Ati nur 270 paediatrics gi/gu exam
Total Questions : 45
Showing 25 questions, Sign in for moreA child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?
Explanation
A. Raising the head of the bed may help with respiratory effort but does not address the underlying issue of decreased responsiveness. Immediate assessment and intervention are necessary.
B. Notifying the healthcare provider is critical as the child’s decreased responsiveness and respiratory rate indicate a potential deterioration in condition that requires prompt medical evaluation.
C. While obtaining an oximeter reading can provide useful information about oxygenation, the priority is to notify the HCP about the change in the child's neurological status.
D. Implementing seizure precautions is important for a child with a brain tumor, but the immediate concern is the change in responsiveness, necessitating HCP notification first.
A nurse is providing teaching to a 17-year-old female client who has severe acne about the use of isotretinoin. Which of the following adverse effects should the nurse instruct the client is the priority to report immediately to the provider?
Explanation
A. Back pain may occur but is not typically urgent unless severe; it’s important to monitor but not the priority.
B. Frequent nosebleeds can occur due to dry mucous membranes but are not the most critical symptom to report immediately.
C. Itching of the skin can be managed with moisturizers and does not represent a medical emergency.
D. Feelings of isolation and depression are serious side effects associated with isotretinoin and should be reported immediately due to the risk of self-harm or suicidal thoughts.
A nurse is caring for a child who is postoperative following surgical removal of a Wilms' tumor. Which of the following assessments sacation.co continue NPO status?
Explanation
A. Passing flatus every 30 minutes indicates bowel activity and suggests that the child may be able to resume oral intake.
B. Absent bowel sounds indicate a lack of gastrointestinal function, which supports the continuation of NPO status until bowel function returns.
C. An increase in abdominal girth, even by 1 cm, can be concerning postoperatively and may indicate fluid retention or other issues, warranting further assessment.
D. Pain at the operative site is expected post-surgery, but it does not directly relate to the child’s ability to resume oral intake.
A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?
Explanation
A. Constipation can occur but is not a direct symptom of sickle cell crisis; it’s more related to hydration and diet.
B. High fever may occur due to infection, but it is not a guaranteed finding in every sickle cell crisis.
C. Bradycardia is not typically associated with sickle cell crisis; tachycardia is more common due to pain and stress.
D. Pain is the hallmark symptom of a sickle cell crisis due to vaso-occlusive episodes leading to ischemia and tissue damage.
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply
Explanation
A. Avoiding bubble baths is important as they can irritate the urethra and exacerbate UTIs.
B. Wiping the perineal area from front to back is essential to prevent bacteria from the rectal area from entering the urinary tract.
C. Completing the course of prescribed antibiotics is crucial to fully eradicate the infection and prevent recurrence.
D. Encouraging frequent voiding helps to flush out bacteria from the urinary tract and prevent infection.
E. Wearing cotton underwear helps keep the area dry and reduce the risk of bacterial growth.
F. Encouraging frequent fluid intake aids in hydration and helps dilute the urine, reducing irritation and promoting flushing of bacteria.
A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is having projectile vomiting immediately after eating Which of the following responses should the nurse make?
Explanation
A. Switching to a different formula may not address the underlying issue and could lead to further complications.
B. Bringing the baby to the clinic is essential as projectile vomiting in an infant can indicate a serious condition such as pyloric stenosis that requires evaluation and intervention.
C. Giving oral rehydration solutions is not appropriate before assessing the infant's condition, especially if there’s a possibility of a serious underlying issue.
D. While burping is generally recommended, it is not the solution to the problem of projectile vomiting and does not address the need for urgent assessment.
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply
Explanation
A. Encouraging frequent fluid intake helps to dilute the urine and promotes urination, which can help flush out bacteria.
B. Frequent voiding is essential to reduce the risk of bacterial growth in the bladder and to alleviate symptoms.
C. Wiping from front to back is important in preventing the spread of bacteria from the rectal area to the urethra, thereby reducing the risk of UTIs.
D. Wearing nylon underwear may trap moisture and create an environment conducive to bacterial growth; cotton underwear is preferred.
E. Completing the course of antibiotics is crucial for fully eradicating the infection and preventing recurrence.
In caring for a child with nephrotic syndrome, which intervention will be most important to be included in the child's plan of care?
Explanation
A. Weighing the child daily on the same scale is critical for monitoring fluid retention and managing edema, which are primary concerns in nephrotic syndrome.
B. Testing urine for glucose levels is not a routine part of nephrotic syndrome management, as glucose levels are not typically affected by this condition.
C. Increasing fluid intake is not advisable in nephrotic syndrome if there is significant edema; fluid management must be tailored to the child's condition.
D. While ambulation is beneficial, it is not as critical as daily weight monitoring in managing nephrotic syndrome.
A nurse in an emergency department is caring for an Infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss?
Explanation
A. Blood pressure can fluctuate and may not accurately reflect fluid loss in an infant, especially in early stages of dehydration.
