ATI Pediatrics Test Bank

A nurse is assisting with the care of a child who is postoperative and received a transfusion

during a surgical procedure. Which of the following findings indicates the child is havig a

hemolytic reaction?

a) Chills and flank pain (Chills and flank pain are findings that indicate an

incompatibility of the transfused blood product with the client's blood. The nurse

should identify this finding as an indication that the child is having a hemolytic

reaction.)

b) Pruritus and flushing

c) Rales and cyanosis

d) Bradycardia and diarrhea

4. A guardian calls the clinic nurse after his child has developed symptoms of varicella

and asks when his child will no longer be contagious. Which of the following responses

should the nurse make?

a) “When your child no longer has a fever.”

b) “Three days after the rash started.”

c) “Six days after lesions appear if they are crusted.” (The nurse should inform the

guardian that a child will stop being contagious around 6 days after the lesions

appeared, as long as they are crusted over.)

d) “When your child’s lesions disappear.”

5. A nurse is collecting date from a child during a well-child visit. The nurse should

recognize that which of the following findings places the child at a higher risk for

abuse?

a) The child is 6 years old.

b) The child is male.

c) The child was born at 30 weeks of gestation. (The nurse should identify that

children who are born prematurely are at greater risk for abuse because of the

potential for impaired bonding during early infancy.)

d) The child was born via cesarean birth.

6. A nurse is reinforcing teaching with the guardian of a child who has a new diagnosis of

rheumatic fever. Which of the following statements by the guardian indicates an

understanding of the teaching?

a) “I should not give my child aspirin for pain or fever.”

b) “My child will take antibiotic for 6 months.”

c) “My child might have a period of irregular movement of the extremities.” (The

nurse should instruct the guardian that the child might experience chorea weeks or

months after the initial diagnosis. Chorea is a temporary lack of coordination and

the presence of sudden, irregular movements or periods of clumsiness.)

d) “I should expect there to be blood in my child’s urine.”

7. A nurse is collecting data from an infant during a well-child visit. Which of the

following sites should the nurse use when obtaining the infant’s heart rate?

a) Apical (The nurse should use the apical pulse to obtain the infant's heart rate and

count it for a full minute, because it gives a reliable rate and rhythm and provides

accurate baseline assessment data. In an infant, the apical heart rate is auscultated at

the fourth intercostal space lateral to the midclavicular line.)

b) Radial

c) Carotid

d) Femoral

8. A nurse is preparing a toddler for suturing of a minor facial laceration. The nurse

should place the toddler in which of the following restraints?

a) Mummy restraint (The nurse should use a mummy wrap when a short-term restraint

is needed for treatment of the toddler that involves the head and neck. The nurse

should always use the least amount of restraint necessary.)

b) Jacket restraint

c) Elbow restraint

d) Wrist restraint

9. A nurse is reinforcing dietary teaching with the parent of a 2-year-old toddler. Which

of the following should the nurse include in the teaching?

a) "It is recommended that the toddler consumes no more than 12 ounces of fruit juice

each day."

b) "An appropriate serving size is 1 tablespoon of food per year of age." (The nurse

should include that an appropriate serving size for a 2-year-old toddler is 1 tbsp of

food per year of age.)

c) "Introduce healthy finger foods like carrots and celery sticks."

d) "Encourage 5 cups of low-fat milk each day."

10. During a well-child visit, the parent of a toddler expresses concern to the nurse that

the toddler takes several hours to fall asleep at night. Which of the following

recommendations should the nurse make?

a) Vary the time the toddler goes to bed each night

b) Allow the toddler to watch television before bedtime

c) Provide the toddler with a favorite toy at bedtime. (The nurse should recommend to

the parent that providing the toddler with a favorite toy at bedtime will help the

toddler to feel more secure and facilitate sleep.)

d) Increase the toddler's activity prior to bedtime

11. A nurse is assisting with the care for a 7-month-old infant who has a cleft palate.

Which of the following actions should the nurse take to decrease the infant’s risk for

aspiration?

a) Feed the infant in supine position.

b) Encourage the mother to breastfeed the infant exclusively.

c) Burp the infant frequently during feedings. (Infants with a cleft palate have

difficulty creating a seal around a bottle. Burping the infant frequently, following

every ounce of fluid consumed, dissipates swallowed air and helps to prevent

aspiration.)

d) Perform nasotracheal suctioning if coughing occurs

12. A nurse is reviewing the laboratory values of a school-age child who has iron

deficiency anemia. Which of the following findings should the nurse expect?

a) Hgb 9.0 g/dL (The nurse should expect a child who has iron deficiency anemia to

have an Hgb level below the expected reference range of 9.5 to 15.5 g/dL. An Hgb

of 9.0 g/dL is below the expected reference range.)

b) Hct 37%

c) Iron 100 mcg/dL

d) Total iron binding capacity 325 mcg/dL

13. A nurse is reinforcing teaching about vital signs with the guardian of a 1-year-old

toddler. Which of the following statements by the guardian indicates an understanding

of the teaching?

a) "My child's pulse could increase to 150 beats a minute with activity.” (A pulse rate

of 150/min is within the expected reference range for a toddler during physical

activity.)

b) "My child's temperature should be 96.8 degrees Fahrenheit."

c) "My child should take 40 breaths a minute."

d) "My child's pulse could get as low as 60 beats a minute while asleep."

