ATI PEDIATRICS PROCTORED LATEST 2023 TEST BANK 100 REAL EXAM QUESTIONS AND DETAILED ANSWERS|AGRADE 1. An assistive personnel (AP) on a pediatric unit brings to the attention of the nurse several client measurements obtained with the morning vital signs. Which of the following clients should the nurse plan to visit first? a. 7-year -old client with diabetes insipidus and a urine specific gravity of 1.002 R A specific gravity of 1.002 is much lower than the expected reference range (1.005 to 1.030) and indicates urine output that is extremely dilute. The client is losing excessive water and is in danger of hypovolemia. Therefore, the nurse should plan to visi t this client first. b. 1-year -old client with roseola and a temperature of 39°C (102.2°F) R A fever of 39°C (102.2°F) is an expected finding in a child with roseola; therefore, this is not the client that the nurse should plan to visit first. c. 4-year -old client with status asthmaticus and a pulse oximetry of 95% R This value, 95%, is considered within the expected range; therefore, this is not the client that the nurse should plan to visit first. d. 10-year -old client with sickle cell anemia and a pain rating of 6 out of 10 R A pain level of 6 is not unexpected or life threatening. Therefore, this is not the client that the nurse should plan to visit first. 2. A nurse is caring for an infant who is dehydrated and requires therapy. The nurse should monitor the infant's response to therapy by a. Weighing the infant at the same time every day. R Weight is the most sensitive indicator of hydration status for clients of all ages. Weight is the only measurement that reflects both measurable fluid balance changes and incidental fluid loss. b. Taking the infant's vital signs every 2 hr. R Vital signs are not a reliable indicator of hydration status. c. Measuring the infant's head circumference twice a day. R Measuring head circumference gives no useful information regarding the hydration status of the infant. d. Counting the number of wet diapers every shift. R Counting wet diapers is inadequate to accurately determine the hydration status of the infant. 3. A nurse is caring for a preterm newborn who is in an incubator. The nurse should make sure that the maximum oxygen concentration to deliver to this client is a. 30%. R This is a safe oxygen concentration to deliver to a preterm newborn, but not the maximum. Of course, the nurse should make sure the newborn receives the oxygen concentration the provider prescribes b. 40%. R Oxygen concentrations higher than 40% can cause retinal damage and visual impairment. This is the maximum concentration to delive r c. 50%. R This is an unsafe oxygen concentration to deliver to a preterm newborn. The nurse should make sure the newborn receives the oxygen concentration the provider prescribes d. 60%. R This is an unsafe oxygen concentration to deliver to a preterm newborn. The nurse should make sure the newborn receives the oxygen concentration the provider prescribes. 4. A nurse is collecting data from an infant. Which of the following is a clinical manifestation of pyloric stenosis? a. Absent bowel sounds R Visible gastric peristaltic waves moving from the left to the right are a clinical manifestation of pyloric stenosis. b. Increased sodium level R Vomiting causes a depletion of fluid and electrolytes, therefore a decrease in serum sodium levels is a clinical manifestation of pyloric stenosis. c. Projectile vomiting after feedings R Pyloric stenosis is a narrowing and thickening of the pyloric canal between the stomach and the duodenum resulting in projectile vomiting. d. Golf ball-sized mass over the left quadrant R An olive -shaped mass is palpable right of the umbilicus is a clinical manifestation of pyloric stenosis. 5. A nurse is caring for a child with acute glomerulonephritis. Which of the following should be the first action by the nurse? a. Place the child on a no-salt-added diet. R Placing the child on a no-salt-added diet is an appropriate action; however, it is not the first action the nurse should take. b. Check the child’s daily weight. R The first action the nurse should take using the nursing process is to collect data from the client; therefore, checking the child’s daily weight should be the first action the nurse takes. c. Educate the parents about potential complications. R Educating the parents about potential complications is an appropriate action; however, it is not the first action the nurse should take. d. Maintain a saline -lock. R Maintaining a saline -lock is an appropriate action; however, it is not the first action the nurse should take. 6. A nurse working at a clinic speaks on the telephone with the parent of a 2-month -old infant. The parent tells the nurse that the infant has projectile vomiting followed by hunger after meals. Which of the following responses by the nurse is appropriate? a. "Bring your infant into the clinic today to be seen." R The manifestations of worsening projectile vomiting, which started at about 6 weeks of age, and the child acting hungry afterwards, are indicative of pyloric stenosis. The baby needs to be examined in the clinic as soon as possible by the provider. b. "Burp your child more frequently during feedings." R This is not an appropriate response by the nurse. c. "Give your infant an oral rehydrating solution." R This is not an appropriate response by the nurse. d. "You might want to try switching to different formula." R This is not an appropriate response by the nurse. 7. A nurse is reinforcing teaching with the parent of a child scheduled for the initial surgery to treat Hirschsprung's disease. The nurse knows that the parent understands the goal of the surgery when the parent states, a. "I'm glad that the ostomy is only temporary." R Hirschsprung's disease is characterized by an area of the large intestine without innervation. The child will probably require 2 surgeries over 18 months to 2 years before normal bowel function is achieved. The initial surgery is for the creation of an ostomy, which relieves the obstructed area and allows the bowel distal to the ostomy to rest. b. "I'm glad my child will have normal bowel movements now." R It will probably take 18 months to 2 years for the child to achieve normal bowel function. c. "I want to learn how to use the feeding tube as soon as possible." R Placement of a feeding tube is not a typical part of the treatment plan for Hirschsprung's disease. d. "The operation will straighten out the kink in the intestine." R This statement indicates a lack of understanding of the pathophysiology of this disease. 8. A school -age child is brought to the emergency department with a 2 -day history of nausea, vomiting, and report of severe right lower quadrant pain. The child's WBC is 17,000/mm3 so appendicitis is suspected. Which of the following statements made by the child is most concerning to the nurse? a. “I am scared and I want to go home.” R Many children are frightened by the health care setting. Since this is not unexpected, this is not the most concerning statement to the nurse. b. “I am hungry and thirsty.”
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