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 5-year-old child who has nephrotic syndrome. Which of the following findings should indicate to the nurse that treatment has been effective?
- No report of pain with voiding
- Urine output 256 mL over 8 hr
- Odorless urine
- Temperature 37.2° C (99° F)
Explanation
Nephrotic syndrome is characterized by fluid retention and edema due to protein loss in the urine. Effective treatment results in mobilization of excess fluid and improved renal perfusion, which is reflected by increased urine output. A urine output of 256 mL over 8 hours in a 5-year-old child represents adequate diuresis and indicates that edema is resolving and the treatment is improving kidney function and fluid balance.
Correct Answer Is:
B. Urine output 256 mL over 8 hrA nurse is performing a home health visit for a pediatric client who has had a recent onset of headaches. The nurse notices the home is poorly ventilated, and there is no placement of carbon monoxide detectors. Which of the following appliances should the nurse identify as a potential source of carbon monoxide?
- Kerosene heater
- Electric stove
- Refrigerator
- Washing machine
Explanation
Explanation
Kerosene heaters are combustion-based appliances that burn fuel to produce heat. When used in poorly ventilated areas, they can release carbon monoxide, a colorless and odorless gas that interferes with oxygen delivery in the body. Children are especially vulnerable to carbon monoxide exposure, which commonly presents with headaches, dizziness, nausea, and lethargy. Identifying and addressing this source is critical to preventing carbon monoxide poisoning.Correct Answer Is:
A. Kerosene heaterWhy the other options are incorrect:
A nurse is caring for a school-age child who underwent a tuberculin skin test 3 days ago and has a 3-mm induration at the test site. The nurse should identify this finding as which of the following?
- Disseminated disease
- A negative result
- Active tuberculosis
- An allergic reaction
Explanation
Explanation
Interpretation of a tuberculin skin test is based on the size of induration and the child’s risk factors. In most children, an induration of less than 5 mm is considered a negative result, indicating no evidence of tuberculosis infection. A 3-mm induration does not meet the threshold for a positive test, even in high-risk populations, and therefore reflects a normal, negative finding rather than active or latent tuberculosis.Correct Answer Is:
B. A negative resultWhy the other options are incorrect:
A nurse in a provider's office is caring for a 1-year-old toddler.
Nurses' Notes
0930:
Parent presents child to provider's office. Parent reports the more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic.
0945:
Notified provider of parent reports and child's fever. New prescriptions received.
1000:
Urine sample obtained via sterile straight catheter.
Medical History
0930:
Three urinary tract infections over the past year treated with antibiotics. Diagnosed at 6 months old with vesicoureteral reflux.
Provider Prescriptions
0945:
Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter.
Vital Signs
0930:
Temperature 38.4° C(101.1° F)
Heart rate 128/min
Respiratory rate 28/min
Diagnostic Results
1030:
Urinalysis:
Appearance: cloudy and dark amber (clear)
Specific gravity 1.035 (1.005 to 1.030)
Leukocyte esterase: positive (negative)
Nitrites: present (nane)
WBCs: 10 (0 to 4)
Exhibit 1
Nurses' Notes
0930:
Parent presents child to provider's office. Parent reports the more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic.
0945:
Notified provider of parent reports and child's fever. New prescriptions received.
1000:
Urine sample obtained via sterile straight catheter.
Exhibit 2
Medical History
0930:
Three urinary tract infections over the past year treated with antibiotics. Diagnosed at 6 months old with vesicoureteral reflux.
Exhibit 3
Provider Prescriptions
0945:
Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter.
Exhibit 4
Vital Signs
0930:
Temperature 38.4° C(101.1° F)
Heart rate 128/min
Respiratory rate 28/min
Exhibit 5
Diagnostic Results
1030:
Urinalysis:
Appearance: cloudy and dark amber (clear)
Specific gravity 1.035 (1.005 to 1.030)
Leukocyte esterase: positive (negative)
Nitrites: present (nane)
WBCs: 10 (0 to 4)
The child is at risk for developing __________ and __________.
