Preview Extract
ATI PEDS PROCTORED EXAM 2023 FORM A /PEDIATRIC ATI
PROCTORED
2023 FORM A CONTAINS ACTUAL QUESTIONS AND CORRECT
ANSWERS|AGRADE(COMPLETE EXAMS)
A nurse is assisting a child who has multiple closed fractures of the lower extremities due to a
motor-vehicle crash. The nurse should monitor the child for which of the following
complications during the first 24 hr. after the injury occurred?
Answer: Compartment syndrome
A nurse is teaching the parent of a toddler who has phenylketonuria about meal planning.
Which of the following information should the nurse include in the teaching?
Answer: Avoid foods containing milk products
A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder.
Which of the following interventions should the nurse include in the plan of care?
Answer: Keep staff visits with the child brief
A nurse is assisting an infant who has severe dehydration due to gastroenteritis. Which of the
following findings should the nurse expect?
Answer: Increase respiratory rate
A nurse is planning care for a child who has cystic fibrosis. Which of the following
interventions should the nurse plan to include?
Answer: Use a vest to perform high-frequency chest compressions
A nurse is teaching the parent of a school age child about bicycle safety. Which of the
following instructions should the nurse include in the teaching?
Answer: Your child should walk the bicycle through intersections
A nurse is preparing a child for a lumbar puncture. In which of the following positions should
the child be placed for the procedure?
Answer: Lateral
A nurse is reviewing the complete blood count results for a child who is receiving treatment
for acute lymphoblastic leukemia. Which of the following findings should indicate to the nurse
that the treatment is having a therapeutic effect?
• WBC count 15.000/mm
• Hemoglobin 6.8 g/dL
• Platelet count 98.0000/mm
• RBC count 5/mm
Answer: RBC count 5/mm- (within expected range of 3.9-5.3)
A nurse is caring for a school age child who has pertussis. Which of the following actions
should the nurse take?
Answer: Report the diagnosis to the public health department
A nurse is assessing a week-old infant. The nurse should identify which of the following
manifestations can indicate neonatal abstinence syndrome?
Answer: Excessive sucking
A nurse is preparing to initiate IV antibiotic therapy for a newly admitted 12-month-old infant.
Which of the following actions should the nurse plan to take?
Answer: Cover the insertion site with an opaque dressing
A nurse is assessing a toddler who is 8 hr. postoperative following a cardiac catheterization
procedure. Which of the following findings should the nurse report to the provider?
Answer: Weak pedal pulse distal to the site
A nurse is providing teaching to the parents of a child who has varicella about management of
the disease. Which of the following instructions should the nurse include in the teaching?
Answer: Apply calamine lotion to vesicles on the child's skin (FYI: Initiate airborne
precautions)
A nurse is planning care for a child who is experiencing a sickle cell crisis. Which of the
following interventions should the nurse include in the plan of care?
Answer: Initiate bed rest
A charge nurses teaching a group of nurses about identifying child abuse. Which of the
following findings should the nurse identify as a potential indicator of child abuse?
Answer: A mother is hesitant to comfort her 6-month-old infant
A nurse is teaching the guardian of a 5-year-old child who has encopresis about management
of the condition. Which of the following statements by the guardian indicates an understanding
of the teaching?
Answer: I will have my child try to defecate 15 minutes after each meal
A nurse is assisting an infant who has respiratory syncytial virus (RSV). For which of the
following findings should the nurse intervene?
Answer: Tachypnea-fast breathing
A nurse is performing a health assessment for a 6-month-old infant. The nurse should begin
the assessment by performing which of the following actions while the infant is quiet and
sitting on the guardians lap?
Answer: Listening to the infant heart and lung sounds
A nurse is caring for an adolescent who has major depressive disorder. Which of the following
actions should the nurse take first?
Answer: Ask the client if he is considering harming himself
A nurse is caring for a child in the PACU following a tonsillectomy. Which of the following
findings requires immediate intervention by the nurse?
Answer: Frequent swallowing-indication of bleeding
A nurse in the emergency department is caring for a school age child who has developed
respiratory stridor, wheezing, and urticarial after receiving an IV medication. Which of the
following actions should the nurse take first?
