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ATI PEDIATRIC EXAM TEST BANK EVERYTHING ON ATI PEDIATRICS INCLUDING NCLEX 350+ QUESTIONS AND CORRECT ANSWERS A+GRADE WITH EXPLANATIONS$14.49
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ATI PEDIATRIC EXAM TEST BANK EVERYTHING
ON ATI PEDIATRICS INCLUDING NCLEX 350+
QUESTIONS AND CORRECT ANSWERS A+GRADE
WITH EXPLANATIONS
1. Molly, with suspected rheumatic fever, is admitted to the pediatric unit.
When obtaining the child’s history, the nurse considers which information
to be most important?
o A. A fever that started 3 days ago
o B. Lack of interest in food
o C. A recent episode of pharyngitis
o D. Vomiting for 2 days
Answer
Correct Answer: C. A recent episode of pharyngitis
A recent episode of pharyngitis is the most important factor in establishing
the diagnosis of rheumatic fever. Activation of the innate immune system
begins with a pharyngeal infection that leads to the presentation of S.
pyogenes antigens to T and B cells. CD4+ T cells are activated and
production of specific IgG and IgM antibodies by B cells ensues
(Cunningham, Pathogenesis of group A streptococcal infections, 2000).
• Option A: The most common presenting features of ARF are
fever (>90% of patients) and arthritis (75% of patients). The
most serious manifestation is carditis (>50% of patients)
because it can lead to chronic rheumatic heart disease—while
all other clinical features fully resolve, often within weeks.
• Option B: The child with ARF may exhibit a lack of interest in
food, but this cannot be specific only to ARF. The main clinical
manifestation of ARF carditis reflects the involvement of the
endocardium, which presents as valvulitis of the mitral valve
(mitral regurgitation) and, less frequently, of the aortic valve
(aortic regurgitation).
• Option D: Although the child may have a history of vomiting,
this finding is not specific to rheumatic fever. A number of
, other clinical features are often observed in patients with ARF
but are not included as manifestations in the Jones Criteria,
including lethargy, abdominal pain, and epistaxis, as well as
rapid sleeping pulse rate and tachycardia out of proportion to
fever.
2. 2. Question
1 point(s)
The nurse is aware that the most common assessment finding in a child
with ulcerative colitis is:
o A. Intense abdominal cramps
o B. Profuse diarrhea
o C. Anal fissures
o D. Abdominal distention
Answer
Correct Answer: B. Profuse diarrhea
The most common assessment finding in a child with ulcerative colitis is
profuse diarrhea. The main symptom of ulcerative colitis is bloody diarrhea,
with or without mucus. Other symptoms include blood in the toilet, on
toilet paper, or in the stool. Characteristically, it involves inflammation
restricted to the mucosa and submucosa of the colon. Typically, the disease
starts in the rectum and extends proximally in a continuous manner.
• Option A: Ulcerative colitis causes intense abdominal cramps.
Associated symptoms also include urgency or tenesmus,
abdominal pain, malaise, weight loss, and fever, depending on
the extent and severity of the disease. The onset of the disease
is typically gradual, and patients will likely experience periods
of spontaneous remission and subsequent relapses.
• Option C: Ulcerative colitis causes anal fissures. There are
some extraintestinal manifestations (EIMs) that are also
present in 10% to 30% of patients with ulcerative colitis.
Extraintestinal manifestations associated with disease activity
include episcleritis, scleritis, and uveitis, peripheral
arthropathies, erythema nodosum, and pyoderma
gangrenosum.
, • Option D: Abdominal distensions are more common in
Crohn’s disease. Patients with flare-ups of Crohn’s disease
typically present with abdominal pain (right lower quadrant),
flatulence/bloating, diarrhea (can include mucus and blood),
fever, weight loss, anemia. In severe cases, perianal abscess,
perianal Crohn’s disease, and cutaneous fistulas can be seen.
3. 3. Question
1 point(s)
When developing a plan of care for a hospitalized child, nurse Mary knows
that children in which age group is most likely to view illness as a
punishment for misdeeds?
o A. Infancy
o B. Preschool age
o C. School age
o D. Adolescence
Answer
Correct Answer: B. Preschool age
Preschool-age children are most likely to view illness as a punishment for
misdeeds. When children in this age group become seriously ill, they may
think it’s punishment for something they did or thought about. They don’t
understand how their parents could not have protected them from this
illness.
• Option A: Separation anxiety, although seen in all age groups,
is most common in older infants. Keeping a consistent routine
is important for a baby and their caregivers. Because babies
can’t talk about their needs, fear is often expressed by crying.
• Option C: Fear of the unknown, loss of control, and separation
from family and friends can be the school-aged child’s main
sources of anxiety and fear related to death. They may fear
their own death because of the uncertainty of what happens
to them after they die.
• Option D: Fear of death is typical of adolescents. Adolescents
also fear mutilation. Most teens are starting to establish their
identity, independence, and relation to peers. The main theme
, in teens is feeling immortal or being exempt from death. Their
realization of their own death threatens all of these objectives.
4. 4. Question
1 point(s)
A female child, age 6, is brought to the health clinic for a routine checkup.
To assess the child’s vision, the nurse should ask:
o A. “Do you have any problems seeing different colors?”
o B. “Do you have trouble seeing at night?”
o C. “Do you have problems with glare?”
o D. “How are you doing in school?”
Answer
Correct Answer: D. “How are you doing in school?”
A child’s poor progress in school may indicate a visual disturbance. Most
children do not have 20/20 vision until after six years of age, but at any
age, visual acuity should be approximately equal between the eyes. The
Multi-Ethnic Pediatric Eye Disease Study provided updated norms for visual
acuity in children two and a half to six years of age.
• Option A: This option is more appropriate to ask when
assessing vision in a geriatric patient. The American Academy
of Ophthalmology recommends the use of an eye chart by
three years of age. Picture charts (Lea or Allen) or matching
charts (HOTV) can be used in preliterate children, and letter
charts (Snellen) can be used in literate children.
• Option B: This option is more appropriate to ask when
assessing vision in a geriatric patient. Vision screening in
children is an ongoing process with different components
occurring at each well-child visit. It can reveal conditions
commonly treated in primary care and can aid in the
discussion of visual concerns with parents or caregivers.
• Option C: This option is more appropriate to ask when
assessing vision in a geriatric patient. The American Academy
of Family Physicians and the U.S. The Preventive Services Task
Force recommends vision screening at least once in all
children three to five years of age (B recommendation).
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