ATI SU26 VN5G 1334 Pediatrics Unit 4 Exam
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Free ATI SU26 VN5G 1334 Pediatrics Unit 4 Exam Questions
A nurse is contributing to the plan of care for a fetus who has been diagnosed with clubfoot via ultrasound. Which of the following procedures should the nurse expect to include in the plan of care?
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Monitor the infant and perform physical therapy if needed to help with mobility.
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Surgery will be performed in utero to correct the deformity.
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A series of casts will be made for the infant soon after birth.
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An orthotic brace will be made when the infant is 6 months of age.
Explanation
Correct Answer:
(C) A series of casts will be made for the infant soon after birth. The standard treatment for clubfoot, known as the Ponseti method, involves applying a series of casts shortly after birth to gradually correct the position of the foot before the infant begins bearing weight.
Why the other options are incorrect:
A. Physical therapy alone is not sufficient to correct the structural deformity of clubfoot and is not the primary treatment approach.
B. In utero surgery is not a standard treatment for clubfoot, which is instead treated postnatally with serial casting.
D. Bracing is used after the casting process, typically starting shortly after the casts are removed, not delayed until 6 months of age, and it is worn to maintain correction rather than to be the initial treatment.
A nurse is collecting data for an infant client who has Down syndrome and does not demonstrate muscle resistance when testing arms and legs. Which of the following disorders should the nurse expect to find?
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Spina bifida
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Cerebral palsy
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Muscular dystrophy
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Hypotonia
Explanation
Correct Answer:
(D) Hypotonia Decreased muscle resistance and tone are hallmark findings commonly associated with Down syndrome, resulting from decreased muscle tone that affects overall strength and motor development.
Why Other Options are Incorrect:
A. Spina bifida is a neural tube defect that primarily affects the spinal cord and is not a common finding characterized specifically by decreased muscle resistance in Down syndrome.
B. Cerebral palsy is a separate neurological disorder affecting movement and muscle tone that is not inherently associated with Down syndrome.
C. Muscular dystrophy is a genetic muscle-wasting disorder that is distinct from Down syndrome and not indicated by this finding alone.
The caregiver of a 1-year-old, uncircumcised infant calls into a nurse advice line. The caregiver states that when bathing their child the foreskin slid back, exposing the tip of the penis. Now, the foreskin will not go back into place and the penis is swollen. Which of the following statements should the nurse recommend?
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"Your child needs to be seen by a health care provider immediately."
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"There's no need to worry, this is normal. Just pull it back into place."
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"Put your child back in the bath and the foreskin should slide back into place."
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"Call back tomorrow if the foreskin is still retracted and we will schedule an appointment."
Explanation
Correct Answer:
(A) "Your child needs to be seen by a health care provider immediately." This presentation describes paraphimosis, a urologic emergency in which the retracted foreskin cannot be returned to its normal position and causes swelling and potential compromise of blood flow to the glans, requiring prompt medical evaluation and intervention.
Why Other Options are Incorrect:
B. Paraphimosis is not a normal finding and should never be manually forced back into place without proper medical evaluation, as this can cause further injury.
C. Bathing will not resolve paraphimosis, and delaying care can lead to worsening swelling and compromised circulation to the glans penis.
D. Waiting until the next day is inappropriate and dangerous, as paraphimosis can lead to tissue ischemia and necrosis if not treated promptly.
A nurse is collecting data from the birth record of a 2-day-old newborn who presents with manifestations of pneumonia. The nurse should recognize that which of the following findings is most likely the cause of the pneumonia?
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Rupture of membranes for 48 hr before delivery
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Macrosomia
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Hypoglycemia during the first 24 hr
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Polyhydramnios
Explanation
Correct Answer:
(A) Rupture of membranes for 48 hr before delivery
Prolonged rupture of membranes, particularly for 18 hours or more before delivery, significantly increases the risk of ascending bacterial infection and subsequent neonatal pneumonia due to prolonged exposure of the fetus to potential pathogens in the amniotic environment.
Why the other options are incorrect:
B. Macrosomia This refers to an infant who is larger than average for gestational age and is not directly associated with an increased risk of neonatal pneumonia.
C. Hypoglycemia during the first 24 hr While this is a metabolic complication that can occur in newborns, it is not a direct causative factor for the development of pneumonia.
D. Polyhydramnios This refers to excessive amniotic fluid and is more commonly associated with other conditions, such as fetal anomalies or maternal diabetes, rather than being a direct cause of neonatal pneumonia.
A nurse has just received hand-off communication at the start of their shift. After reviewing each client's status, which of the following clients should the nurse see first?
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A 15-year-old adolescent who had a laparoscopic appendectomy 30 hr ago, rates their pain a 3 on a scale of 1 to 10, and is preparing for discharge this morning
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A 3-year-old toddler who aspirated several sunflower seeds and continues to cough with an O2 saturation of 91%
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A 6-year-old child admitted with asthma exacerbation who used a rescue inhaler 16 hr ago
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An 18-month-old admitted for dehydration 2 days ago who has had six wet diapers in the last 24 hr and ate 90% of their meals
Explanation
Correct Answer:
(B) A 3-year-old toddler who aspirated several sunflower seeds and continues to cough with an O2 saturation of 91% This child shows signs of ongoing airway compromise and hypoxia, indicated by persistent coughing and a low oxygen saturation, making this the priority client requiring immediate assessment and intervention.
