ATI_RN Pediatric Nursing 2023 at at Baton Rouge Community College
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Free ATI_RN Pediatric Nursing 2023 at at Baton Rouge Community College Questions
A nurse is caring for a child who has bacterial meningitis. Which of the following findings should indicate to the nurse that the child can be removed from droplet precautions?
- Antibiotics initiated 24 hr ago
- Negative cerebrospinal fluid culture
- Temperature below 37.4° C (99.3° F)
- Absent nuchal rigidity
Explanation
Explanation
Children with bacterial meningitis require droplet precautions to prevent transmission of infectious organisms, particularly during the early phase of illness. According to infection-control guidelines, droplet precautions may be discontinued after the child has received effective antibiotic therapy for at least 24 hours, as this significantly reduces the risk of transmission. Clinical improvement or laboratory results are not required before removing precautions; timing of appropriate antibiotic treatment is the key determinant.Correct Answer Is:
A. Antibiotics initiated 24 hr agoWhy the other options are incorrect:
A nurse is caring for a preschooler who has a gastrostomy tube. Which of the following actions should the nurse take?
- Place a transparent occlusive dressing over the site.
- Cleanse the tube site with hydrogen peroxide.
- Use barrier ointments around the site.
- Maintain tension between the tubing and the site.
Explanation
Barrier ointments help protect the skin surrounding a gastrostomy tube from moisture, leakage of gastric contents, and irritation. Children with gastrostomy tubes are at risk for skin breakdown and infection due to constant exposure to digestive enzymes. Applying a protective barrier maintains skin integrity, prevents excoriation, and promotes healing, making it an essential part of routine gastrostomy site care.
Correct Answer Is:
C. Use barrier ointments around the site.A nurse is caring for a preschooler who is postoperative following a tonsillectomy. The child is now ready to resume oral intake. Which of the following dietary choices should the nurse offer the child?
- Sugar-free cherry gelatin
- Lime-flavored ice pop
- Chocolate milk
- Vanilla ice cream
Explanation
After a tonsillectomy, the priority is to prevent bleeding, reduce throat irritation, and promote comfort. Cold, clear, non-citrus, and non–red-colored fluids are recommended because they help reduce throat swelling and allow bleeding to be easily identified if it occurs. A lime-flavored ice pop provides cold therapy, hydration, and soothing comfort without increasing mucus production or masking blood, making it an appropriate first oral intake choice.
Correct Answer Is:
B. Lime-flavored ice popA nurse is teaching the mother of an 8-week-old infant who is breastfed about methods to manage colic. Which of the following instructions should the nurse recommend? (Select all that apply.)
- Apply a hot water bottle to the infant’s abdomen.
- Feed the infant 1/2 tsp of honey daily.
- Offer the infant 1 oz of star anise tea.
- Have the mother avoid milk products.
- Allow the infant to suck on a pacifier.
Explanation
Explanation
D. Have the mother avoid milk products.In breastfed infants, colic can be associated with sensitivity to proteins in the mother’s diet, particularly cow’s milk. Eliminating dairy products may reduce gastrointestinal irritation and excessive crying. Dietary modification in the breastfeeding parent is a recommended, noninvasive strategy to help manage colic symptoms in young infants.
E. Allow the infant to suck on a pacifier.
Non-nutritive sucking is a soothing technique that can help calm infants with colic. Sucking promotes self-soothing, reduces crying episodes, and provides comfort without introducing additional feeding or substances. Pacifier use is considered a safe and effective method to help manage colic-related irritability in young infants.
Correct Answer Is:
D. Have the mother avoid milk products.E. Allow the infant to suck on a pacifier.
A nurse is assessing a child who has multiple closed fractures of the lower extremities due to a motor-vehicle crash. The nurse should monitor the child for which of the following complications during the first 24 hr after the injury occurred?
- Compartment syndrome
- Volkmann ischemic contracture
- Renal calculi
- Osteomyelitis
Explanation
Compartment syndrome is a life-threatening complication that can develop within hours after fractures, especially involving the lower extremities. Bleeding and edema within a confined muscle compartment increase pressure, reducing blood flow and leading to tissue ischemia and nerve damage. Early signs include increasing pain unrelieved by analgesics, pallor, paresthesia, decreased pulses, and paralysis. Immediate recognition during the first 24 hours is critical to prevent permanent muscle and nerve injury or limb loss.
Correct Answer Is:
A. Compartment syndromeA nurse is preparing to administer ampicillin 50 mg/kg/day divided equally every 6 hr 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 to the nearest whole number.)