- Nephrotic syndrome and polycystic kidney disease
- Acute glomerulonephritis and nephrotic syndrome
- Pyelonephritis and renal scarring
- Polycystic kidney disease and acute glomerulonephritis
Explanation
Explanation
The toddler has vesicoureteral reflux and recurrent UTIs, which allow bacteria to ascend from the bladder into the kidneys. Current findings of fever, lethargy, cloudy urine, positive leukocyte esterase, nitrites, and elevated white blood cells indicate an active urinary tract infection that can progress to pyelonephritis. Repeated kidney infections significantly increase the risk of renal scarring, which may lead to long-term complications such as hypertension and chronic kidney disease.Correct Answer Is:
C. Pyelonephritis and renal scarringA nurse is caring for an adolescent who has a new diagnosis of type 1 diabetes mellitus. Which of the following recommendations should the nurse make?
- Follow up with physical therapy.
- Store opened vials of insulin for up to 60 days.
- Monitor capillary blood glucose daily.
- Consult with a nutritionist.
Explanation
Explanation
Nutritional management is a cornerstone of care for adolescents with type 1 diabetes mellitus. Consulting with a nutritionist helps the adolescent and family learn carbohydrate counting, meal planning, portion control, and how food intake affects blood glucose levels. This individualized education supports effective insulin dosing, promotes glycemic control, reduces the risk of hypo- or hyperglycemia, and helps the adolescent maintain normal growth and development while managing a lifelong condition.Correct Answer Is:
D. Consult with a nutritionist.Why the other options are incorrect:
A nurse is performing an assessment for a 5-year-old child who has celiac disease. Which of the following findings should the nurse expect?
- Hematemesis
- Sausage-shaped mass in the upper right abdomen
- Malnutrition
- Red currant jelly-like stools
Explanation
Celiac disease is an autoimmune disorder in which ingestion of gluten damages the intestinal villi, leading to impaired absorption of nutrients. Over time, this malabsorption results in poor weight gain, growth delays, vitamin and mineral deficiencies, and overall malnutrition. In children, this often presents as failure to thrive, fatigue, abdominal distension, and delayed development, making malnutrition a hallmark finding.
Correct Answer Is:
C. MalnutritionA nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?
- Set the administration rate on the feeding pump.
- Flush the tube with water.
- Check the pH of the gastric secretions.
- Attach the feeding bag tubing to the end of the NG tube.
Explanation
Explanation
Before administering an enteral feeding, the nurse must first verify correct placement of the NG tube to prevent aspiration and respiratory complications. Checking the pH of gastric secretions is a primary, evidence-based method for confirming that the tube is located in the stomach rather than the lungs. Feeding should never begin until placement is verified, as incorrect placement can result in serious harm, including aspiration pneumonia.Correct Answer Is:
C. Check the pH of the gastric secretions.Why the other options are incorrect:
A nurse is caring for an infant who has heart failure and is receiving digoxin. Which of the following findings indicates a positive response to the medication?
- Respiratory rate 32/min
- Urine output 2 mL/kg/hr
- Capillary refill 4 seconds
- Heart rate 187/min
Explanation
Explanation
Digoxin improves myocardial contractility and cardiac output in infants with heart failure. As cardiac output improves, renal perfusion increases, leading to improved urine output. A urine output of 2 mL/kg/hr indicates adequate kidney perfusion and effective circulation, which is a key indicator that the medication is successfully improving the infant’s cardiac function and reducing fluid overload associated with heart failure.Correct Answer Is:
B. Urine output 2 mL/kg/hrWhy the other options are incorrect:
A nurse is performing a dressing change for a child and notices that the gauze dressing is adhering to the wound bed. Which of the following actions should the nurse take?
- Apply firm pressure to the wound base while removing the gauze dressing.
- Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing.
- Saturate the gauze dressing with sterile saline solution prior to removing it.
- Continue to remove the gauze dressing by pulling it parallel to the skin.
Explanation
Explanation
When a gauze dressing adheres to the wound bed, forcibly removing it can disrupt granulation tissue, increase pain, and cause bleeding. Saturating the dressing with sterile saline loosens dried exudate and allows the gauze to separate gently from the wound surface. This protects newly forming tissue, minimizes trauma and discomfort, and promotes proper wound healing, making it the safest and most appropriate nursing intervention.Correct Answer Is:
C. Saturate the gauze dressing with sterile saline solution prior to removing it.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 intoleranceHow to Order
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