14. A nurse is caring for an adolescent who has acne and anew prescription for

isotretinoin. For which of the following adverse effects should the nurse monitor?

a) Hypersalivation

b) Depression (Clients taking isotretinoin can experience mental status changes, such

as suicidal thoughts, aggression, emotional lability, and depression. The nurse

should monitor the adolescent's mental status while taking isotretinoin.)

c) Bradycardia

d) Hyperreflexia

15. A nurse is reinforcing teaching about interventions for mild hypoglycemia with the

parent of a child who has diabetes mellitus. Which of the following statements by the

parent indicates that the teaching has been effective?

a) "I should administer a glucagon injection to my child."

b) "I should give my child 5 grams of a simple carbohydrate."

c) "I should give my child 4 ounces of orange juice followed by cheese and crackers."

(The parent should treat mild hypoglycemia with 10 to 15 g of a simple

carbohydrate, such as 4 oz. of orange juice, and follow it with a starch-protein

snack.)

d) "I should give my child a snack that is 10 percent of his daily caloric intake."

16. A nurse is collecting data from a 10-month-old infant. Which of the following findings

should the nurse report to the provider?

a) Pulls self to standing position

b) Moves by creeping on hands and knees

c) Takes intentional steps when standing

d) Sits with support by leaning on hands (The nurse should identify that sitting with

support can indicate a developmental delay, because an infant should be able to sit

unsupported by 8 months of age. Therefore, the nurse should report this finding to

the provider.)

17. A nurse is preparing to administer phenobarbital to a toddler who has a seizure

disorder and weights 10 kg (22 lb). The prescription reads phenobarbital sodium 2.5

mg/kg PO BID. Available is phenobarbital 20 mg/5 mL. How many mL should the

nurse administer with each dose? (Round to the nearest hundredth. Use a leading zero

if it applies. Do not use a trailing zero

Ratio and Proportion

6.26 mL

Step 1: What is the unit of measurement the nurse should calculate? mL

Step 2: What is the dose the nurse should administer? Dose to administer = Desired 2.5

mg/kg = 2.5 x 10 = 25 mg

Step 3: What is the dose available? Dose available = Have 20 mg

Step 4: Should the nurse convert the units of measurement? No

Step 5: What is the quantity of the dose available? 5 mL

Step 6: Set up an equation and solve for X.

Have/Quantity = Desired/X

20 mg/5 mL = 25 mg/X mL

X = 6.25

18. A nurse is caring for a child who has type 1 diabetes mellitus and has been receiving

insulin via subcutaneous infusion pump. Which of the following laboratory tests would

verify the average blood glucose level over the past 2 months?

a) Postprandial blood glucose

b) Fasting blood glucose

c) Glycosylated hemoglobin (Glycosylated hemoglobin provides an accurate average

of the client's blood glucose level over the past 120 days. This test can be used to

determine the effectiveness of, or compliance with, a treatment plan. It can also be

used to diagnose diabetes mellitus.)

d) Mean corpuscular hemoglobin

19. A nurse is reinforcing teaching with the guardian of a child who has a new

prescription for levalbuterol solution for use in a nebulizer. Which of the following

statements by the guardian indicates an understanding of the teaching?

a) "I should store the unused medication in the freezer."

b) "I should make sure I use the vial within 3 weeks of opening it from the foil

package."

c) "My child might be drowsy while taking this medication."

d) "My child might experience palpitations after taking this medication." (Palpitations

are an adverse effect of levalbuterol. If this occurs, the guardian should discontinue

the medication and notify the provider.

20. A nurse is collecting data from a 12-month-old infant during a well-child visit. At

birth, the infant’s weight was 3.6 kg (8 lb.) and his length was 50.8 cm (20 in). Based

on this data, whichof the following findings should the nurse expect?

a) The infant weighs 6.4 kg (14 lb)

b) The infant is 101.6 cm (40 in) long

c) The infant is 76.2 cm (30 in) long (The nurse should expect a length of 76.2 cm (30

in), because the infant's length should increase by about 50% by 12 months of age.)

d) The infant weighs 14.5 kg (32 lb)

21. A nurse is reinforcing teaching about home care with the guardian of a 14-month-old

toddler who has spastic cerebral palsy. Which of the following statements by the

guardian indicates an understanding of the teaching?

a) "I will perform daily stretching exercises to my toddler's affected muscles." (The

nurse should reinforce that performing stretching exercises of the toddler's affected

muscles will prevent muscle contractures.)

b) "I will ensure my toddler avoids activities that involve repetitive joint movements."

c) "I will place my toddler on his stomach to nap after meals."

d) "I will give my toddler pain medication just after he performs strenuous activities."