- 10 mL
- 12 mL
- 15 mL
- 18 mL
Explanation
Explanation
The total daily dose is 50 mg/kg/day × 30 kg = 1,500 mg/day. The medication is given every 6 hours, which equals 4 doses per day. Each dose is 1,500 mg ÷ 4 = 375 mg per dose. The concentration is 125 mg per 5 mL, which equals 25 mg/mL. Dividing 375 mg by 25 mg/mL results in 15 mL per dose.Correct Answer Is:
C. 15 mLA nurse is caring for an 8-year-old child who has a new onset of generalized seizures. Which of the following interventions should the nurse include in the plan of care?
- Restrain the child’s arms during a seizure.
- Elevate the head of the bed to 30° during a seizure.
- Administer oral valproic acid during a seizure.
- Loosen restrictive clothing during a seizure.
Explanation
Explanation
During a seizure, the priority nursing intervention is to maintain airway patency and promote safety without interfering with the seizure activity. Loosening restrictive clothing, especially around the neck and chest, helps reduce the risk of impaired breathing and allows for adequate chest expansion. This intervention minimizes the risk of hypoxia while avoiding actions that could cause injury or aspiration during the seizure.Correct Answer Is:
D. Loosen restrictive clothing during a seizure.Why the other options are incorrect:
A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following findings should the nurse identify as an indication of heart failure?
- Decreased respirations
- Exercise intolerance
- Bradycardia
- Weight loss
Explanation
Exercise intolerance is a common indicator of heart failure in children because decreased cardiac output limits the heart’s ability to meet the body’s increased oxygen and energy demands during activity. Following cardiac surgery, a child with heart failure may fatigue easily, become short of breath with minimal exertion, or be unable to tolerate normal play activities. This finding reflects impaired circulation and inadequate tissue perfusion, making it a key sign of ongoing or developing heart failure.
Correct Answer Is:
B. Exercise intoleranceA nurse is admitting an 8-year-old child to the pediatric unit.
Nurses' Notes
Day 1, 1020:
Child is a direct admit from a pediatric clinic and is accompanied by their guardian. Guardian reports that child has been sick for about 2 days with fever and chills and appears to be more irritable. Approximately 2 weeks ago, guardian reports that their child had an upper respiratory infection that was managed with over-the-counter medications. Guardian also reports that child has no prior medical conditions and has received all recommended scheduled immunizations.
1030:
Child reports nausea and headache and rates the pain as 7 on a scale of 0 to 10. Lethargic and responsive to verbal stimuli. Agitation and irritability noted. Nuchal rigidity noted. Pupils equal, round, and reactive to light. Mucous membranes pink dry, and sticky. Cervical lymph slightly enlarged. Respirations irregular. No accessory muscle use noted. Breath sounds clear anterior posterior bilaterally. Heart rhythm regular without murmurs. Radial and pedal pulses 1+ bilateral. Capillary refill seconds. Abdomen flat and non-distended. Bowel sounds ac in all 4 quadrants. Extremities are warm and dry to touch
Flow Sheet
Day 1, 1030:
Temperature 38.7° C (101.7° F)
Heart rate 114/min
Respiratory rate 26/min
Blood pressure 114/80 mm Hg
SpO2 97% on room air
Height 122 cm (48 in)
Weight 29 kg (64 lb)
Diagnostic Results
Day 1, 1040:
Potassium 3.8 mEq/L (3.4 to 4.7 mEq/L)
Hemoglobin 9.5 g/dL (10 to 15.5 g/dL)
Hematocrit 30% (32% to 44%)
RBC count 4.2 x 106/pL (4.0 to 5.5 x 106/pL)
WBC count 14,000 mm3 (5,000 to 10,000 mm3)
Platelets 350,000/mm3 (150,000 to 400,000/mm3)
Glucose 90 mg/dL (< 200 mg/dL)
Blood cultures pending
Provider Prescriptions
Day 1, 1020:
Admit directly to pediatric unit.
Keep child NPO.
Obtain comprehensive metabolic panel and blood cultures
STAT.
Vital signs every 30 min, then every hr x 4, then every 4 hr.
Exhibit 1
Nurses' Notes
Day 1, 1020:
Child is a direct admit from a pediatric clinic and is accompanied by their guardian. Guardian reports that child has been sick for about 2 days with fever and chills and appears to be more irritable. Approximately 2 weeks ago, guardian reports that their child had an upper respiratory infection that was managed with over-the-counter medications. Guardian also reports that child has no prior medical conditions and has received all recommended scheduled immunizations.
