ATI RN Pediatric Nursing Online Practice 2023 B

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2023 P

59 terms nur A nurse is caring for a preschool-age child. For each assessment finding, click to specify if the finding is consistent with nightmares or sleep terrors. Each finding may support more than 1 disease process.

-Timing of child's crying: Nightmares

-Child's responsiveness to guardian: Nightmares

-Child's return to sleeping: Sleep terrors

-Child's description of the dream: Nightmares

-Impulsivity: Sleep terrors and Nightmares

-Child's concentration: Sleep terrors and Nightmares

-Daytime alertness: Sleep terrors and Nightmares

Rationale: When analyzing cues, the nurse should recognize that manifestations of nightmares include awakening during the night after a scary dream. Nightmares are a sleep disturbance that cause distress after the dream is over. The child might be crying, fearful of returning to sleep, and believe the dream is real. Sleep disturbances cause interruptions in the sleep-wake cycle and can cause impaired concentration, daytime fatigue, and impulsive behaviors.When analyzing cues, the nurse should recognize that manifestations of sleep terrors include a partial awakening during a deep sleep. Sleep terrors are sleep disturbances that cause a child to exhibit behaviors such as thrashing, screaming, moaning, and diaphoresis that disappear once the child awakens. The child does not remember the episode and is not comforted by others during the disturbance. The child usually falls asleep easily afterwards. Sleep terrors cause interruptions in the sleep-wake cycle and can cause impaired concentration, daytime fatigue, and impulsive behaviors.

A nurse is caring for a toddler who has acute otitis media and a temperature of 40 C (104 F). After administering acetaminophen, which of the following actions should the nurse plan to take to reduce the toddler's temperature?-Dress the toddler in minimal clothing

Rationale: The nurse should recognize that dressing the toddler in minimal

clothing will expose the skin to air and maximize heat evaporation from the skin, thus reducing the toddler's temperature.A nurse on a pediatric unit is caring for a school-age child. After reviewing the information in the child's medical record, which of the following findings should the nurse report to the provider?Select the 4 findings that the nurse should report to the provider.-Arterial blood gases Rationale: The child's arterial blood gases (ABGs) indicate respiratory alkalosis, which is associated with complications of asthma, such as hyperventilation and hypoxia. Therefore, the nurse should report these findings to the provider.-WBC Count

Rationale: The child's WBC count is above the expected reference range, which

could be an indication of infection or inflammation. Therefore, the nurse should report this finding to the provider.-Oxygen Saturation

Rationale: The child's oxygen saturation level has decreased below the expected

reference range despite the use of supplemental oxygen. Therefore, the nurse should report this finding to the provider.-Respiratory Assessment

Rationale: The child's respiratory assessment indicates increased respiratory

distress, as evidenced by the presence of tachypnea, retractions, and increased wheezing. Therefore, the nurse should report these findings to the provider.A nurse is caring for a preschooler who has congestive heart failure. The nurse observes wide QRS complexes and peaked T waves on the cardiac monitor. Which of the following prescriptions should the nurse clarify with the provider?-Potassium chloride Rationale: The nurse should identify that a child who has congestive heart failure can develop electrolyte imbalances, such as hyperkalemia or hypokalemia. The nurse should identify that the child is exhibiting manifestations of hyperkalemia and contact the provider about the administration of potassium chloride, which can increase the severity of hyperkalemia.

A nurse is caring for a toddler. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Potential Condition: Cystic Fibrosis

Actions to take:

1: Educate the guardian about swear chloride testing.

2: Prepare toddler for chest physiotherapy.

Parameters to Monitor:

1: Oxygen saturation level

2: Stools

Rationale: Upon recognizing and analyzing client findings, the nurse's priority

hypothesis is that the toddler is most likely experiencing cystic fibrosis and that is it important to generate solutions and take actions by planning to educate the guardian about sweat chloride testing for the toddler and prepare the toddler for chest physiotherapy. The toddler is most likely experiencing cystic fibrosis, as evidenced by reports of recurring respiratory infections, wheezing, coughing, tachypnea, tachycardia, labored respirations, decreased oxygen saturation, nasal congestion, inability to gain weight, loose fatty stool, salty tasting sweat, and hyponatremia. To evaluate the toddler's response to these interventions, the nurse should monitor the toddler's oxygen saturation level and stools. These are parameters that indicate if the toddler is further experiencing respiratory distress, inadequate intake, and dehydration, which can lead to further complications, including pneumothorax, respiratory failure, and failure to thrive.A school nurse is preparing to administer atomoxetine 1.2 mg/kg/day PO to a school-age child who weighs 75 lb.Available is atomoxetine 40 mg/capsule. How many capsules should the nurse administer per day? Round to the nearest whole number.1

Rationale:

75 lb = 34.0909 kg 1.2 mg x 34.0909 kg = 40.9090

40.9090 / 40 = 1.02 = 1

A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. Which of the following nutritional items should the nurse offer to the toddler?-Oral rehydration solution

Rationale: A toddler who has acute diarrhea should consume an oral rehydration

solution to replace electrolytes and water by promoting the reabsorption of water and sodium. This promotes recovery from dehydration.

A nurse is caring for a toddler. Click to highlight the findings that require follow-up.-Toddler appears lethargic -Toddler is uninterested in eating -Ribbon-like, foul-smelling stools -Hypoactive bowel sounds -Abdomen distended -Palpable fecal mass -Blood pressure 110/70 mm Hg

Rationale: When recognizing cues, the nurse should identify that the assessment

findings of lethargy, disinterest in eating, hypoactive bowel sounds, distended abdomen, palpable fecal mass, ribbon-like, foul-smelling stools and elevated blood pressure require follow-up. These findings indicate the toddler's constipation has worsened and the toddler needs further evaluation for suspected Hirschsprung's disease.A nurse in a provider's office is caring for a preschooler.Which of the following statements by a guardian indicate that the discharge teaching was effective?Select all that apply.-"We should apply a skin emollient immediately after bathing out child." Rationale: An emollient is an oil that moisturizes the skin and should be applied immediately after bathing, while the skin is damp, to prevent drying. Therefore this statement by the guardian indicates the teaching has been effective.-"We should keep our child's fingernails trimmed short." Rationale: The child's fingernails and toenails should be kept short, trimmed, and filed to prevent scratching with sharp edges. Therefore this statement by the guardian indicates the teaching has been effective.-"We should use a mild detergent for our laundry."

Rationale: The use of mild detergents for laundry helps prevent allergens and

itching. Therefore this statement by the guardian indicates the teaching has been effective.A nurse is preparing to administer ibuprofen 5 mg/kg every 6 hr PRN for temperature above 38.0 C (100.5 F) to an infant who weighs 17.6 lb. Available is ibuprofen oral suspension 100 mg/5mL. How many mL should the nurse administer to the infant per dose? Round to the nearest whole number.2

Rationale:

17.6 lb = 8 kg

• mg x 8 kg = 40

40 mg / 100 mg = 0.4 0.4 x 5 mL = 2 A nurse is providing dietary teaching to the parent of a school-age child who has celiac disease. The nurse should recommend that the parent offer which of the following foods to the child?-White rice

Rationale: The nurse should recommend that the parent offer white rice to the

child because it is a gluten-free food. The nurse should instruct the parent that the child will remain on a lifelong gluten-free diet and the child should not consume oats, rye, barley, or wheat, and that sometimes lactose deficiency can be secondary to this disease.