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ATI Pediatrics Proctored Exam | ACCURATE
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Which of the following is the cause of Type I DM A. Insulin Resistance B. Glucose Intolerance w/first trimester C. Alpha cell destruction D. Beta Cell Destruction
- ANSWERS-D. Beta Cell Destruction Which of the following indicates that the client is adhering to plan of care A. Hemoglobin A1C B. Polyuria C. Polydipsia D. Increased Ketone Levels
- ANSWERS-A. Hemoglobin A1C A client with a post op hip replacement has the following information on the care plan: Client will achieve a decrease in pain to a level 3 by discharge. Where on the care plan should the nurse put this information A. Under Nursing DX B. Under goal Section C. Under intervention/implementation D. Under evaluation
- ANSWERS-B. Under goal Section
Which of the following is an early sign of compartment syndrome A. Increased Pain B. No Pulse C. Muscle Weakness D. Swelling of the Extremities
- ANSWERS-A. Increased Pain The client with a cough and fever is coming in the ambulatory care clinic for care. Which information should the nurse give the receptionist prior to the clients arrival A. Give the client a mask as soon as the client arrives B. Give everyone in the clinic a ask before the client arrives C. Cancel the appointment and tell the client to reschedule D. Place the client in close proximity to the other clients for comfort
- ANSWERS-A. Give the client a mask as soon as the client arrives The ambulatory care nurse is conducting the medication reconciliation for a client who was recently prescribed warfarin. What medication should the nurse tell the client to discontinue A. Iron Supplements B. Vitamin D C. Metoprolol D. Gingko Biloba
- ANSWERS-D. Gingko Biloba Which of the following statements made by the client about primary care prevention of Type I DM is correct A. If I take metformin as ordered I will be ok B. The only thing I need to do is to lower my calories C. If I increase my physical activities I will reduce my chance of having Type I DM
A. LDL Particles B. HDL particles C. Triglycerides D. Amino Acids
- ANSWERS-A. LDL Particles If a patient is scheduled for a right breast biopsy, but no site markings are visible when the patient is draped, the ambulatory care nurse should A. Assume the surgeon knows the correct site B. Stop the procedure until correct site is confirmed C. Make a note to remind staff to mark surgical sites D. Ask surgeon if the side is correct
- ANSWERS-B. Stop the procedure until correct site is confirmed When reviewing data as part of process improvement, the ambulatory care nurse notes an improvement in patient satisfaction from 78-92% after the addition of a new staff, this change is probably a A. Random Event B. Common cause Variation C. Special Cause Variation D Statistical Aberration
- ANSWERS-C. Special Cause Variation When assessing key performance measures as part of the ambulatory care process improvement assessment, which of the following relates to access of care A. FTE support staff per MD B. Rejection/Denial rate of insurance C. Immunization rates
D. Average telephone wait time
- ANSWERS-D. Average telephone wait time Which of the following is a nonverbal clue that a patient may be anxious A. Patient rubs his eyes and yawns B. Patient has flat aspect and responds in monosyllables C. Patient pupils are constricted and patient sniffs repeatedly D. Patient rubs hands together constantly
- ANSWERS-D. Patient rubs hands together constantly The Ambulatory care nurse is concerned that staff members are not listening carefully or patiently to older patients. Which of the following interactions indicates a listening fault A. Staff person finishes a patients sentences B. Staff person ask additional questions when the patient stops speaking C. Staff person focuses completely on patient when patient speaks D. Staff persons addresses the questions to patient instead of caretaker
- ANSWERS-A. Staff person finishes a patients sentences If blood specimens are drawn in the ambulatory care center and transported to the library for testing, which of the following specimens must be protected from exposure to light A. CBC B. Bilirubin C. Glucose D. Parathyroid Hormone
- ANSWERS-B. Bilirubin priority intervention for a toddler with epiglottitis
- ANSWERS-prepare the toddler for nasotracheal intubation/tracheostomy
- ANSWERS-erythema infectiosum (fifth disease), lasts 1-4 days splenomegaly
- ANSWERS-infectious mononucleosis ways to prevent acute asthma attacks
- airconditioners
- NO cough suppressants
- wet mop bare floors weekly
- keep child indoors when mowing the yard findings associated with bacterial meningitis
- ANSWERS--increased CSF pressure
- increased WBC count
- increased protein concentration
- decreased glucose level rheumatic fever nursing interventions - ANSWERS--maintain on bed rest
- administer salicylates nursing interventions for a child with heart failure - ANSWERS--small, frequent meals
- restrict play activities to minimize energy expenditure
- weigh the child daily
- maintain the bed in semi-Fowler's position sign of a hemolytic transfusion reaction - ANSWERS-flank pain
