ATI Pediatric Nursing Online Practice 2023 A with NGN Questions and Answers & Rationales (, Exams of Pediatrics

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ATI Pediatric Nursing Online Practice

2023 A

with NGN Questions and Answers & Rationales

(Verified Ques & Ans)

with Questions and Answers & Rationales (60 Verified Ques & Ans)

1. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priorityaction by the nurse Answer: Administer epinephrine IM Rationale: When using the urgent vs. non-urgent approach to client care, the nurseshould determine that the priority action is administering epinephrine IM to the child.During an anaphylactic reaction, histamine release causes bronchoconstriction andvasodilation. This is an emergency because ultimately it causes decreased blood return to the heart.

2. A nurse in a pediatric emergency department is planning care for

an ado- lescent. Based on the information in the adolescent's medical record, which of the following actions should the nurse plan to take? Select all that apply Answer: Apply supplemental oxygen Rationale: According to the medical record and chest x-ray report, the adolescentcould potentially have a pneumothorax. Also according to the medical record andchest x-ray report, the adolescent's oxygen saturation level is decreasing, which indicates hypoxia. Therefore, the nurse should plan to administer supplemental oxygen. Prepare for chest tube insertion Rationale: According to the medical record and chest x-ray report, the adolescentcould potentially have a pneumothorax. A pneumothorax is the presence of air in the pleural cavity, which results in decreased lung expansion. The adolescent could experience dyspnea, tachypnea, tachycardia, hypoxia, and pain. This requiresprompt intervention by the provider, such as the placement of a chest

tube into thethoracic cavity to remove air and fluid from the pleural space, if present, allowing thelung to re-expand.

3. 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 Answer: Monitorthe child's oxygen saturation Rationale: The nurse should monitor the child's oxygen saturation level because thechild is experiencing acute respiratory distress and it is necessary to determine if the child is responding to treatment. 4. A nurse is providing teaching about play activities for social development to the guardians of a preschooler. Which of the following play activities shouldthe nurse recommend for the child Answer: Playing dress-up

Rationale: The nurse should instruct the guardians that at the preschool age, play should focus on social, mental, and physical development. Therefore, playingdress-up is a recommended play activity for this child.

5. A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse see first Answer: A school-age child who has sicklecell anemia and reports decreased vision in the left eye Rationale: When using the urgent vs. non-urgent approach to client care, the nurseshould determine the priority finding is a report of decreased vision in the left eye. This finding indicates that the child is experiencing a vaso-occlusive crisis and should be reported to the provider immediately. Therefore, the nurse should see thischild first. 6. A nurse is providing teaching to the parents of a preschooler who has heartfailure and a new prescription for digoxin twice daily. Which of the

following instructions should the nurse include in the teaching Answer: "Brush the child's teethafter giving the medication."

Rationale: The nurse should instruct the parents to brush the child's teeth after administering digoxin to prevent tooth decay caused by the medication, which comesas a sweetened liquid to enhance the taste.

7. A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the followingto the affected area Answer: Zinc oxide Rationale: Diaper dermatitis is a common inflammatory skin disorder caused by contact with an irritant such as urine, feces, soap, or friction, and takes the form ofscaling, blisters, or papules with erythema. Providing a protective barrier, such aszinc oxide, against the irritants allows the skin to heal.

8. A nurse is caring for a client who has been receiving IV fluids via a peripheralIV catheter. When preparing to discontinue the IV fluids and catheter, which of the following actions should the nurse plan to take? (Move the steps into the box on the right, placing them in the

order of performance. Use all the steps.): First, the nurse should turn off the IV pump. Next, the nurse should occludethe IV tubing, and then remove the tape securing the catheter. Last, the nurse shouldapply pressure over the catheter insertion site.

9. A nurse is assessing a school-age child who has an acute spinal

cord injuryfollowing a sports injury 1 week ago. Identify the area the nurse should tap to

elicit the biceps reflex. (You will find hot spots to select in the artwork below.Select only the hot spot that corresponds to your answer.): A

10. A nurse is caring for a school-age child who is receiving chemotherapy and is severely immunocompromised. Which of the following actions shouldthe nurse take Answer: Screen the child's visitors for indications of infection. Rationale: A child who is severely immunocompromised is unable to adequately respond to infectious organisms, resulting in the potential for overwhelming infection.Therefore, the nurse should screen the child's visitors for indications of infection. 11. A nurse is providing teaching to the parent of a school-age child who has anew prescription for oral nystatin for the treatment of oral candidiasis. Which of the following instructions should the nurse include Answer: "Shake the medicationprior to administration." Rationale: The nurse should instruct the parent to shake the

medication prior toadministration to disperse the medication evenly within the suspension.