22. A nurse is assisting with the development of a health promotion program for the

guardians of adolescents. Which of the following information about adolescents should

the nurse recommend to include in the program?

a) The sleep patterns of adolescents are well established.

b) The percentage of adolescents that consider suicide is higher for males than for

females.

c) The leading cause of death in adolescents is physical injury. (The nurse should

recommend including this information, because injuries from motor-vehicle crashes

are the leading cause of death in the adolescent population.)

d) The caloric intake needs of adolescents are less than that of school-age children.

23. A nurse in a pediatric clinic is caring for an infant who has heart failure and a

prescription for digoxin. Which of the following statements by the parent indicates the

desired therapeutic effect of the medication?

a) "My baby is breathing easier than she used to." (The nurse should identify that the

desired effect of digoxin is to increase cardiac output and decrease venous pressure

and pulmonary edema, which will reduce respiratory demands.)

b) "My baby is taking longer naps."

c) "My baby is having fewer wet diapers."

d) "My baby's heart rate is faster than it used to be."

24. A nurse is contributing to the plan of care for a 10-month-old infant who is

postoperative following cleft palate repair. Which of the following actions should the

nurse include in the plan of care?

a) Place the infant in side-lying position. (The nurse should place the infant in sidelying position to promote healing and prevent injury to the surgical site.)

b) Offer the infant liquids with a straw.

c) Prohibit the guardian from holding the infant for 8 hr.

d) Cleanse the suture line with a lemon glycerin swab.

25. A nurse is caring for a toddler following a tonsillectomy. Which of the following is the

priority finding that the nurse should report to the provider?

a) Drowsiness

b) Throat pain

c) Continuous swallowing (When using the urgent vs. nonurgent approach to client

care, the nurse should identify that continuous swallowing is a manifestation of

hemorrhage. Therefore, this is the priority finding for the nurse to report to the

provider.)

d) Dark brown emesis

26. A nurse is reinforcing teaching with the guardian of a school age-age child who has

acute bacterial conjunctivitis and a new prescription for sulfacetamide. Which of the

following instructions should the nurse include?

a) Remove dried drainage with a cold washcloth.

b) Instill medication immediately after cleansing the eye. (The nurse should instruct

the guardian to place the medication in the eye immediately after cleansing.)

c) Apply an occlusive gauze over the child's eye.

d) Cleanse the eye by gently wiping from the outer aspect of the eye inward toward

the nose.

27. A nurse is preparing to leave the room after performing nasal suctioning for an infant

who has respiratory syncytial virus (RSV). Identify the sequence in which the nurse

should remove the following personal protective equipment (PPE). (Move the steps

into the box on the right, placing them in the order of performance. Use all the steps.)

Mask Gloves

Gloves Goggle

Gown Gown

Goggle Mask

The infant is on droplet and contact precautions due to the RSV. First, the nurse should

remove his gloves, because these are the most contaminated. Second, the nurse should

remove goggles, so they do not interfere with removing the other PPE. The nurse should

then remove the gown, and finally the mask, to decrease exposure to the disease.

28. A nurse in a provider’s office is caring for a preschooler who has findings of croup.

Which of the following statements by the parent requires immediate intervention by

the nurse?

a) "My child has refused to drink any fluids for the past 8 hours." (An inadequate fluid

intake indicates the child is at greatest risk for dehydration and electrolyte

imbalance. Therefore, this statement by the parent requires immediate intervention

by the nurse.)

b) "My child has been coughing throughout the night."

c) "My child is very hoarse and has a fever of 100.4 degrees Fahrenheit."

d) "My child recently had the flu."

29. A nurse is administering an injection of epinephrine to a child who is experiencing

manifestations of anaphylaxis. The nurse should monitor for which of the following

adverse effects?

a) Pinpoint pupils

b) Decreased heart rate

c) Increased systolic blood pressure (Epinephrine is an adrenergic agonist used to treat

anaphylaxis by activating the sympathetic nervous system. The nurse should expect

the child to have an increased systolic blood pressure following administration of

epinephrine.)

d) Dry skin

30. A nurse is reinforcing anticipatory guidance to the parents of an adolescent. Which of

the following recommendations should the nurse include?

a) Compare the adolescent's behavior to older siblings.

b) Be open to the adolescent's point of view. (During this stage of development,

adolescents are developing autonomy and self-identity. The nurse should

recommend that the parents actively listen and be open to the adolescent's point of

view, even if the parents disagree with his viewpoint.)

c) Select school activities for the adolescent.

d) Provide the adolescent with flexible rules