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Ati nurs 243 paediatrics proctored exam
Ati nurs 243 paediatrics proctored exam
Total Questions : 36
Showing 10 questions Sign up for moreA home health nurse is doing the first intake visit for a child who has hemiplegic cerebral palsy. When developing a plan of care for this child, which of the following goals is the priority for the nurse to include in the plan of care?
Explanation
A. While providing assistance with activities of daily living is important, ensuring the child's environment is safe is a higher priority to prevent injuries.
B. Modifying the home for safety is the priority because children with hemiplegic cerebral palsy have motor impairments that increase their risk for accidents and injuries. A safe environment is essential for the child’s well-being.
C. Providing respite services for the parents is beneficial for the family’s overall stress management, but it is not as immediate a concern as ensuring the child’s safety.
D. Improving communication skills is important for the child's overall development, but ensuring a safe living environment takes precedence to prevent potential harm.
The nurse is caring for a school-age girl who had an arterial cardiac catheterization. The child tells the nurse that the bandage is "wet." On assessment, the bandage and bed are soaked with blood. The nurse must do which of the following FIRST?
Explanation
A. Applying direct pressure at the site and one inch above the catheterization site is the immediate priority to control the bleeding and prevent further blood loss.
B. Notifying the interventional cardiologist and the catheterization lab is important but should be done after initial bleeding control measures are taken.
C. Placing the bed in the Trendelenburg position is not appropriate for managing active bleeding from a catheterization site.
D. Reinforcing the bandage is not sufficient to control active bleeding; direct pressure is necessary.
The nurse is caring for a preschool aged child immediately following an open repair of a Ventricular Septal Defect. There has been no drainage from the mediastinal chest tubes in the last 2 hours. Based on this finding what will be the nurse's priority intervention?
Explanation
A. Documenting the information without taking action is inappropriate as lack of drainage could indicate a serious complication.
B. Encouraging the child to cough and deep breathe might be beneficial, but immediate reporting of this finding is critical.
C. Lack of drainage from the chest tubes following cardiac surgery can be life-threatening, indicating possible cardiac tamponade or tube occlusion. Immediate reporting is necessary for prompt intervention.
D. Assisting the child to a sitting position is not the priority; immediate evaluation by the healthcare team is required.
A nurse is speaking with the parents of a 4-year-old boy who has a cerebral palsy. The parents tell the nurse they have taken their son's name off the list for baseball next season. Which of the following is the BEST response for the nurse to make?
Explanation
A. This response is not supportive and does not consider adaptive sports opportunities that may be available.
B. Suggesting a different activity might be helpful, but it does not address the parents' feelings or provide support for their decision.
C. Asking to discuss their decision and explore alternatives is the best response as it opens a dialogue, provides support, and helps the parents consider other options for their child's participation in activities.
D. This response does not support the parents' emotional needs or explore other possibilities for the child to stay active.
A school aged child is being evaluated for possible glomerulonephritis. During the physical exam the nurse recognizes that which of the following, is a possible cause?
Explanation
A. A history of runny nose and itchy eyes is more indicative of an allergic reaction, not glomerulonephritis.
B. A viral illness is less likely to cause glomerulonephritis compared to a bacterial infection like strep throat.
C. A urinary tract infection is not typically associated with the development of glomerulonephritis.
D. Glomerulonephritis often follows a streptococcal infection, such as strep throat, occurring within the last two weeks. This is known as post-streptococcal glomerulonephritis.
A home health nurse is doing the first intake visit for a child who has hemiplegic cerebral palsy. When developing a plan of care for this child, which of the following goals is the priority for the nurse to include in the plan of care?
Explanation
A. While providing assistance with activities of daily living is important, ensuring the child's environment is safe is a higher priority to prevent injuries.
B. Modifying the home for safety is the priority because children with hemiplegic cerebral palsy have motor impairments that increase their risk for accidents and injuries. A safe environment is essential for the child’s well-being.
C. Providing respite services for the parents is beneficial for the family’s overall stress management, but it is not as immediate a concern as ensuring the child’s safety.
D. Improving communication skills is important for the child's overall development, but ensuring a safe living environment takes precedence to prevent potential harm.
Explanation
Monitor RLE pulses with vital signs:
Anticipated. Regular monitoring of pulses, especially in areas of pain or tenderness, is essential to assess for adequate perfusion and circulation, which can be compromised in vaso-occlusive crisis.
Administer Oxycodone 3 mg Q3-4 hours PRN for pain:
Anticipated. Pain management is crucial in treating vaso-occlusive crises. Continuation of pain medication is necessary to keep the child's pain under control.
Continue IV NSS bolus @ 67 ml/hour:
Anticipated. Hydration is vital in managing a vaso-occlusive crisis as it helps to reduce blood viscosity and prevent further sickling of red blood cells.
Decrease O2 to 2 L/min:
Contraindicated. Maintaining adequate oxygenation is important in managing vaso-occlusive crises to ensure that tissues receive sufficient oxygen and to prevent further sickling of red blood cells. Decreasing oxygen flow can compromise oxygen delivery.
A 2-year-old child is diagnosed with neuroblastoma. The nurse understands that which of the following tests help to determine the extent of tumor metastasis?
Explanation
A. A basic metabolic panel is a blood test that measures various substances in the blood, but it is not used to determine the extent of tumor metastasis.
B. A lumbar puncture can be used to detect cancer cells in the cerebrospinal fluid, but it does not provide a full picture of metastasis.
C. A head CT (computed tomography) scan is a valuable imaging test that can help determine the extent of tumor metastasis, particularly to the brain or skull.
D. A biopsy is used to diagnose the type of tumor but is not typically used to determine the extent of metastasis on its own.
A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?
Explanation
A. A blood pressure of 100/56 and a small weight gain may indicate fluid retention, but they are not immediately life-threatening.
B. A heart rate of 150 beats/minute with crying can be normal for a child of this age, especially during emotional distress.
C. An apical pulse of 70 beats/minute and vomiting are concerning because they may indicate digoxin toxicity. A low heart rate (bradycardia) in a child on digoxin requires immediate attention.
D. An hourly urine output of 45 mL/hour is adequate and not concerning in this context.
The nurse understands that in the preoperative period the infant with a myelomeningocele must be placed in which of the following positions?
Explanation
A. Prone and in full Trendelenburg position is not appropriate as it could increase intracranial pressure and compromise breathing.
B. Supine with head slightly elevated is not suitable because it can put pressure on the myelomeningocele sac.
C. Side-lying with head slightly elevated is also not ideal as it can lead to pressure on the sac.
D. Prone with hips flexed and legs abducted is the best position to avoid pressure on the myelomeningocele sac, prevent trauma, and reduce the risk of infection before surgical repair.
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