Why the other options are incorrect:
A. This client has well-controlled pain and is stable for discharge, indicating no urgent need for immediate attention.
C. Using a rescue inhaler 16 hours ago without current data suggesting distress indicates this child is likely stable at this time.
D. Adequate urine output and oral intake indicate this child is responding well to treatment for dehydration and is not in acute distress.
A nurse working in a pediatric inpatient unit is teaching the parents of a 10-year-old child who has suspected appendicitis about non-pharmacological pain control measures. Which statement by the parents indicates an understanding of the teaching?
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"We should encourage our child to lie flat on their back to rest."
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"Having our child pull their legs closer to their chest might provide relief."
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"Applying a warm compress to our child's abdomen can help ease the pain."
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"Gently massaging our child's abdomen in a circular motion can help."
Explanation
Correct Answer:
(B) "Having our child pull their legs closer to their chest might provide relief." Flexing the hips and knees toward the chest reduces tension on the inflamed peritoneum and abdominal muscles, which can help relieve discomfort associated with appendicitis.
Why the other options are incorrect:
A. Lying flat with the legs extended can increase tension on the abdomen and worsen pain associated with peritoneal irritation.
C. Applying heat to the abdomen is contraindicated in suspected appendicitis because it can increase blood flow to the area and raise the risk of perforation.
D. Massaging the abdomen can increase the risk of rupture of an inflamed appendix and is contraindicated in suspected appendicitis.
A nurse is assisting in the care of a 6-year-old client who has nephrotic syndrome. Which of the following adverse effects of corticosteroids should the nurse recognize as having the potential to impact the child's psychosocial development? (Select All that Apply.)
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Weight gain
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Irritability
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Osteoporosis
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Hypertension
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Nausea
Explanation
Correct Answer:
(A) Weight gain, (B) Irritability Weight gain can alter body image and lead to teasing or self-esteem issues affecting social interactions, while irritability and mood changes can disrupt relationships with peers and family, both of which have a direct impact on psychosocial development.
Why the other options are incorrect:
C. Osteoporosis is a physical adverse effect related to bone density and does not directly influence psychosocial development.
D. Hypertension is a physiologic cardiovascular effect and does not have a direct impact on psychosocial functioning.
E. Nausea is a physical gastrointestinal symptom and does not directly affect psychosocial development.
A nurse is assisting with care for an 11-year-old child who has appendicitis. For which of the following complications should the nurse anticipate assisting with collecting data for the RN assessment of the client?
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Gastroenteritis
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Pyloric stenosis
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Peritonitis
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Celiac disease
Explanation
Correct Answer:
(C) Peritonitis If an inflamed appendix ruptures, its contents can spill into the abdominal cavity, causing widespread infection and inflammation of the peritoneum, making peritonitis the most significant and anticipated complication of appendicitis.
Why Other Options are Incorrect:
A. Gastroenteritis is an inflammatory condition of the stomach and intestines typically caused by infection, not a complication resulting from appendicitis.
B. Pyloric stenosis is a congenital narrowing of the pylorus typically presenting in infancy and is unrelated to appendicitis.
D. Celiac disease is an autoimmune reaction to gluten and is not a complication associated with appendicitis.
A nurse is reinforcing teaching with a 13-year-old client who has irritable bowel syndrome (IBS). Which of the following statements should the nurse include in the teaching?
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"A high-protein, low-carbohydrate diet helps prevent IBS flares."
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"Maintain a strict gluten-free diet to avoid IBS flares."
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"Taking daily laxatives is essential in preventing IBS flares."
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"Avoid common triggers like caffeine and artificial sweeteners to avoid IBS flares."
Explanation
Correct Answer:
(D) "Avoid common triggers like caffeine and artificial sweeteners to avoid IBS flares." Caffeine and artificial sweeteners are well-recognized dietary triggers that can stimulate bowel activity and worsen IBS symptoms, so avoiding them is a key component of symptom management teaching.
Why the other options are incorrect:
A. There is no established evidence that a high-protein, low-carbohydrate diet specifically prevents IBS flares.
B. A strict gluten-free diet is only necessary for clients with celiac disease or gluten sensitivity, not as a general IBS management strategy unless gluten is an identified trigger.
C. Daily use of laxatives is not recommended for routine IBS management and can lead to dependency or worsening bowel dysfunction.
A nurse is reinforcing teaching with a pediatric client who has had a traumatic leg amputation about phantom limb sensation (PLS). Which of the following statements should the nurse include while reinforcing their teaching?
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"Phantom limb sensation occurs when the bone in the leg continues to grow and damages surrounding tissues."
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"Phantom limb sensation will make you think you feel your leg, even though it is not there."
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"Phantom limb sensation is caused by irritation and swelling where the amputation was done."
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"Phantom limb sensation is most common in children who are born without a leg."
Explanation
Correct Answer:
(B) "Phantom limb sensation will make you think you feel your leg, even though it is not there." Phantom limb sensation occurs when the brain continues to receive nerve signals from the area where the limb used to be, causing the individual to perceive sensations such as pain, itching, or movement in the missing limb.
Why the other options are incorrect:
A. Phantom limb sensation is a neurological phenomenon related to nerve signaling, not related to bone growth or tissue damage.
C. While local irritation or swelling at the amputation site can occur, phantom limb sensation itself originates from altered nerve pathways and brain perception, not local site irritation.
D. Phantom limb sensation occurs in individuals who have lost a limb they once had; it is not associated with congenital limb absence since there was never a limb present to generate the original neural map.
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