B. Respiratory rate may increase with distress but is not a direct indicator of fluid loss.
C. Skin integrity can show signs of dehydration, but it is not as definitive as changes in body weight.
D. Body weight is the most reliable indicator of fluid loss, as it reflects changes in fluid status directly and provides a clear measure for assessing hydration.
A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan?
Explanation
A. Antibiotics are not routinely indicated for acute glomerulonephritis unless there is an underlying infection; the condition is often related to an immune response.
B. Monitoring weight is crucial in acute glomerulonephritis to assess for fluid retention and manage edema effectively.
C. Fluid intake may need to be restricted to manage hypertension and edema, so encouraging increased intake is not appropriate.
D. While ambulation is important for general health, it is not a primary intervention for managing acute glomerulonephritis.
A nurse is caring for a client who is HIV positive and is one day postoperative following an appendectomy. The nurse should wear a gown as personal protective equipment when taking which of the following actions?
Explanation
A. Administering an IV bolus medication does not typically require gowning unless there is a risk of exposure to bodily fluids.
B. Talking to the client does not necessitate wearing a gown, as it does not pose a risk of exposure.
C. Administering an IM injection may require gloves but not necessarily a gown unless there is a risk of splashing.
D. Completing a dressing change involves potential exposure to bodily fluids, so wearing a gown is appropriate for infection control.
The nurse is reviewing appropriate nutritional options for a child who is receiving chemotherapy and has been prescribed a neutropenic diet. The nurse would recommend which of the following options
Explanation
A. Bagels with cream cheese and lox are not recommended as lox may carry a risk of contamination.
B. A vanilla milkshake made with pasteurized milk is safe for a neutropenic diet as pasteurization kills harmful bacteria.
C. Ham and cheese sandwiches may not be safe unless the ham is fully cooked, as deli meats can harbor bacteria.
D. Sushi is not appropriate for a neutropenic diet due to the risk of raw fish and potential bacteria.
A nurse is caring for a 4-month-old infant who is one day postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take? Select all that apply
Explanation
A. Positioning the infant on their back and upright in Semi-Fowler's helps prevent aspiration and supports respiratory function after surgery.
B. Encouraging parents to hold the baby is important for bonding, but caution should be taken to avoid placing pressure on the surgical site.
C. Aspirin should not be administered due to the risk of Reye's syndrome; acetaminophen is typically used for pain management in infants.
D. Applying elbow restraints as ordered is necessary to prevent the infant from pulling at the surgical site and to ensure proper healing.
E. Maintaining IV therapy is crucial for nutrition until the infant can take oral feeds safely.
A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid?
Explanation
A. An oral rehydration solution is specifically designed to replace lost fluids and electrolytes, making it the best choice for children recovering from gastroenteritis.
B. Water alone does not provide the necessary electrolytes and may not effectively rehydrate the child.
C. Broth can provide some hydration but lacks the specific electrolyte balance found in oral rehydration solutions.
D. Diluted apple juice is not as effective for rehydration as a balanced oral rehydration solution, which is specifically formulated for this purpose.
An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Assessment findings: Temp 100.6F, RR-22. HR-105, BP= 130/89 Which condition should the nurse suspect?
Explanation
A. Acute glomerulonephritis is characterized by the sudden onset of hematuria (reddish-brown urine), proteinuria (4+ protein), and a recent history of streptococcal infection, making it the most likely diagnosis.
B. Renal agenesis is a congenital condition and would not present suddenly with abdominal pain and hematuria.
C. Nephrotic syndrome typically presents with significant proteinuria, but the acute onset of symptoms and recent strep throat history point more toward glomerulonephritis.
D. Polycystic kidney disease usually presents with abdominal or flank pain, hypertension, and hematuria over a more chronic course, not typically after an acute infection.
The nurse discusses management with the caregiver of a toddler with acute otitis media. Which statement indicates that the caregiver needs additional teaching?
Explanation
A. Administering Children's Tylenol (acetaminophen) is appropriate for pain relief in toddlers and does not indicate a need for further teaching.
B. Children's Ibuprofen is also acceptable for pain management in this age group, demonstrating the caregiver's understanding of pain management options.
C. Completing the entire course of antibiotics is essential to ensure the infection is fully treated and helps prevent antibiotic resistance.
D. Baby aspirin is contraindicated in children due to the risk of Reye’s syndrome, indicating that the caregiver needs further teaching regarding safe medication administration for pain.
9-year-old client presents to the emergency department after a bee sting and experiencing bouts of nausea and vomiting. The nurse notes the client's blood pressure is 68/40 mm Hg, pulse is 148 beats/minute. 02 saturation is 86%, and the child is dyspneic. Which action is the nurse's priority?
Explanation
A. Administering Benadryl may help with allergic reactions but is not the immediate priority when the patient is showing signs of severe hypotension and respiratory distress.
B. Applying ice to the site may help with local swelling but does not address the systemic reaction the child is experiencing.
