ATI PN Nursing Care of Children Proctored Exam (12 Versions) 2020/2021 | Questions & Answers ⭐⭐⭐⭐⭐ Guaranteed A+: Latest 2023:2024

ATI PN NURSING CARE OF CHILDREN PROCTORED EXAM

VERSION 1

A nurse is caring for a school-age child who is receiving a blood transfusion. Which of the following manifestations should alert the nurse to a

possible hemolytic transfusion reaction?

a. Laryngeal edema

b. Flank pain

c. Distended neck veins

d. Muscular weakness

Answer- b. Flank pain. The nurse should recognize that flank pain is caused by the breakdown of RBCs and is an indication of a hemolytic

reaction to the blood transfusion.

A- Laryngeal edema is an indication of an allergic reaction to the blood transfusion.

C- Distended neck veins are an indication of circulatory overload, which is a complication of a blood transfusion.

D- Muscle weakness is an indication of an electrolyte disturbance, which is a complication of a blood transfusion.

A community health nurse is assessing an 18-month-old toddler in a community day care. Which of the following findings should the nurse

identify as a potential indication of physical neglect?

a. Resists having an axillary temperature taken

b. Exhibits withdrawal behaviors when her parent leaves

c. Has multiple bruises on her knees

d. Poor personal hygiene

Answer- d. Poor personal hygiene. Poor personal hygiene in a toddler is a potential indication of physical neglect. Because toddlers are still

dependent on their parents for help with hygiene needs, poor personal hygiene indicates a lack of supervision.

A- The toddler has begun to develop a sense of body image and boundaries and can be resistant to intrusive assessments such as assessing the

mouth or ears, or taking an axillary temperature. Therefore, this finding is not an indication of physical neglect.

B- Separation anxiety is an expected finding for a toddler. The child of this age can become fearful and exhibit regressive behaviors when left

alone with strangers and separated from her parents; therefore, this finding is not an indication of physical neglect.

C- The 18-month-old toddler has accomplished the gross motor skills of standing and walking and has begun to try to run but falls easily and can

have bruises on her knees. Therefore, this finding is not an indication of physical neglect.

A nurse is caring for a school-age child who is receiving chemotherapy and is severely immunocompromised. Which of the following actions

should the nurse take?

a. Use surgical asepsis when providing routine care for the child.

b. Administer the measles, mumps, rubella (MMR) vaccine to the child.

c. Screen the child's visitors for indications of infection.

d. Infuse packed RBCs.

Answer- c. Screen the child's visitors for indications of infection. The child who is severely immunocompromised is unable to adequately respond

to infectious organisms resulting in the potential for overwhelming infection; therefore, the nurse should screen the child's visitors for

indications of infection.

A- It is not necessary for the nurse to use surgical asepsis when providing direct care. Strict hand washing and medical asepsis are recommended

to prevent the spread of infection.

B- It is contraindicated for a child who is severely immunocompromised to receive the MMR vaccine because it is a live virus vaccine and the

child may not be able to build adequate antibodies to prevent infection with the organism.

D- A child who is immunocompromised as a result of chemotherapy will have a decreased neutrophil count. The nurse should plan to infuse

packed RBCs to the child who is anemic. However, packed RBCs will not increase the child’s neutrophil count.

A nurse is teaching a school-age child who has a severe allergy to bee venom and his parent about epinephrine. Which of the following

instructions should the nurse include in the teaching?

a. Use a second dose if the first dose of epinephrine does not completely reverse the symptoms.

b. Store unused epinephrine syringes in the refrigerator.

c. Shake the epinephrine syringe prior to use to dissolve the precipitate.

d. Administer the medication subcutaneously in the back of the arm.

Answer- a. Use a second dose if the first dose of epinephrine does not completely reverse the symptoms. A biphasic response, in which the child

will appear to recover and then experience a recurrence of symptoms, is possible with some allergic reactions. The nurse should instruct the

parent and child to use a second dose if the first dose does not resolve all the symptoms.