12. A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by a parent indicates an understanding theteaching Answer: "Mononucleosis is caused by an infection with the Epstein-Barr virus." Rationale: The nurse should identify that mononucleosis is a mildly contagious illness that occurs sporadically or in groups, and is primarily caused by the Ep-stein-Barr virus. 13. A nurse is creating a plan of care for a school-age child who has heart disease and has developed heart failure. Which of the following interventionsshould the nurse include in the plan Answer: Provide small, frequent meals for the child. Rationale: The metabolic rate of a child who has heart failure is high because of poorcardiac function. Therefore, the nurse should provide small, frequent meals for thechild because it helps to conserve energy. 14. A nurse is providing anticipatory guidance to the

guardian of a toddler. Which of the following expected behavior characteristics of toddlers shouldthe nurse include

Answer: Expresses likes and dislikes Rationale: The nurse should include that expressing likes and dislikes is an expectedbehavior of toddlers. This is the time in life when a toddler is developing autonomy and self-concept. They will try to assert themselves and frequently refuse to comply.The guardian should allow the child to have some control, but also set limits for themso they learn from their behavior and learn to control their actions.

15. A charge nurse is preparing to make a room assignment for a newly ad- mitted school-age child. Which of the following considerations is the nurse'spriority Answer: Disease process Rationale: 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'spriority consideration. 16. A nurse is caring for a preschooler who is scheduled for hydrotherapy treatment for wound debridement following a burn injury. Which of the fol- lowing actions should the nurse take prior to the procedure Answer: Administer ananalgesic to the child. Rationale: Hydrotherapy for debridement of a wound is an extremely painful pro- cedure that requires analgesia and/or sedation. Controlling pain leads to reduced physiological demands on the body caused by stress and decreases the

likelihoodof children developing depression and post-traumatic stress disorder.

17. A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of the following statements by

the parent indi- cates an understanding of the teaching Answer: "I should keep my child indoors whenI mow the yard." Rationale: The nurse should instruct the parent to keep the preschooler indoors during lawn maintenance or when the pollen count is increased. Guarding against exposure to known allergens found outdoors, such as grass, tree, and weed pollen,will decrease the frequency of the preschooler's asthma attacks.

18. A nurse is reviewing the dietary choices of an adolescent who has iron deficiency anemia. The nurse should identify that which of the following menuitems has the highest amount of nonheme iron Answer: ½ cup raisins Rationale: The nurse should encourage the adolescent to eat raisins because theycontain the highest amount of non-heme iron. 19. A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthritis. Which of the following instructions should

the nurse include in the teaching Answer: "Encourage the child to perform independentself-care."

Rationale: The nurse should teach the family the importance of encouraging the childto perform independent self-care. This will minimize the child's pain while maximizing

mobility. Encouraging and praising the child's efforts for independence will alsoincrease their self-esteem.

20. A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take Answer: Apply topical analgesic cream to thesite 1 hr prior to the procedure. Rationale: The nurse should apply a topical analgesic to the lumbar site 1 hr prior tothe procedure to decrease the adolescent's pain while the lumbar needle is inserted. 21. A nurse in the outpatient pediatric clinic is caring for a 2-year- old child. Click to highlight the findings that require follow-up. To deselect a finding,click on the finding again. Nurses' Notes - 2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being

renovated, about 6months ago. Parent reports having difficulty getting: When recognizing cues, the nurse should identify that pale pink mucous membranes, living in an older urban house that is being renovated, and the parent's report that the toddler seemsless active

and gets tired more quickly are findings that require follow-up. These findings are associated with lead poisoning, and the child's blood lead level shouldbe determined. Pale pink membranes, decreased activity, and tiring more quickly aremanifestations of anemia, which can result from increased blood lead levels. Olderurban homes are a common source of lead, especially during renovation, which mayaerosolize the lead particles.

22. A nurse in the outpatient pediatric clinic is caring for a 2-year-old child. Drag words from the choices below to fill in each blank in the followingsentence. Nurses' Notes - 2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to Nurses'N: When analyzing cues, the nurse should identify that the child is a risk for devel- oping intellectual deficits, such as a decreased IQ, due to the

increase in membranepermeability of the brain tissue resulting in increased intracranial pressure, tissue ischemia, and atrophy. The nurse should also identify that the child is at risk for

decreased kidney function due to the damage of the proximal tubules caused by theelevated blood lead level.

23. The nurse has reviewed the child's nurses notes, assessment, vital signs,providers prescriptions and laboratory results for the 0800 one month ago visit. Complete the following sentence by using the lists of options. The nurse should first address the child's , followed by the child's . Nurses' Notes - 2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports mo: When prioritizing hypotheses, the nurse should first address the child's elevatedBLL, followed by the child's hemoglobin. Using the priority framework of safety and risk reduction, the nurse should recognize that the child's BLL presents an increased risk for long-term cognitive impairment and behavioral issues and shouldbe addressed first.