Answer: Administer epinephrine
A nurse is caring for a school aged child who is 1hr postoperative following a tonsillectomy.
Which of the following actions should the nurse take first? ( Select all that apply)
Answer: • Observe the child for frequent swallowing
• Discourage the child from coughing
• Administer an analgesic to the child on a scheduled basis
A nurse is teaching the guardian of an infant who has congestive heart failure about methods to
preserve energy during bottle feeding. Which of the following statements by the guardian
indicates a clear understanding of the teaching?
Answer: I will feed my baby every 2 hours
A nurse in a family practice clinic is assessing a preschool age child who recently experienced
the death of a sibling. Which of the following reactions in an age-appropriate response to
death?
Answer: The child feels responsible for the siblings death
A nurse is teaching a parent of a toddler about administering digoxin. Which of the following
statements by the parent indicates a clear understanding of the teaching?
Answer: I should give my child water after giving the medication-(FYI: if the child has teeth,
brush their teeth to prevent tooth decay)
A nurse is providing a teaching to the guardian of a 2-year-old about typical toddler behavior.
Which of the following behaviors should the nurse include?
Answer: Frequency negative responses
A nurse is caring for a client who is postoperative following placement of a halo vest to
manage a cervical vertebral fracture. Which of the following actions should the nurse take?
Answer: Reposition the client using a turning sheet
A nurse is caring for a 1-year-old infant who has GERD. Which of the following actions
should the nurse take to promote sleep for the infant?
Answer: Place the infant in a left lateral position'-prevent aspiration
A nurse is assessing a toddler who has a history of lead poisoning. Which of the following
actions should the nurse take?
Answer: Perform development testing for delays
A nurse is collecting data from a toddler who weighs 25 kg (44lb) and has a full thickness burn
to 10% of his body. Which of the following findings should the nurse report to the provider?
Answer: Increased restlessness
A nurse is educating an adolescent following the application of an arm cast. Which of the
following statements by the client indicates an understanding of the teaching?
Answer: I will elevate my broken arm on pillows a tonight
A nurse is teaching a parent about home interventions for a preschooler who is experiencing
night terrors. Which of the following instructions should the nurse include in the teaching?
Answer: Avoid allowing your child to sleep in your bed
A nurse is reviewing the laboratory results of a preschooler who has gastroenteritis and notes
the client's potassium level is 3.2 mEq/L. Which of the following assessment findings should
the nurse expect?
Answer: hyporeflexia (although you may see hypertension, this is incorrect, low potassium
makes everything slow)
A nurse is assessing a child who has heart failure. Which of the following findings is a clinical
manifestation associated with this diagnosis? (Select all that apply)
Answer: • Tachypnea
• Dyspnea
• Cyanosis
A nurse is caring for an adolescent who has scoliosis and is refusing to wear a back brace
which of the following statements should the nurse make?
Answer: Let's sit down and discuss why you do not want to wear the brace.
A nurse is providing teaching to a parent of a child who has HIV. Which of the following
statements by the parent indicates an understanding of the teaching?
Answer: I will ensure that my child is tested for tuberculosis every year.
A nurse is caring for a 2-month-old infant who has heart failure and is receiving furosemide.
Which of the following findings is the nurse's priority?
Answer: Sunken anterior fontanel
A nurse in an emergency department is caring for a child who experienced submersion injury.
Which of the following is the priority action for the nurse to take?
Answer: Assist with intubation.
A nurse is caring for a school-age child who is experiencing a sickle cell crisis. Which of the
following actions should the nurse take?
Answer: Apply warm compresses to the affected area.
A nurse is planning care for an adolescent following repair of Meckel diverticulum. Which of
the following actions should the nurse include in the plan of care?
Answer: Maintain an NG tube for decompression.
A nurse is teaching a parent of a10-month-old infant about home safety. Which of the
following instructions should the nurse include in the teaching?( select all that apply).
Answer: Place gate at the top and bottom of the stairs. Ensure the crib mattress is in the lowest
position.
A nurse is communicating with a child who had hearing loss. Which of the following action
should the nurse take?
Answer: Use light touch when initiating conversation.
A nurse is creating plan of care for an adolescent who has muscular dystrophy. Which of the
following intervention should the nurse include in the plan?
