Ati rn pediatric nursing 2023
Total Questions : 66
Showing 25 questions, Sign in for moreA nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?
Explanation
Choice A rationale
This is incorrect because the child’s feet should be able to touch the ground comfortably when seated on the bicycle, kbut not necessarily 3 to 6 inches off the ground. Proper seat height is crucial for balance and control.
Choice B rationale
Riding against the flow of traffic is dangerous and increases the risk of accidents. Bicyclists should always ride with the flow of traffic to be more predictable to drivers.
Choice C rationale
Walking the bicycle through intersections is a key safety measure to prevent accidents. It ensures that the child is more visible to drivers and reduces the risk of collisions.
Choice D rationale
Keeping the bicycle at least 3 feet from the curb is not a standard safety recommendation. Instead, children should ride as close to the curb as safely possible, following the flow of traffic.
Which of the following best describes the purpose of obtaining consent?
Explanation
Choice A rationale
The primary purpose of obtaining consent is to ensure that the patient understands the risks, benefits, and alternatives of the proposed treatment. This process respects patient autonomy and allows them to make informed decisions about their care.
Choice B rationale
While family input can be important, obtaining consent is primarily about ensuring the patient themselves understands and agrees to the treatment. It is not about obtaining permission from the family.
Choice C rationale
Protecting the nurse from legal liability is not the main purpose of obtaining consent. The focus is on patient understanding and autonomy.
Choice D rationale
Consent is about involving the patient in their care decisions, not bypassing their input. It ensures that the patient is fully informed and agrees to the treatment plan.
The RN reviews therapeutic and nontherapeutic communication techniques with a group of nursing students. Which of the following demonstrates the use of therapeutic communication techniques?
Explanation
Choice A rationale
This statement is nontherapeutic because it shifts the focus away from the patient and onto the nurse’s personal experience. It can minimize the patient’s feelings and is not helpful in providing support.
Choice B rationale
Asking the patient to demonstrate how they give themselves insulin is a therapeutic communication technique. It shows interest in the patient’s self-care practices and provides an opportunity for the nurse to offer guidance and support.
Choice C rationale
This statement is nontherapeutic because it offers false reassurance. It does not address the patient’s concerns or provide any real support.
Choice D rationale
This statement is also nontherapeutic because it offers false reassurance and does not address the patient’s specific concerns or needs.
A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm. Which of the following information is the priority for the nurse to include?
Explanation
Choice A rationale
Restricting the child’s strenuous activities for 3 days is important, but it is not the priority. Monitoring for signs of impaired circulation or complications is more critical.
Choice B rationale
Using a hair dryer on a cool setting to relieve itching can be helpful, but it is not the priority. The priority is to monitor for signs of impaired circulation.
Choice C rationale
Monitoring for pallor or swelling in the child’s affected hand is the priority because it can indicate impaired circulation or compartment syndrome, which are serious complications that require immediate attention.
Choice D rationale
Examining the child for skin irritation at the cast edges is important to prevent complications, but it is not the priority over monitoring for circulation and potential complications.
A nurse is caring for a client. Which action demonstrates effective collaboration?
Explanation
Choice A rationale
Performing the dressing change independently does not demonstrate effective collaboration. Effective collaboration involves working with other healthcare professionals to provide the best care for the patient. By performing the dressing change independently, the nurse is not utilizing the expertise and support of the healthcare team.
Choice B rationale
Seeking guidance from the wound care nurse demonstrates effective collaboration. The wound care nurse has specialized knowledge and skills in wound management, and seeking their guidance ensures that the patient receives the best possible care. This collaborative approach enhances patient outcomes and promotes a team-based approach to healthcare.
Choice C rationale
Asking another nurse to complete the dressing change does not demonstrate effective collaboration. While delegating tasks can be part of collaboration, it is important that the nurse seeks guidance from the appropriate specialist, in this case, the wound care nurse, to ensure the best care for the patient.
Choice D rationale
Consulting only the client’s family for assistance does not demonstrate effective collaboration. While involving the family in the care process is important, it is essential to collaborate with other healthcare professionals who have the expertise to provide the best care for the patient.
A nurse is caring for a 1-year-old child who has been hospitalized. Which of the following items in the child’s room is a common source of health care-associated infection?
Explanation
Choice A rationale
Disposable diapers are not typically sources of healthcare-associated infections if used appropriately. They are designed for single use and are disposed of after use, minimizing the risk of infection.
Choice B rationale
Protective plastic gowns are not typically sources of healthcare-associated infections if used appropriately. They are designed to protect healthcare workers and patients from the spread of infections and are disposed of after use.
Choice C rationale
Unopened bottles of formula are not typically sources of healthcare-associated infections. They are sealed and sterile until opened, reducing the risk of contamination.