B- The nurse should instruct the parent and child to store epinephrine in a dark area at room temperature. Refrigeration of an epinephrine

syringe can result in failure of the injection mechanism to work.

C- The nurse should instruct the child and his parent that the formation of precipitate or a brown coloration to the solution is an indication that

the medication should be replaced and not used.

D- The nurse should instruct the child and his parent to inject the medication intramuscularly into the anterolateral aspect of the middle thigh.

A nurse is assessing a school-age child who has appendicitis with possible perforation. The nurse should identify which of the following as a

manifestation of peritonitis?

a. Hyperactive bowel sounds

b. Abdominal distention

c. Bradycardia

d. Polyuria

Answer- b. Abdominal distention. The nurse should recognize that abdominal distention is a manifestation of peritonitis. Peritonitis is an

inflammation of the lining of the abdominal wall. This inflammation in the abdomen, along with the ileus that develops, causes abdominal

distention.

A- Hypoactive bowel sounds are a manifestation of peritonitis. The peritoneal inflammation caused by the feces and bacteria released from the

perforated appendix results in the development of an ileus, and a decrease in bowel motility.

C- Tachycardia is a manifestation of peritonitis resulting from infection and fluid shifts within the abdomen, which causes hypovolemia.

D- Polyuria occurs with an elevated glucose level and is not a manifestation of peritonitis.

A nurse is reviewing the laboratory report of a 6-year-old child who is receiving chemotherapy. Which of the following laboratory values

should the nurse report to the provider?

a. Hgb 8.5 g/dL

b. WBC 9,500/mm3

c. Prealbumin18 mg/dL

d. Platelets 300,000/mm3

Answer- a. Hgb 8.5 g/dL. The child receiving chemotherapy is at risk for anemia due to the chemotherapy effects on the blood forming cells of

the bone marrow. The development of anemia is diagnosed through laboratory testing of hemoglobin and hematocrit levels. The nurse should

recognize that a hemoglobin level of 8.5 g/dL is below the expected reference range for a 6-year-old child and should be reported to the

provider.

B- The child receiving chemotherapy is at risk for infection due to the myelosuppressing effects of the medication used to treat the cancer. The

presence of infection can be evaluated through body temperature, redness, edema, warmth, or drainage of wound or IV sites, as well as through

measurements of WBC and absolute neutrophil counts. A WBC count of 9,500/mm3 is within the expected reference range for a 6-year-old child.

C- The child receiving chemotherapy is at risk for malnutrition as a result of nausea and vomiting, stomatitis, and pain. Nutritional status can be

evaluated through prealbumin, albumin, and transferrin levels. A prealbumin level 0f 18 mg/dL is within the expected reference range for a 6-

year-old child.

D- The child receiving chemotherapy is at risk for hemorrhage due to the thrombocytopenic effects of the medications used to treat cancer. The

development of thrombocytopenia is diagnosed through laboratory testing of platelet levels. A platelet count of 300,000/mm3 is within the

expected reference range for a 6-year-old child.

A nurse is caring for a school-age child who is receiving a cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of

the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first?

a. Prednisone

b. Epinephrine

c. Diphenhydramine

d. Albuterol

Answer- b. Epinephrine. This child is most likely experiencing an anaphylactic reaction to the cefazolin. According to evidence-based practice the

nurse should first administer epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that stimulates the heart, causes

vasoconstriction of blood vessels in the skin and mucous membranes, and triggers bronchodilation in the lungs.

A- Prednisone is an anti-inflammatory agent that can treat severe inflammation Although it will benefit a child who is having an anaphylactic

reaction, it is not the first medication the nurse should administer.

C- Even though histamines are not the major mediators of an anaphylactic reaction, administering an antihistamine such as diphenhydramine

can help to decrease the allergic reaction. However, it is not the first medication the nurse should administer.

D- Albuterol is a beta adrenergic agonist that can treat acute bronchospasms. Although albuterol will improve the child's breathing, it is not the

first medication the nurse should administer.