Answer: Encourage the adolescent to perform incentive spirometry to maintain lung capacity.
A nurse is creating a plan of care for a toddler who is recovering following a routine surgical
procedure. Which of the following interventions should the nurse include?
Answer: Encourage the toddler to use an incentive spirometer.
A nurse is caring for a child who has bacterial meningitis. Which of the following findings
should indicate to the nurse that the child can be removed from droplet precaution?
Answer: Antibiotics initiated 24hr ago
A nurse is preparing to perform a venipuncture to collect a blood sample from an infant.
Which of the following restraints should the nurse plan to use for this procedure?
Answer: Mummy
A nurse is planning to perform tracheostomy care for a toddler. Which of the following is an
appropriate action for nurse to take?
Answer: Have the child flex his head when securing the ties.
A nurse is teaching an adolescent who has type1 diabetes mellitus. Which of the following
finding is the nurse priority?
Answer: HgbA1c 11.5%.-(expected lab value 4-6%)
A nurse is planning to admit a preschooler from the PACU following removal of a Wilms'
tumor. Which of the following children should the nurse identify as an appropriate roommate
for the preschooler?
Answer: A child who has a fractured left femur.
A nurse is planning to administer immunizations to a 2-month -old infant. Which of the
following actions should the nurse take to decrease the infant pain?
Answer: Administer the injections while the infant is breastfeeding.
A nurse is caring for a 4-year-old child who is postoperative following an appendectomy.
Which of the following pain rating scales should the nurse use to assess the child's need for
pain medication?
Answer: FACE
A nurse is reviewing the medical record of a 15-month -old child who is schedule to receive
the measles, mumps, & rubella (MMR) vaccine. Which of the following finding should the
nurse identify as a contraindication for receiving this vaccine?
Answer: Allergy to neomycin
A nurse is caring for a child who received partial thickness burns to over 50% of his body 10
days ago and has splints over his joints to prevent contractures. Which of the following action
should the nurse take? ( select all that apply).
Answer: • Provide a high-calorie diet.
• Monitor intake and output
• Change dressing using aseptic technique.
A nurse is planning care for an adolescent who has sickle cell anemia. Which of the following
immunization should the nurse include in the plan?
Answer: Pneumococcal conjugate (PCV13)
A nurse is assessing a client who has Hodgkin's lymphoma. Which of the following findings
should the nurse expect?
Answer: Night sweat.
A nurse is teaching a group of parents about childhood immunizations. The nurse should
identify that the infant should receive the first dose of which of the following immunizations at
12 months of age.
Answer: Varicella.
A nurse in a community clinic is reviewing the laboratory result of four clients. the nurse
should identify that which of the following sexually transmitted infections is nationally
notifiable?
Answer: Gonorrhea
A nurse is caring for a group of clients. Which of the following findings should the nurse
report to the provider?
Answer: An 18 -month -old toddler who has a heart rate of 68/min.-too low for a toddler
A nurse is caring for a preschooler who has a brain tumor. Which of the following findings is
the priority for the nurse to report to the provider?
Answer: Diplopia.
A nurse is admitting a child who has acute epiglottitis. Which of the following action should
the nurse take?
Answer: Initiate droplet isolation precaution.
A nurse is caring for an infant who has increased intracranial pressure (ICP). Which of the
following should the nurse identify as late finding of (ICP)?
Answer: Flexion posturing
A nurse is assessing a 24-month -old toddler. Which of the following finding should the nurse
report to the provider?
Answer: Has a vocabulary of 30 words. -a two-year-old should speak up to 200 words or more
A nurse is teaching about growth and development to a parent of a 12-year-old child. The
nurse should instruct the parent to expect the child to exhibit which of the following
characteristics during early adolescence.
Answer: Mood swing.
A nurse is evaluating 4-year -old child who has cystic fibrosis and has been receiving chest
physiotherapy treatments. The nurse should identify which of the following findings as an
indication that the therapy has been effective?
Answer: Increase expectoration
A nurse is providing teaching to the guardians of an infant who require a pavlik harness.
Which instructions should the nurse include?
Answer: Place the diaper under the straps of the harness.