Choice D rationale
Bedside computer keyboards can harbor pathogens and serve as fomites for transmitting infections. They are frequently touched by healthcare workers and can become contaminated with pathogens, making them a common source of healthcare-associated infections.
A nurse is reviewing the complete blood count results for a 4-year-old child who is receiving treatment for acute lymphoblastic leukemia. Which of the following findings should indicate to the nurse that the treatment is having a therapeutic effect?
Explanation
Choice A rationale
A hemoglobin level of 6.8 g/dL is significantly lower than the normal range (9.5 to 14 g/dL) and indicates anemia. This finding does not suggest that the treatment for acute lymphoblastic leukemia is having a therapeutic effect.
Choice B rationale
An RBC count of 5/mm³ is within the normal range (4 to 5.5/mm³) but does not specifically indicate that the treatment for acute lymphoblastic leukemia is having a therapeutic effect.
Choice C rationale
A WBC count of 15,000/mm³ is higher than the normal range (5,000 to 10,000/mm³) but can indicate that the treatment is having a therapeutic effect. In the context of acute lymphoblastic leukemia, an elevated WBC count can be a sign that the body is responding to treatment.
Choice D rationale
A platelet count of 98,000/mm³ is lower than the normal range (150,000 to 400,000/mm³) and does not indicate that the treatment for acute lymphoblastic leukemia is having a therapeutic effect.
A nurse is assessing a 7-year-old child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
Explanation
Choice A rationale
Increased capillary refill time is not typically associated with hypoglycemia. It may indicate poor peripheral circulation but is not a common sign of low blood sugar levels.
Choice B rationale
Decreased appetite is not typically associated with hypoglycemia. Hypoglycemia usually causes symptoms such as shakiness, sweating, and confusion.
Choice C rationale
Thirst is not typically associated with hypoglycemia. It is more commonly a symptom of hyperglycemia (high blood sugar levels).
Choice D rationale
Shakiness or tremors are common signs of hypoglycemia. When blood sugar levels drop, the body responds by releasing adrenaline, which can cause shakiness.
A nurse is providing education to a client. Which of the following nonverbal techniques should the nurse use to enhance the importance of the education?
Explanation
Choice A rationale
Having their cell phone visible and diverting the eyes to check messages is not an effective nonverbal technique for enhancing the importance of education. It can be distracting and may convey a lack of interest or attention to the client.
Choice B rationale
Crossing arms over the chest and avoiding eye contact can be perceived as defensive or disinterested body language. It does not enhance the importance of education and may create a barrier to effective communication.
Choice C rationale
Smiling, nodding, and touching the client’s hand are positive nonverbal techniques that can enhance the importance of education. These actions convey warmth, empathy, and attentiveness, making the client feel valued and understood.
Choice D rationale
Leaning gently over the back of a chair with legs crossed can be perceived as casual or relaxed body language. It does not convey the importance of the education being provided.
A nurse is caring for a 5-year-old child following a tonsillectomy and adenoidectomy. Which of the following findings should the nurse identify as an indication of hemorrhage?
Explanation
Choice A rationale
Continuous swallowing can be an indication of hemorrhage following a tonsillectomy and adenoidectomy. This is because the child may be swallowing blood that is coming from the surgical site.
Choice B rationale
Blood pressure of 95/56 mm Hg is within the normal range for a 5-year-old child and does not specifically indicate hemorrhage.
Choice C rationale
A heart rate of 54/min is lower than the normal range for a 5-year-old child and may indicate bradycardia, but it is not a specific sign of hemorrhage.
Choice D rationale
Flushing of the face is not a specific sign of hemorrhage. It may indicate other conditions but is not typically associated with bleeding following a tonsillectomy and adenoidectomy.
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Explanation
Choice A rationale
Weighing the child once per day is crucial in the acute stage of nephrotic syndrome to monitor fluid retention and the effectiveness of treatment. Daily weight monitoring helps in assessing the child’s fluid balance and detecting any sudden weight gain, which could indicate worsening edema.
Choice B rationale
Increasing fluid intake to 2 L/day is not recommended for a child in the acute stage of nephrotic syndrome. This condition is characterized by significant protein loss leading to edema, and increasing fluid intake would exacerbate the problem. Fluid restriction is often necessary to manage edema.
Choice C rationale
Positioning the child supine at bedtime is not beneficial for managing nephrotic syndrome. Elevating the child’s head and legs can help reduce edema, while supine positioning might worsen it by allowing fluid to accumulate in dependent areas.
Choice D rationale
Limiting calorie intake to 45 cal/kg/day is not appropriate for a child with nephrotic syndrome. Adequate nutrition is essential for healing and recovery, and restricting calories could be harmful. The focus should be on providing a balanced diet to support the child’s overall health.