C. Giving epinephrine is the priority action as it counteracts the anaphylactic reaction, improves blood pressure, and alleviates respiratory distress.
D. Determining if the sting is in situ is less critical than addressing the child's life-threatening symptoms.
A nurse is caring for a client who will have blood sampling for a serum creatinine level and asks what this test shows. Which of the following responses should the nurse make?
Explanation
A. Deflecting the question to the doctor does not provide the patient with helpful information and shows a lack of communication.
B. While the test can indicate renal impairment, it is more accurate to say it assesses overall kidney function rather than confirming a specific disease.
C. Although medications can affect kidney function, the serum creatinine level is not specifically for evaluating medication interference.
D. The serum creatinine test is a standard measure of kidney function, indicating how well the kidneys are filtering waste from the blood.
The nurse is providing care to a child with acute abdominal pain, currant-jelly-like stools and suspected intussusception. The nurse will discuss with the caregivers that the child will have which procedure
Explanation
A. While abdominal surgery may be needed in some cases of intussusception, non-surgical interventions are often attempted first.
B. An enema with air infusion (often a contrast enema) can be used to treat intussusception by helping to unfold the intestine, making it a commonly discussed procedure.
C. An ano-rectal pull-through procedure is not related to intussusception and is usually indicated for conditions like Hirschsprung's disease.
D. A colostomy may be necessary in cases of bowel necrosis or perforation but is not the first-line treatment for intussusception.
A nurse is caring for a toddler who has acute otitis media. Which of the following is the priority action for the nurse to take?
Explanation
A. Educating the family about antibiotics is important but not the immediate priority for symptom management.
B. Administering analgesic medication addresses the child's pain and discomfort, which is a priority in acute otitis media.
C. Applying an ice pack can provide some comfort but does not directly address the child's pain as effectively as medication.
D. Providing diversional activities may help occupy the child but is not a direct intervention for the pain associated with acute otitis media.
A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?
Explanation
A. While monitoring temperature can be important, it is not the primary focus post-crisis unless there are specific concerns.
B. Cold compresses can constrict blood vessels and worsen sickling; heat is usually recommended for pain relief in sickle cell crisis.
C. Restricting outdoor play is not necessary; children with sickle cell anemia should be encouraged to engage in regular activities within their limits.
D. Offering fluids frequently helps prevent dehydration, which can trigger a sickle cell crisis, making it an essential part of discharge teaching.
The nurse is caring for a 2 month old child with a fever of 101.76. The child also appears toxic with poor color. Which of the following actions would the nurse expect to implement as a priority?
Explanation
A. While fluid replacement is important, in a toxic-appearing child, oral fluids may not be safe or adequate due to potential dehydration and risk of worsening condition.
B. Administering antibiotics is the priority action because the child shows signs of potential serious infection, and timely antibiotic treatment is crucial in young infants who may quickly deteriorate.
C. Obtaining a specimen for a complete blood count is necessary for diagnosing infection but is not as urgent as administering antibiotics.
D. While obtaining a urinalysis may help identify a urinary tract infection, it is not the immediate priority compared to starting antibiotic therapy.
The home health care nurse is visiting a child with renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD). Which of the following would lead the nurse to identify a nursing diagnosis of fluid overload related to CAPD?
Explanation
A. Poor skin turgor typically indicates dehydration, not fluid overload.
B. Shortness of breath can be a sign of fluid overload, particularly in children with renal failure, as excess fluid can accumulate and lead to pulmonary edema.
C. Redness at the tube insertion site may indicate infection but does not specifically relate to fluid overload.
D. Fever is a sign of infection or inflammation and does not directly indicate fluid overload.
A 6 year old child presents to the pediatric clinic with vesicular rash and honey crusted plaques around the nose and mouth. Which of the following statements by the parent indicates the need for further teaching?
Explanation
A. Encouraging handwashing is important to prevent spreading infection and shows understanding of hygiene practices.
B. Advising the child not to touch their face is important to prevent secondary infections and spread of the rash.
C. Providing a separate towel helps prevent the spread of infection, demonstrating good understanding of precautions.
D. Filling a prescription for antiviral ointment is inappropriate in this case; the honey-crusted plaques suggest impetigo, which is typically treated with topical or oral antibiotics, not antiviral ointment.
A 3 year old child with upper respiratory infection and low-grade fever is being treated with Acetominophen. The nurse is reviewing important anticipatory guidance with the parents which statement by the parents indicates the need for further teaching about this medication?
Explanation
A. Acetaminophen can be given every 4 to 6 hours, but every 2 hours is too frequent and indicates a need for further teaching.
B. The maximum daily dose for a child should be based on their weight and typically should not exceed 75 mg/kg/day; stating 4000 mg is too high for a child, indicating a misunderstanding of dosing.
C. Administering acetaminophen rectally is appropriate if the child cannot take it orally, particularly during vomiting episodes.
D. Notifying the provider about jaundice is critical, as it may indicate liver dysfunction, which is important when using acetaminophen.
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