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Term
A nurse in the ED is auscul tating the lungs of an adolescent who is
experiencing dyspnea. The nur se shoul d identify the sound as which of
the following ?1 of 66
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ATI PEDS NGN PROCTORED NEWEST 2024 COMPLETE 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ B
The nur se shoul d avoid pl acing the sensor on the wrist because this placement will
result in an ina ccurate reading.
The nur se shoul d secur e the sensor to the great toe of the inf ant and then pl ace a
snug- fitting sock on the foot to hold the sensor in pl ace. The nur se shoul d also
check the sk in under the sensor site frequentl y for temper ature, color, and the
presence of a pulse.
The nur se shoul d secur e the sensor to the inde x finger of a child and then use a
self-adhering b anda ge to hold the sensor in pl ace; ho wever, this site is not
recommended for pulse oximetr y of an inf ant.
The nur se shoul d avoid pl acing the sensor on the heel of the inf ant's foot because
this placement will result in an ina ccurate reading.
A
The nur se shoul d place the inf ant in a knee-ches t position during a hyper cyanotic
spell to decrease the return of desa turated venous blood from the legs and to
direct more blood into the pul monar y artery by increasing s ystemic vascul ar
resistance .
The nur se shoul d adminis ter morphine IV to the inf ant, instead of meperidine, to
decrease infundibul ar spasms that cause a decrease in pul monar y blood flow and
right-to-left shunting.
The nur se shoul d continue the adminis tration of IV fluids during a hyper cyanotic
spell to decrease the viscosity of the inf ant's blood, which decreases the risk of a
cerebrovascul ar accident .
The nur se shoul d apply oxygen at 100% via face mask to assist with dilation of the
pulmonar y artery and impr ove oxygen suppl y to the br ain. Whee zesMY ANSWER The nur se shoul d identify the sound during auscul tation
as whee zes, which are high-pit ched, musical or whistling-like sounds hear d
primaril y on expiration as air passes through and vibrates narr owed airways.
CracklesThe nur se shoul d identify crackles as high-pit ched, short , and
noncontinuous sounds usual ly hear d at the end of inspir ation. Crackles occur
when air expands deflated alveoli or when the p assage of air through smal l
airways is disrupt ed.
Pleural friction rub The nur se shoul d identify a pleural friction rub as a loud,
rough , grating sound that can be hear d during inspir ation or expiration. A
pleural friction rub occur s when the pl eurae are infl amed and the surf aces
rub together .
RhonchiThe nur se shoul d identify rhonchi as low-pitched, continuous sounds
that have a snor e-like quality and are usual ly louder during e xpiration.
Rhonchi occur when the larger airways are obstruct ed.
A
The nur se shoul d expect Kussmaul respir ations in a child who has diabetic
ketoacidosis. These deep and r apid r espir ations are the bo dy's attempt to elimina te
excess carbon dioxide and achieve a state of homeos tasis.
The nur se shoul d expect shallow respir ations in a child who has respir atory
depr ession r elated to opioid adminis tration. Ho wever, shal low respir ations are not
an expect ed finding in a child who has ketoacidosis.
The nur se shoul d expect paradoxic respir ations in a child who has flail ches t.
However, paradoxic respir ations are not an expect ed finding in a child who has
ketoacidosis.
The nur se shoul d expect perio ds of apnea lasting 20 seconds or more in a child
who has sleep apnea. Ho wever, perio ds of apnea are not an expect ed finding in a
child who has ketoacidosis.
Don't know? Term
A school nurse is providing an in ser vice for faculty about impr oving
educa tion for students who have ADHD . Which of the following
statements by a faculty member indica tes an under standing of the
teaching ?2 of 66
Term
A nurse is planning an educa tional program for school age children
and their parents about bicy cle safety. Which of the following
informa tion shoul d the nur se pl an to include?3 of 66Give this one a try later!
"I will plan to increase the amount of
home work I assign to students who
have ADHD ."
"I will give students who have ADHD
the same amount of time as other
students to compl ete tests."
"I will allow students who have ADHD
one r est break throughout the day."
"I will teach challenging
academic subjects to students
who have ADHD in the
morning."
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