A nurse is providing teaching to the guardian of a 2-year-old child about typical toddler behavior. Which of the following behaviors should the nurse include?
Explanation
Choice A rationale
Toddlers are typically more emotionally labile, meaning they experience rapid and intense emotional changes. This is a normal part of their development as they learn to navigate their emotions.
Choice B rationale
Frequent negative responses, such as saying “no” often, are common in toddlers. This behavior is part of their development as they assert their independence and test boundaries.
Choice C rationale
Toddlers are generally more resistant to routines as they seek to assert their independence and explore their environment. They may resist following set routines as a way of expressing their autonomy.
Choice D rationale
Increased dependency is not typical toddler behavior. Toddlers are usually striving for more independence and autonomy, even though they still rely on caregivers for support.
What is the primary difference between a Power of Attorney (POA) and a Healthcare Proxy?
Explanation
Choice A rationale
A Power of Attorney (POA) cannot be revoked by a healthcare provider. It can only be revoked by the person who granted it or by a court under certain circumstances.
Choice B rationale
A POA does not need to be appointed by a court. It is a legal document that an individual can create to grant authority to another person to make decisions on their behalf. A Healthcare Proxy specifically grants authority over medical decisions.
Choice C rationale
A POA is not only applicable to minors. It can be used by adults to grant authority over financial matters, while a Healthcare Proxy grants authority over medical decisions.
Choice D rationale
A POA grants authority over financial matters, allowing the appointed person to manage finances, pay bills, and make financial decisions. A Healthcare Proxy grants authority over medical decisions, allowing the appointed person to make healthcare decisions if the individual is incapacitated.
A nurse is assessing a 4-month-old infant during a well-baby visit. For which of the following findings should the nurse notify the provider?
Explanation
Choice A rationale
The presence of the Doll’s eye reflex (oculocephalic reflex) beyond the newborn period is abnormal and should be reported. This reflex should disappear by 2-3 months of age. Its persistence may indicate neurological issues.
Choice B rationale
No head lag when pulled to a sitting position is a normal finding in a 4-month-old infant. By this age, infants typically have developed enough neck muscle strength to hold their head steady.
Choice C rationale
The presence of tears when crying is a normal finding in a 4-month-old infant. Tear production usually begins around 2-3 months of age.
Choice D rationale
A positive Babinski reflex is normal in infants up to 2 years old. It is an expected finding and does not require notification to the provider.
A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
Explanation
Choice A rationale
A digoxin level of 1.2 ng/mL is within the therapeutic range (0.8 to 2 ng/mL) for toddlers receiving digoxin therapy. This level does not require a revision of the plan of care.
Choice B rationale
An apical pulse of 100/min is within the normal range for toddlers. Digoxin therapy requires monitoring of the heart rate, but this pulse rate does not necessitate a change in the plan of care.
Choice C rationale
A potassium level of 4.0 mEq/L is within the normal range (3.4 to 4.7 mEq/L) for toddlers. This electrolyte level does not require a revision of the plan of care.
Choice D rationale
Vomiting is a potential sign of digoxin toxicity. A toddler who has vomited 2 times in the last hour may be experiencing digoxin toxicity, and the plan of care should be revised to address this issue.
A nurse is providing discharge teaching to a parent of a child who has juvenile idiopathic arthritis and a new prescription for prednisone. Which of the following statements should the nurse include in the teaching?
Explanation
Choice A rationale
Prednisone is a corticosteroid that suppresses the immune system, making the child more susceptible to infections. Therefore, monitoring for signs of infection is crucial.
Choice B rationale
Prednisone can cause potassium loss, so limiting potassium-rich foods is not recommended. Instead, maintaining a balanced diet is important.
Choice C rationale
Prednisone does not stimulate growth spurts. In fact, long-term use can potentially stunt growth in children.
Choice D rationale
Discontinuing prednisone abruptly can cause adrenal insufficiency. If gastrointestinal upset occurs, the medication should be taken with food or the dosage adjusted, but not discontinued without consulting a healthcare provider.
A nurse is assessing a school-age child who is receiving morphine. For which of the following adverse effects should the nurse monitor?
Explanation
Choice A rationale
Bradypnea, or slow breathing, is a common and serious side effect of morphine, especially in children. It requires immediate attention.
Choice B rationale
Morphine does not typically affect wound healing. This is more associated with corticosteroids.
Choice C rationale
Morphine can cause hypotension, not hypertension.
Choice D rationale
Stevens-Johnson syndrome is a rare but severe reaction to medications, including some antibiotics and anticonvulsants, but not commonly associated with morphine.
A nurse is applying soft limb restraints to a child who is acting aggressively toward staff. Which of the following actions should the nurse take?
Explanation
Choice A rationale
Restraint prescriptions should be renewed every 24 hours, not 48 hours, to ensure the child’s safety and necessity of restraints.