pneymococcal polysaccharide - ANSWERS-administered to children 2-18 years old who have a specific high-risk condition that places them at risk for an infection with Streptococcus pneumococci, which causes meningitis, otitis media, and pneumonia. meningococcal polysaccharide - ANSWERS-all incoming college students should receive this vaccine When is the final rotavirus dose administered? - ANSWERS-before 8 months of age When is the herpes zoster immunization given? What is it for? - ANSWERS-adults over 60 years old to prevent shingles What is the most common food allergy in children? - ANSWERS-cow's milk What positions may be used during a lumbar puncture? - ANSWERS--side lying position
- flexed sitting position What position is used for a femoral venipuncture? - ANSWERS-supine with legs in a frog position How is Hirshprung's disease diagnosed? - ANSWERS-biopsy on a small amount of tissue from the colon How is pyloric stenosis diagnosed? - ANSWERS-an upper GI series nursing interventions post op following a surgical repair of cleft lip and palate - ANSWERS-- avoid placing objects in the infant's mouth
- gently suction the mouth with a bulb syringe PRN to maintain a patent airway
- avoid feedings just before bedtime
- at rice cereal to the milk/formula to thicken the feedings and decrease the episodes of vomiting phenytoin - ANSWERS-seizure medication lab findings in a child with acute lymphocytic leukemia - ANSWERS--low platelet count
- low RBC count
- very high WBC count
- low Hct level What can a child with rheumatic fever take to control inflammation in the joints to decrease joint pain? - ANSWERS-aspirin treatment for intussusception - ANSWERS-barium enema What does an increased Hct level indicate? - ANSWERS-dehydration osteomyelitis - ANSWERS-infection in the bone minimal change nephrotic syndrome - ANSWERS-kidney disease in which large amounts of protein are lost in urine What can reduce the absorption and effects of lead? - ANSWERS-adequate intake of calcium and iron What happens to the voice during epiglottitis? - ANSWERS-it becomes hoarse
sodium normal range - ANSWERS- 135 - 145 manifestations of pneumonia in infants - ANSWERS-nasal flaring increased WBCs diarrhea abdominal distention What is an expected finding of endocarditis? - ANSWERS-headache What is an expected finding in a school-age child with glomerulonephritis? - ANSWERS-brown colored urine McBurney's point - ANSWERS--lower right abdomen
- pain in appendicitis Celiac disease expected findings - ANSWERS--steatorrhea
- distended abdomen
- weight loss What type of vomiting is common with pyloric stenosis? - ANSWERS-projectile vomiting What is used to treat scabies lesions? - ANSWERS-permethrin 5% cream manifestation of pertussis - ANSWERS-dry hacking cough manifestation of acute streptococcal pharyngitis - ANSWERS-inflamed throat with exudate
Can a child with celiac disease eat malt? - ANSWERS-no, it has gluten in it What should be done after administering PO suspension digoxin? - ANSWERS-brush the child's teeth manifestations of digoxin toxicity - ANSWERS-nausea, vomiting, decreased appetite indications of brainstem herniation - ANSWERS-Cushing's triad: htn, bradycardia, decreased respirations interventions for lead toxicity - ANSWERS--diet rich in calcium, vitamin C, and iron
- chelation therapy for lead levels 45 mcg/dL or greater expected findings following an appendectomy - ANSWERS--absence of peristalsis
- WBC >10,000/mm indications of early septic shock - ANSWERS-fever & chills plan of care pre-op for a preschooler with a Wilm's tumor - ANSWERS--avoid palpating the abdomen
- auscultate bowel sounds
- do not engage in play with other children - increases risk of injury
- do not explain about pain till post op so as not to increase anxiety indications of SIADH - ANSWERS--low sodium level
- high urine specific gravity
- decreased urine output
- hypoosmolality
- overhydration
- mental confusion
- bounding pulses
- increased BP
- tachycardia An allergy to neomycin, eggs, or gelatin contraindicates what vaccine? - ANSWERS-MMR wheezes - ANSWERS-high-pitched, musical, whistling-like sounds heard primarily on expiration as air passes through and vibrates narrowed airways crackles - ANSWERS--high-pitched, short, and noncontinuous sounds heard usually at the end of inspiration
- occur when air expands deflated alveoli or when the passage of air through small airways is disrupted post op care following a cardiac catheterization - ANSWERS--avoid strenuous activities but may attend school the next day
- resume regular diet
- keep site clean and dry for at least 3 days and do not take a tub bath for those 3 days
- remove the pressure dressing the day after the procedure and apply a new adhesive bandage strip daily for at least the next 2 days mononucleosis - ANSWERS--caused by Epstein-Barr virus
- no known specific txt
- monospot to diagnose
- acute s/s last approx. 10 days with fatigue lasting up to 4 wks
- complications: splenomegaly - restrict activities for 2-3 months to avoid rupturing the spleen