A nurse is providing education about dietary modifications to the parents of a school-age child
who has glomerulonephritis. Which of the following information should the nurse include in
the teaching?
Answer: Decrease the child's sodium intake.
A nurse is providing teaching to the parents of a school-age child newly diagnosed with a
seizure disorder. The nurse should teach the parents to take which of the following actions
during a seizure?
Answer: Clear the area of hard objects
A nurse is providing anticipatory guidance to a parent of a 1- month-old infant. The nurse
should include that it is recommended to start the series of which of the following
immunization first?
Answer: Inactive poliovirus
A nurse is reviewing the laboratory report of a toddler who has hemolytic uremic syndrome.
Which of the following findings should the nurse expect?
Answer: BUN 28 mg/dL-expected range 10-20
A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines.
Which of the following instructions should the nurse include in the teaching?
Answer: You can replace milk with nondairy sources of calcium
A nurse on a pediatric intensive care unit is caring for a toddler who weighs 12 kg (26.5lb) and
is postoperative following open-heart surgery. Which of the following findings should the
nurse report to the provider?
Answer: Urine output of 15 ml in the last 2 hr (0.5- 1 mL/kg/hour)
A nurse is providing dietary teaching to a parent of a 10-monthold infant who has
phenylketonuria. Which of the following responses by the parent indicates an understanding of
the teaching?
Answer: I will steam carrots and cut them into small pieces for her.
A nurse is providing teaching to the parents of a preschool-age child who has celiac disease.
Which of the following instructions should the nurse include?
Answer: Your child will be on a gluten-free diet for the rest of her life.
A nurse is administering albuterol by metered dose inhaler for a preschool-age child who is
experiencing an asthma exacerbation. Which of the following findings should the nurse report
to the provider?
Answer: Intercostal retractions
A nurse is caring for a school-age child who has heart failure. Which of the following findings
should the nurse expect? (Select all that apply)
Answer: Tachycardia, Dyspnea, and cyanosis, bounding peripheral pulses
A nurse in an emergency department is assessing a toddler who has a head injury. Which of the
following findings should the nurse report to the provider?
Answer: -Vomiting (FYI: This is the patient a nurse should see first when using the urgent vs
nonurgent approach due to likelihood of increased ICP related to a concussion)
A nurse is caring for a toddler who is in the terminal stage of neuroblastoma. The parents ask,
"How can we help our child now?" Which of the following responses by the nurse is
appropriate?
Answer: Stay close to your child.
A nurse is preparing to administer cephalexin 25 mg/kg PO to a child who has otitis media and
weighs 22 kg (48.5lb). Available is cephalexin solution 250 mg/5mL. How many mL should
the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do
not use a trailing zero.)
Answer: 11 mL
-22 × 25 = 550
-550/250 = 2.2
-2.2 × 5 = 11
During a well-baby visit, the parent of a 2-week-old newborn tells the nurse, "My baby always
keeps her head tilted to the right side." The nurse should further assess which of the following
areas?
Answer: Sternocleidomastoid muscle
A nurse is caring for a single mother of a 6-month-old infant. During a well-baby visit, the
mother expresses feeling "inexperienced" in caring for the baby. The nurse should recommend
which of the following community resources?
Answer: Parent Enhancement Center
A nurse is admitting an infant who has GERD. Which of the following is the priority
assessment finding?
Answer: Regurgitation (wheezing?)
A nurse is caring for an infant who has severe dehydration. Which of the following clinical
findings should the nurse expect?
Answer: Rapid respirations
A nurse is teaching a group of female adolescents about healthy eating. Which of the following
instructions should the nurse include in the teaching?
Answer: "Increase the amount of your dietary iron intake"
A nurse is preparing to administer immunizations to a 3-monthold infant. Which of the
following is an appropriate action for the nurse to take to deliver atraumatic care?
Answer: Provide a pacifier coated with oral sucrose solution prior to the injections.
A nurse is caring for a child who has impetigo contagiosa that developed in the hospital.
Which of the following actions should the nurse take?
Answer: Initiate contact isolation precautions.
A nurse is providing discharge teaching to the parents of a school- age child who has cystic
fibrosis. Which of the following responses by the parents indicates an understanding of the
teaching?
