Review Ati N400 pediatric exam 2

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Ati N400 pediatric exam 2

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Total Questions : 30

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Question 1:

The pediatric nurse understands that a common symptom of Hirschsprung’s disease

A. fever and chills B. severe constipation C. jaundice and steatorrhea D. muscle weakness

Answer and Explanation

Choice A:

Fever and chills are more indicative of infection, not Hirschsprung’s disease.

Choice B:

Severe constipation (along with abdominal distention and failure to pass meconium in newborns) is a hallmark sign of Hirschsprung’s disease due to the absence of ganglion cells in parts of the intestine, causing functional obstruction.

Choice C:

Jaundice and steatorrhea are associated with liver or biliary disorders, not Hirschsprung’s disease.

Choice D:

Muscle weakness is not a characteristic symptom of Hirschsprung’s disease.

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Question 2:

A nurse is providing education to the parents of a child who is receiving chemotherapy and is at risk for developing mucositis. Which of the following statements by the parents indicates an understanding of the teaching?

A. "We will encourage our child to eat spicy foods to reduce mucositis." B. "We will avoid providing our child with any oral hygiene care during chemotherapy." C. "We will use a soft-bristle toothbrush to clean our child's teeth." D. "We will give our child ice-cold beverages to soothe the oral mucosa."

Answer and Explanation

Choice A:

Spicy foods can irritate the oral mucosa and worsen mucositis; they should be avoided.

Choice B:

Oral hygiene should not be avoided—gentle oral care is essential to reduce infection risk and discomfort.

Choice C:

Using a soft-bristle toothbrush is correct because it allows for oral hygiene while minimizing trauma to delicate tissues.

Choice D:

Ice-cold beverages may provide temporary comfort but do not replace the need for proper oral care with a soft-bristle brush.

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Question 3:

The nurse recognizes which assessments are appropriate for a 7-week-old infant post-operative Ventriculoperitoneal (VP) shunt? (Select All that Apply.)

A. Observe the infant's level of consciousness and neurologic status B. Assess anterior fontanel C. Assess the infant's feeding and tolerance of feedings D. Evaluate the infant's hydration status and intake and output E. Assess the infant's incision sites for signs of infection or drainage F. Place sterile saline soaked dressing over the exposed sac G. Monitor the infant's pain level and provide appropriate pain management H. Monitor vital signs, including temperature, heart rate, and respiratory rate

Answer and Explanation

Choice A:

Monitoring level of consciousness and neurologic status is essential to detect shunt malfunction or increased intracranial pressure.

Choice B:

Assessing the anterior fontanel helps identify signs of increased intracranial pressure or shunt malfunction.

Choice C:

Feeding patterns and tolerance can reflect neurologic status and overall recovery.

Choice D:

Hydration status and intake/output are critical to assess fluid balance and shunt function.

Choice E:

Incision sites must be monitored for signs of infection or drainage, which can indicate complications.

Choice F:

A sterile saline–soaked dressing is used for myelomeningocele prior to repair, not for VP shunt post-op care.

Choice G:

Pain management is vital for comfort and to support recovery.

Choice H:

Monitoring vital signs helps identify infection, increased intracranial pressure, or other complications.

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Question 4:

Which intervention should the nurse teach to parents of how to help prevent respiratory infections in infants with Down syndrome?

A. Avoiding skin-to-skin contact with the infant B. Keeping the infant in a dry environment C. Use of a cool mist humidifier in the infant's room D. Feeding the infant with high-sugar formula

Answer and Explanation

Choice A:

Skin-to-skin contact promotes bonding and thermoregulation; it does not increase respiratory infection risk.

Choice B:

A dry environment can dry mucous membranes, making the infant more susceptible to infection.

Choice C:

A cool mist humidifier keeps the airway moist, reduces mucus thickening, and helps prevent respiratory infections, which infants with Down syndrome are at increased risk for due to hypotonia and airway abnormalities.

Choice D:

High-sugar formula has no role in infection prevention and could contribute to other health issues.

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Question 5:

A nurse is caring for 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?

A. Osteoporosis B. Weight gain C. Hypertension D. Nausea E. Irritability

Answer and Explanation

Choice A:

While a possible long-term adverse effect, it does not typically affect psychosocial development in a 6-year-old.

Choice B:

Corticosteroid-induced weight gain can alter body image, leading to self-consciousness and social difficulties at this developmental stage.

Choice C:

A medical concern but not directly linked to psychosocial development in children.

Choice D:

Primarily a physical discomfort; it does not significantly impact psychosocial development.

Choice E:

Mood changes such as irritability can interfere with social interactions and emotional regulation, affecting psychosocial development.

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Question 6:

When teaching a parent about the administration of digoxin elixir to a 4-year-old child, which of the following instructions should the nurse include?