Choice B rationale
Restraints should never be tied to the side rails as this can cause injury. They should be tied to the bed frame.
Choice C rationale
Quick-release knots are recommended for restraints to ensure they can be removed quickly in an emergency.
Choice D rationale
The child should be assessed more frequently than every 4 hours, typically every 2 hours, to ensure their safety and comfort.
A nurse is assessing a school-age child who is receiving prednisolone. For which of the following adverse effects should the nurse monitor?
Explanation
Choice A rationale
Prednisolone can cause hypertension, not hypotension.
Choice B rationale
Prolonged wound healing is a known side effect of corticosteroids like prednisolone due to their immunosuppressive effects.
Choice C rationale
Renal failure is not a common side effect of prednisolone.
Choice D rationale
Stevens-Johnson syndrome is not commonly associated with prednisolone.
A nurse is caring for an infant who has necrotizing enterocolitis. Which of the following findings should the nurse expect?
Explanation
Choice A rationale
Vomiting can occur in infants with necrotizing enterocolitis, but it is not the most specific finding.
Choice B rationale
Hypertension is not typically associated with necrotizing enterocolitis.
Choice C rationale
A rounded abdomen is a common finding in infants with necrotizing enterocolitis due to intestinal swelling and gas accumulation.
Choice D rationale
Tachypnea can occur, but it is not as specific as a rounded abdomen.
A nurse is planning care for a preschooler who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan?
Explanation
Choice A rationale
Holding the child during assessments may cause distress and is not recommended for children with autism spectrum disorder.
Choice B rationale
Establishing a reward system is an effective intervention for children with autism spectrum disorder as it reinforces positive behaviors.
Choice C rationale
Maintaining extended eye contact can be uncomfortable for children with autism and is not recommended.
Choice D rationale
Engaging in cooperative play may be challenging for children with autism, and structured activities are often more beneficial.
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a non-pharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler’s pain level?
Explanation
Choice A rationale
The FLACC scale (Face, Legs, Activity, Cry, Consolability) is designed to assess pain in children who are unable to communicate their pain verbally, including those who are cognitively impaired. It evaluates five categories: facial expression, leg movement, activity, cry, and consolability, each scored from 0 to 2, with a total score ranging from 0 to 1012.
Choice B rationale
The FACES pain scale is a self-report tool that uses facial expressions to help children aged 3 and older communicate their pain level. It is not suitable for toddlers who are cognitively impaired and unable to self-report.
Choice C rationale
The Visual Analog Scale (VAS) is a unidimensional measure of pain intensity, typically used in older children and adults who can understand and mark their pain level on a continuum. It is not appropriate for toddlers who are cognitively impaired.
Choice D rationale
The CRIES scale is used to assess pain in neonates and infants, particularly postoperatively. It evaluates crying, oxygen requirement, increased vital signs, facial expression, and sleeplessness. It is not designed for toddlers.
A nurse is preparing to assess a 4-year-old child’s visual acuity. Which of the following actions should the nurse plan to take?
Explanation
Choice A rationale
The tumbling E chart is used for visual acuity assessment in children who cannot read letters, such as those who are too young or have language barriers. It involves identifying the direction of the letter “E” in various orientations.
Choice B rationale
Testing the child without glasses before testing with glasses is not the standard procedure for visual acuity assessment. The correct approach is to test with the child’s usual corrective lenses if they have them.
Choice C rationale
The standard distance for visual acuity testing using a chart is 3 meters (10 feet) for children, not 4.6 meters (15 feet).
Choice D rationale
Assessing each eye separately first, then both eyes together, is the correct procedure for visual acuity testing. This ensures accurate measurement of each eye’s visual acuity.
A nurse is teaching a group of parents about childhood immunizations. The nurse should identify that infants should receive the first dose of which of the following immunizations at 12 months of age?
Explanation
Choice A rationale
The inactivated polio virus (IPV) vaccine is typically administered at 2 months, 4 months, and 6-18 months of age, not at 12 months.
Choice B rationale
The hepatitis B vaccine is given at birth, 1-2 months, and 6-18 months of age.
Choice C rationale
The varicella (chickenpox) vaccine is recommended to be given at 12-15 months of age for the first dose.
Choice D rationale
The human papillomavirus (HPV) vaccine is recommended for preteens aged 11-12 years, not for infants.
A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take?
Explanation
Choice A rationale
Amphotericin B is an antifungal medication and is not used to treat impetigo, which is a bacterial infection.
Choice B rationale
Initiating contact isolation precautions is appropriate for impetigo contagiosa to prevent the spread of the highly contagious bacterial infection.
Choice C rationale
Lidocaine ointment is used for pain relief and is not a treatment for impetigo.
Choice D rationale
Impetigo is not a reportable disease to the state health department.
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