Answer: "I will give my child pancreatic enzymes with snacks and meals."
A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamicin. Which
of the following laboratory values should the nurse report to the provider?
Answer: Creatinine 1.4 mg/dL- expected range 0.5-1.3- gentamicin in nephrotoxic, need good
kidney function to expel antibiotic from body
A nurse is providing teaching to the parents of a school-age child who has ADHD and a new
prescription for methylphenidate. The nurse should explain that this medication will have
which of the following therapeutic effects?
Answer: Increasing focus
A nurse is teaching an adolescent how to manage his cystic fibrosis. Which of the following
statements the adolescent indicates an understanding of the teaching?
Answer: "I will increase my intake of vitamin D."
A nurse in a provider's office is caring for a preschool-age child who might have acute
epiglottitis. Which of the following actions should the nurse take?
Answer: Provide humidified oxygen via nasal cannula.
A nurse is providing teaching to the parents of a child who has impetigo. Which of the
following instructions should the nurse include in the teaching?
Answer: Apply bactericidal ointment to lesions.
A nurse is reviewing the laboratory report of a school-age child who has rheumatic fever.
Which of the following laboratory findings should the nurse expect?
Answer: Increased antistreptolysin o titer (ASO)
A nurse is administering an opioid to an adolescent who is in sickle cell crisis. Which
statement is true regarding opioid pain management?
Answer: Oral opioid doses should be larger than parenteral doses
A nurse is preparing to perform peritoneal dialysis for a child who has an elevated serum
creatinine level. After explaining the procedure, which of the following actions should the
nurse plan to take?
Answer: Obtain the child's weight
A nurse is caring for an adolescent who is 1 hr postoperative following an appendectomy.
Which of the following findings should the nurse report to the provider?
Answer: muscle rigidity
A nurse is caring for a preschool-age child who is postoperative following a tonsillectomy and
is clearing her throat frequently. Which of the following actions should the nurse take first?
Answer: Observe the child throat with a flashlight → assess before intervening
A nurse is planning care for a toddler who has developed oral ulcers in response to
chemotherapy. Which of the following actions should the nurse include in the plan of care?
Answer: Cleanse the gums with saline soaked gauze
A nurse is planning care for a child immediately following the insertion of a chest tube for
continuous suction with a closed drainage system. Which of the following interventions should
the nurse include in the plan of care?
Answer: Ensure continuous bubbling is present in the suction control chamber
A nurse is prioritizing care for four clients. Which of the following clients should the nurse
assess first?
Answer: An adolescent who has a sickle cell anemia and slurred speech
A nurse is assessing an adolescent who has Crushing's syndrome. Which of the following
should the nurse expect?
Answer: blood glucose 320
A nurse is caring for a preschooler who has a brain tumor. Which of the following findings is
the priority for the nurse to report to the provider?
Answer: Diplopia
A charge nurse is planning care for an infant who has failure to thrive. Which of the following
actions should the nurse include in the plan of care?
Answer: Assign consistent nursing staff to care for the infant.
A nurse is providing discharge teaching to the parents of an infant who is at risk for sudden
infant death syndrome (SIDS). Which of the following statements by the parents indicates an
understanding of the teaching?
Answer: "I will dress my baby in lightweight clothing to sleep."
A nurse is caring for a child who has acute glomerulonephritis. Which of the following finding
should the nurse expect?
Answer: Periorbital edema
A nurse is assessing a 1-month-old infant at a well-child visit. Identify the location the nurse
should stroke to elicit the rooting reflex. (You will find hot spots to select in the artwork
below. Select only the hot spot that corresponds to your answer.)
Answer: Stroke the cheek
A nurse is providing postoperative care for a child following an arterial cardiac catheterization.
Which of the following actions should the nurse take?
Answer: Keep the affected extremity straight for at least 6 hrs. (FYI: Wait 3 days before
taking a tub bath, change dressing the next day and apply new dressing)
A nurse in a provider's office is providing teaching to the parents of preschooler who has
Down syndrome. Which of the following statements by one of the parent indicates an
understanding of the instructions?
Answer: We'll be sure to demonstrate a new skill before expecting our son to perform it.