- increase fluids when sick desmopressin - ANSWERS-used to treat hyposecretion of ADH CF diet management - ANSWERS--administer pancreatic enzymes within 30 min of meals and snacks
- increase pancreatic enzymes if steatorrhea occurs
- encourage fluid intake
- increase fat content to 40% of total calories 9. A nurse is caring for a preschool-age child who is dying. Which of the following findings is an age-appropriate reaction to death by the child? (Select all that apply.) a. The child views death as similar to sleep. b. The child is interested in what happens to his body after death. c. The child recognizes that death is permanent. d. The child believes his thoughts can cause death. e. The child thinks death is a punishment. a. The child views death as similar to sleep. b. The child is interested in what happens to his body after death. e. The child thinks death is a punishment. 9. A nurse is teaching the parent of an infant about home safety. Which of the following information should the nurse include? a. Use a wheeled infant walker. b. Place soft pillows around the edge of the infant's crib. c. Position the car seat so it is rear-facing. d. Secure a safety gate at the top and bottom of the stairs. e. Maintain the water heater temperature at 49° C (120° F). c. Position the car seat so it is rear-facing. d. Secure a safety gate at the top and bottom of the stairs. e. Maintain the water heater temperature at 49° C (120° F). 9. A nurse is caring for an adolescent who is receiving pain medication via a PCA pump. When the nurse assess the client's pain at 0800, the client describes the pain as a 3 on a scale of 1 to 10. At 100, the client describes the pain as a 5. The nurse discovers the client has not pushed the button to deliver medication in the past 2 hr. Which of the following actions should the nurse take? a. Ask the provider to discontinue the PCA so the nurse can administer PRN pain medication. b. Suggest the client's parent push the button for the client if the parent thinks the adolescent is having pain. c. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to 10.
Reinforce teaching with the client about how to push the button to deliver themed. Reinforce teaching with the client about how to push the button to deliver themed.
9. A nurse is assessing a 12-month-old male infant's vital signs during a well- child visit. The infant is in the 90th percentile of height. Which of the following findings should the nurse report to the provider? a. Heart rate 175/min b. Respiratory rate 26/min c. Blood pressure 88/40 mm Hg) d. Temperature 37.6° C (99.7° F Heart rate 175/min 9. A nurse is teaching the parent of a 12-month-old infant about nutrition. Which of the following statements by the parent indicates a need for further teaching? a. "I can give my baby 4 ounces of juice to drink each day." b. "I will offer my baby dry cereal and chilled banana slices as snacks." c. "I am introducing my baby to the same foods the family eats." d. "My infant drinks at least 2 quarts of skim milk each day." "My infant drinks at least 2 quarts of skim milk each day." 9. A nurse is assisting a provider during a femoral venipuncture on a toddler. The nurse should place the child in which of the following positions? a. Side-lying b. Semi-recumbent c. Flexed sitting d. Supine Supine 9. A nurse is assessing a 9-month-old infant during a well-child visit. Which of the following findings indicates that the infant has a developmental delay? a. Creeps on hands and knees b. Inability to vocalize vowel sounds c. Uses crude pincer grasp d. Stands by holding onto support Inability to vocalize vowel sounds 9. A nurse is preparing to administer a liquid medication to an infant. Which of the following actions should the nurse take? a. Administer the medication while the infant is supine. b. Give the medication at the side of the infant's mouth. c. Add the medication to a full bottle of the infant's formula. d. Administer the medication slowly while holding the nares closed. Give the medication at the side of the infant's mouth. 9. A nurse on a pediatric unit is reviewing the health record of a client who is demonstrating increasing levels of stress after admission. The nurse should identify which of the following findings as a risk factor for a stress-related reaction to hospitalization? a. Age 10 b. First hospitalization
of the following instructions should the nurse include in the teaching?a) "You may bathe your infant in an infant bathtub when you go home." "Apply hydrocortisone cream to your infant's penis daily." "You should clamp your infant's stent twice daily." "Allow the stent to drain directly into your infant's diaper." "Allow the stent to drain directly into your infant's diaper." A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry.The nurse should secure the sensor to which of the following areas on the infant? Wrist Great toe Index finger Heel Great toe A nurse is caring for a school-age child who has primary nephrotic syndrome and is taking prednisone. Following I week of treatment, which of the following manifestations indicates to the nurse that the medication is effective? a Decreased edema Increased abdominal girth Decreased appetite Increased protein in the urine a Decreased edema