A. Give water to the child to rinse their mouth after administration to prevent tooth decay. B. Administer the medication with a high-fiber meal. C. Check the child's heart rate before administration and hold the dose if the heart rate is greater than 70 BPM. D. Use a regular household spoon to measure the medication.

Answer and Explanation

Choice A:

Giving water after digoxin elixir helps rinse the mouth and teeth, reducing the risk of tooth decay caused by the sweetened solution.

Choice B:

Digoxin should not be administered with high-fiber foods, as fiber can decrease its absorption.

Choice C:

The nurse should hold digoxin if the heart rate is below 70 BPM in children, not above.

Choice D:

Household spoons are inaccurate for dosing; an oral syringe or calibrated device should be used.

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Question 7:

A nurse recognizes that the most likely initial clinical finding in infants with sickle cell disease is:

A. Jaundice of the skin and eyes B. Fever without a source C. Swelling of the hands and feet D. Failure to thrive

Answer and Explanation

Choice A:

Jaundice can occur due to hemolysis but is not usually the earliest or most specific initial finding.

Choice B:

Fever may occur with infection, but it is not typically the first sign of sickle cell disease in infants.

Choice C:

Swelling of the hands and feet (dactylitis) is often the earliest clinical manifestation in infants, caused by vaso-occlusion from sickled cells.

Choice D:

Failure to thrive may develop later due to chronic illness but is not usually the initial finding.

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Question 8:

A nurse anticipates the priority treatment for children diagnosed with Kawasaki disease Is:

A. High dose Aspirin B. Enoxaparin sodium C. Corticosteroids D. Béta-blockers

Answer and Explanation

Choice A:

High-dose aspirin is given during the acute phase of Kawasaki disease to reduce inflammation, fever, and platelet aggregation. It helps decrease the risk of coronary artery aneurysms.

Choice B:

Enoxaparin sodium (an anticoagulant) is not the standard initial treatment for Kawasaki disease.

Choice C:

Corticosteroids may be considered in refractory cases but are not the first-line therapy.

Choice D:

Beta-blockers are not used for the acute management of Kawasaki disease.

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Question 9:

A nurse is educating a parent of a child who has a high lead level about the importance of foods high in iron and calcium. Which of the following statements by the parent indicates a correct understanding of the nurse's teaching?

A. "I will give my child more processed foods to increase their iron and calcium intake." B. "I will limit my child's consumption of dairy products to increase their iron intake." C. "I will make sure my child eats plenty of fruits and vegetables." D. "I will encourage my child to drink more soda to increase their calcium intake."

Answer and Explanation

Choice A:

Processed foods are generally low in iron and calcium and do not help reduce lead absorption.

Choice B:

Dairy products are a good source of calcium and should not be limited unless directed for another medical reason.

Choice C:

Fruits and vegetables (especially leafy greens and iron-rich produce) provide important sources of iron and calcium, which compete with lead for absorption and help lower lead toxicity.

Choice D:

Soda does not contain calcium and may worsen nutritional status, interfering with healthy intake.

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Question 10:

When caring for a child with glomerulonephritis, what key assessments should the nurse prioritize? (Select All that Apply.)

A. Assessing joint mobility B. Checking visual acuity during the admission interview C. Vital signs and neurological status especially with edema D. Urine volume and character E. Measuring blood glucose levels F. Evaluating tolerance of a regular diet with possible restrictions if oliguric G. Weigh child same time each day (same scale)

Answer and Explanation

Choice A:

Assessing joint mobility is not a priority for glomerulonephritis. This condition primarily affects the kidneys, not the musculoskeletal system.

Choice B:

Checking visual acuity is not a key assessment in glomerulonephritis, though periorbital edema may cause puffiness around the eyes, vision itself is not the focus of concern.

Choice C:

Monitoring vital signs and neurological status is crucial. Hypertension is a common complication of glomerulonephritis due to sodium and fluid retention. Severe hypertension can also cause neurological changes such as headache, irritability, or seizures, so frequent assessments are necessary.

Choice D:

Assessing urine volume and character is a priority. Children may have hematuria (cola- or tea-colored urine), proteinuria, or oliguria. Monitoring urine helps determine kidney function and progression of the disease.

Choice E:

Measuring blood glucose levels is not directly related to glomerulonephritis unless the child has a concurrent diagnosis such as diabetes mellitus.

Choice F:

Evaluating the child’s tolerance of diet is important. With oliguria, there may be a need for fluid, sodium, or potassium restrictions to prevent worsening fluid overload or electrolyte imbalances. The nurse should ensure the child’s nutritional needs are met within prescribed limits.

Choice G:

Daily weights using the same scale, at the same time each day, in similar clothing, provide the most accurate measure of fluid balance. Even small weight changes can indicate significant fluid retention, which is more sensitive than intake and output measurements alone.

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Ati N400 pediatric exam 2

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