A nurse is teaching a parent of a 10-month-old infant about home safety. Which of the
following instructions should the nurse include in the teaching? (Select all that apply)
Answer: • Place gates at the top and bottom of the stairs
• Ensure the crib mattress is in the lowest position
A nurse is providing discharge teaching to a parent of a toddler who has a ventriculoperitoneal
shunt. Which of the following statement by the parent indicates an understanding of the
teaching?
Answer: I should call my doctor if my child begins vomiting.
A nurse in a provider's office is assessing the vital signs of a 2year- old child at a well-child
visit. Which of the following findings should the nurse report to the provider?
Answer: BP 118/74 mm Hg
A nurse is assessing a 3-month-old infant who has diarrhea. Which of the following findings
should the nurse expect?
Answer: Increased hematocrit
A nurse is preparing to administer imipenem/cilastatin 25 mg/kg to a child who weights 77 lb.
How many mg should the nurse plan to administer? (Round the answer to the nearest whole
number. Use a leading zero if it applies. Do not use a trailing zero.)
Answer:
875 mg(77/2.2lb = 35 kg > 25mg × 35 = 875 mg)
77/2.2 = 35
35 x 25 = 875
A nurse is providing teaching to a parent of an infant who has a 1 cm (0.4 in) umbilical hernia.
Which of the following instructions should the nurse include in the teaching?
Answer: The bulge can temporarily enlarge when your baby cries.
A nurse is admitting a child who has pertussis. Which of the following transmission-based
precaution should the nurse initiate?
Answer: Droplet precautions
A nurse is reviewing the medical record of a 24-month-old child who has acute lymphocytic
leukemia. Which of the following actions should the nurse take? (Click the exhibit button for
additional information about the client. There are three tabs that contain separate categories of
data.)
Answer: Initiate bleeding precaution
A school nurse is assessing a 7-year-old student. The nurse should identify which of the
following findings as a potential indicator of physical abuse?
Answer: Bruising around the wrists
A nurse is providing teaching to the parent of a school-age child who has diabetes mellitus
about managing diabetes during illness. Which of the following statements by the parent
indicates an understanding of the teaching?
Answer: I will increase the amount of fluids I offer my children
A nurse is providing discharge teaching to the parents of a toddler who has iron deficiency
anemia and a new prescription for ferrous sulfate elixir. Which of the following instructions
should the nurse include?
Answer: Administer this medication to your child with a dropper.
A nurse is caring for an infant who has tetralogy of fallot and is having a hypercyanotic
episode after crying. Which of the following intervention should the nurse implement.
Answer: Place the infant in the knee-chest position.
A nurse is providing teaching to an adolescent who has vulvovaginitis. Which of the following
statement should the nurse include in the teaching?
Answer: Apply a warm, moist compress three times per day.
A nurse is providing discharge instructions to the parents of a toddler who has heart failure and
a new prescription for digoxin. Which of the following statements indicate an understanding of
the instructions?
Answer: We will wait to give the medication at the next scheduled time if dose is missed.
A nurse is planning an in-service for parents of school-age children about the treatment of
pediculosis capitis. Which of the following instructions should the nurse plan to include in the
teaching?
Answer: Remove nits from the child’s hair using a fine tooth comb
A nurse is assessing an adolescent who has infectious mononucleosis. Which of the following
findings should the nurse expect?
Answer: Cervical adenopathy
A nurse in an emergency department is assessing an adolescent who reports inhalation of
gasoline. Which of following findings should the nurse expect?
Answer: Ataxia
A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions
should the nurse plan to take?
Answer: Use a tumbling E chart for the assessment
A nurse in an emergency department is caring for a child following an overdose of
acetylsalicylic acid. Which of the following medications should the nurse plan to administer?
Answer: Phytonadione
A nurse is providing teaching to the parents of a toddler who is exhibiting negativism during
mealtimes. Which of the following statements by the nurse is appropriate?
Answer: Ask her if she would like to have her favorite salad for lunch
A nurse in an emergency department is caring for a child who weighs 18 kg (39.7 lb) and
indigested six 500 mg acetaminophen tablets 4 hr ago. Which of the following actions should
the nurse take?
