean before applying any further treatments. Therefore, the correct answer is c. Wash the wound gently with mild soap and water.
A nurse is teaching the parent of a preschool-age child about digoxin administration. Which of the following statements by the parent indicates an understanding of the teaching?
- "I will mix the medication in a glass with 4 ounces of orange juice."
- "I will tell my child to brush her teeth after she takes this medication."
- "I will take my child's pulse for 30 seconds before giving the medication."
- "I will repeat the dose if she vomits after taking the medication."
Explanation
Taking the child's pulse for 30 seconds before administering digoxin is an essential step. The nurse should instruct the parent to check the child's heart rate, and if the pulse is below a certain threshold (usually 60-90 beats per minute for preschoolers), the parent should hold the dose and notify the healthcare provider. This is because digoxin can cause bradycardia (slow heart rate), and it is crucial to avoid administering the medication if the pulse is too low.
Correct Answer Is:
C. "I will take my child's pulse for 30 seconds before giving the medication."
A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome?
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Congenital heart disease.
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Fragile X chromosome.
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Trisomy 13.
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Pyloric stenosis.
Explanation
Correct Answer: Congenital heart disease.
Explanation:
Congenital heart disease is a common condition in children with Down syndrome, affecting about 40-60% of them. The most common types of congenital heart defects seen in these children include atrioventricular septal defects (AVSDs) and ventricular septal defects (VSDs). Early detection and management are critical to prevent complications and improve quality of life for these children.
Why Other Options Are Wrong:
Fragile X chromosome:
Fragile X syndrome is not associated with Down syndrome. While both conditions are genetic, fragile X syndrome is a separate chromosomal disorder that causes intellectual disabilities but does not directly affect children with Down syndrome.
Trisomy 13:
Trisomy 13 (Patau syndrome) is a distinct chromosomal disorder, unrelated to Down syndrome. It has its own set of features, including severe intellectual disabilities and various physical abnormalities, but it does not overlap with the characteristics of Down syndrome.
Pyloric stenosis:
Pyloric stenosis is a condition where the pylorus muscle thickens, obstructing food passage. It is not commonly seen in children with Down syndrome and is more frequently observed in other populations, making it an unlikely answer in this context.
A nurse is providing teaching to a parent of an infant who has diaper rash. Which of the following statements by the parent indicates an understanding of the teaching?
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“I will use antibacterial soap to wash the rash with each diaper change.”
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“I will keep the area warm and moist.”
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“I will use super-absorbent disposable diapers.”
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“I will sprinkle talcum powder over the affected area twice daily.”
Explanation
Correct Answer: "I will use super-absorbent disposable diapers."
The use of super-absorbent disposable diapers is recommended for managing diaper rash. These diapers help keep the skin dry by drawing moisture away from the skin, which is essential in preventing further irritation and promoting healing. Keeping the skin dry is crucial in managing diaper rash, as prolonged exposure to moisture can worsen the condition.
Why Other Options are Wrong:
"I will use antibacterial soap to wash the rash with each diaper change":
Antibacterial soap is not necessary for treating diaper rash. In fact, using harsh soaps can irritate the skin further. It's best to clean the area gently with warm water and a mild soap, and avoid using antibacterial products unless there is a secondary bacterial infection.
"I will keep the area warm and moist":
Keeping the area moist and warm is actually counterproductive when treating diaper rash. Moisture and heat can promote the growth of bacteria or fungi and worsen the rash. The affected area should be kept clean, dry, and exposed to air as much as possible to promote healing.
"I will sprinkle talcum powder over the affected area twice daily":
Talcum powder should be avoided because it can cause respiratory issues if inhaled by the infant. Additionally, it can exacerbate the rash if it gets trapped in the folds of the skin. Instead, barrier creams or ointments, such as those containing zinc oxide, are recommended for protecting the skin and promoting healing.
Summary:
The correct action for managing diaper rash is using super-absorbent disposable diapers to keep the area dry and minimize irritation. Other actions such as using antibacterial soap, keeping the area warm and moist, or sprinkling talcum powder can worsen the condition and should be avoided. Proper diaper care includes using gentle cleansing methods and keeping the skin dry and protected.
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