1030:
Child reports nausea and headache and rates the pain as 7 on a scale of 0 to 10. Lethargic and responsive to verbal stimuli. Agitation and irritability noted. Nuchal rigidity noted. Pupils equal, round, and reactive to light. Mucous membranes pink dry, and sticky. Cervical lymph slightly enlarged. Respirations irregular. No accessory muscle use noted. Breath sounds clear anterior posterior bilaterally. Heart rhythm regular without murmurs. Radial and pedal pulses 1+ bilateral. Capillary refill seconds. Abdomen flat and non-distended. Bowel sounds ac in all 4 quadrants. Extremities are warm and dry to touch
Exhibit 2
Flow Sheet
Day 1, 1030:
Temperature 38.7° C (101.7° F)
Heart rate 114/min
Respiratory rate 26/min
Blood pressure 114/80 mm Hg
SpO2 97% on room air
Height 122 cm (48 in)
Weight 29 kg (64 lb)
Exhibit 3
Diagnostic Results
Day 1, 1040:
Potassium 3.8 mEq/L (3.4 to 4.7 mEq/L)
Hemoglobin 9.5 g/dL (10 to 15.5 g/dL)
Hematocrit 30% (32% to 44%)
RBC count 4.2 x 106/pL (4.0 to 5.5 x 106/pL)
WBC count 14,000 mm3 (5,000 to 10,000 mm3)
Platelets 350,000/mm3 (150,000 to 400,000/mm3)
Glucose 90 mg/dL (< 200 mg/dL)
Blood cultures pending
Exhibit 4
Provider Prescriptions
Day 1, 1020:
Admit directly to pediatric unit.
Keep child NPO.
Obtain comprehensive metabolic panel and blood cultures
STAT.
Vital signs every 30 min, then every hr x 4, then every 4 hr.
A nurse is reviewing the child's electronic medical record (EMR). Which of the following findings should the nurse identify as requiring immediate follow-up?
Select the 5 findings that require immediate follow-up.
- Hemoglobin
- Glucose
- Pain assessment
- Peripheral pulses
- Temperature
- Abdominal assessment
- Neurologic assessment
- WBC
Explanation
Explanation
C. Pain assessmentThe child reports a headache rated 7/10 accompanied by nausea, lethargy, and irritability. Severe headache in combination with nuchal rigidity and altered responsiveness is concerning for meningeal irritation or increased intracranial pressure. This finding requires immediate follow-up to guide urgent neurologic evaluation and intervention.
D. Peripheral pulses
Radial and pedal pulses documented as 1+ bilaterally indicate decreased peripheral perfusion. In the setting of fever, lethargy, and suspected infection, weak pulses may signal early circulatory compromise or sepsis. This finding requires prompt reassessment and close monitoring.
E. Temperature
A temperature of 38.7° C (101.7° F) with chills and irritability suggests an acute infectious process. Fever combined with neurologic signs raises concern for meningitis or systemic infection, requiring immediate follow-up for rapid evaluation and treatment.
G. Neurologic assessment
Lethargy, agitation, irritability, nuchal rigidity, and irregular respirations are significant neurologic red flags. These findings strongly suggest central nervous system involvement, such as meningitis or rising intracranial pressure, and require immediate provider notification and intervention.
H. WBC
An elevated WBC count of 14,000/mm³ indicates an active inflammatory or infectious process. When paired with fever and neurologic symptoms, this finding supports possible serious bacterial infection and requires urgent follow-up to prevent rapid deterioration.
Correct Answer Is:
C. Pain assessmentD. Peripheral pulses
E. Temperature
G. Neurologic assessment
H. WBC
A nurse is caring for an adolescent who has acute glomerulonephritis. Which of the following actions should the nurse take?
- Increase the client’s dietary protein intake.
- Assess the client’s blood pressure every 8 hr.
- Weigh the client daily.
- Avoid palpating the client’s abdomen.
Explanation
Acute glomerulonephritis causes decreased kidney filtration, leading to fluid retention and edema. Daily weight measurement is the most sensitive and accurate method for evaluating fluid balance and detecting subtle changes in fluid status. Monitoring weight allows the nurse to assess the effectiveness of treatment, identify worsening fluid overload early, and guide interventions to prevent complications such as hypertension and pulmonary edema.
Correct Answer Is:
C. Weigh the client daily.How to Order
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