Answer: Prepare to give oral N-acetylcysteine
A nurse is preparing a school-age child for an invasive procedure. Which of the following
actions should the nurse plan to take?
Answer: Explain the procedure to the child when they are in the playroom
A nurse is preparing a school-age child following the application of a cast for a fractured right
tibia. Which of the following actions should the nurse take first?
Answer: Elevate the child’s leg
A nurse in a pediatric clinic is providing teaching to the guardian of an infant who has a new
prescription for digoxin. Which of the following manifestations should the nurse include as an
indication of digoxin toxicity?
Answer: Bradycardia
A nurse is assessing a toddler who has cystic fibrosis. Which of the following findings should
the nurse expect?
Answer: Steatorrhea
A nurse is preparing to initiate IV antibiotic therapy for a newly admitted 12-month-old infant.
Which of the following actions should the nurse plan to take?
Answer: Use a 24-gauge catheter to start the IV
A nurse is providing teaching about the effects of sun exposure to a parent of a toddler which
of the following responses by the parent indicates an understanding of the teaching?
Answer: My child should wear a wide brimmed that
Providing support to a family whose infant died from sudden infant death syndrome (SIDS).
Which of the following actions should the nurse take?
Answer: Acknowledge the family members feelings of guilt
A nurse is monitoring an infant who was receiving opioids for pain. Which of the following
findings should indicate to the nurse that the medication is having a therapeutic effects?
Answer: Relaxed facial expression
The nurse is evaluating a four-year-old who has cystic fibrosis and has been receiving chest
physiotherapy treatment. The nurse should identify which of the following findings of an
indication that the therapy has been effective?
Answer: Increased expectoration
A nurse is providing teaching to the parents of an infant who is to undergo pilocarpine
iontophoresis testing for cystic fibrosis. Which of the following statements should the nurse
include in the teaching?
Answer: The test will measure the amount of chloride in your baby's sweat"
A nurse is teaching home care to the parents of a preschool-age child who has heart failure.
Which of the following information should the nurse include in the teaching?
Answer: Provide for periods of rest
A nurse in the emergency department is caring for an adolescent who is requesting testing for
STIs. Which of the following actions is appropriate for the nurse to take?
Answer: Obtain written consent from the client
A nurse is preparing to administer an enteral feeding to an adolescent who has NG tube. Which
of the following actions should the nurse take first?
Answer: Check the pH of the gastric secretions
A nurse is caring for a 10-month-old child who was brought to the emergency department by
his parents following a head injury. Which of the following actions should the nurse take first?
Answer: Assess respiratory status
A nurse is discussing coping mechanisms with a parent of a 3- month-old infant. Which of the
following therapeutic questions should the nurse ask the parent?
Answer: What do you do when your infant is fussy?"
A nurse in a PACU is admitting a client who is postoperative following a tonsillectomy. Which
of the following actions should the nurse plan to take to prevent aspiration?
Answer: Withhold fluids until the client demonstrates a gag reflex
A nurse is checking the vital signs of a 3-year-old child during a well-child visit. Which of the
following findings should the nurse report to the provider?
Answer: Respirations 30/min
A nurse is collecting neurological data on an adolescent. Which of the following is an
appropriate reaction by the adolescent when the nurse checks the trigeminal cranial nerve?
Answer: Clenching teeth together tightly
A nurse is administering an opioid to an adolescent who is in sickle cell crisis. Which
statement is true regarding opioid pain management?
Answer: Oral opioids should not be combined with other types of pain relievers.
A nurse is helping a school-age child who has celiac disease select menu items for the next
day's meals and snacks. Which of the following foods should the nurse encourage the client to
choose?
Answer: A cheese omelet with orange juice.
A nurse is reviewing the results of the newborn screening for a newborn who is 1 week old.
Results include total T4 0.8 mcg/dL, phenylalanine 0.7 mg/dL, and negative galactosemia.
Which of the following interventions should the nurse include in the plan of care?
Answer: Instruct the newborn's parent about how to administer levothyroxine
A nurse is caring for a child who has epiglottitis due to an infection with Haemophilus
influenzae type B. Which of the following actions should the nurse take? (Select all that
apply).
Answer: • Begin droplet precautions
• Initiate IV access
• Monitor oxygen saturation
