Question

A nurse is preparing to administer 0.9% 1L to infuse over 8 hr. The drop factor of the manual IV tubing set is 15 gtts/ml. The nurse should set the manual IV infusion to deliver howmany gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer 1

Correct Answers:

31

Rationale :

💠Total infusion vol:=1000ml 💠Duration of infusion ;=8hrs 💠1hr=60mins×8=480 💠Drop factor =15gtt/ml 💠Flow rate=total vol(in ml)÷time(in minutes) ×Drop factors =(1000÷ 480) ×15=31.25gtt/min 💠Round off =31gtt/min

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Answer 2

Correct Answers:

A sore throat 2 weeks ago

Rationale :

🔶 Acute glomerulonephritis often develops 1–3 weeks after a streptococcal throat infection, such as strep throat. 🔶 Streptococcal bacteria can trigger an immune response, causing inflammation in the glomeruli of the kidneys. 🔶 The classic pediatric scenario involves a recent history of pharyngitis (sore throat), not other unrelated illnesses. 🔶 Other symptoms or conditions (like measles, allergies, or dysuria) do not have a direct causal link to glomerulonephritis. 🔶 Recognizing this relationship enables timely assessment and management to prevent renal complications.

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Answer 3

Correct Answers

Blank 1 Correct Option: IV fluid bolus
Blank 2 Correct Option: electrolyte replacement

Rationale :

✅ The child is showing clear signs of dehydration: Symptoms such as dry mucous membranes, sluggish skin recoil, tachycardia, irritability, and dark concentrated urine all point to significant fluid loss. Immediate IV fluid bolus is necessary to restore intravascular volume and improve perfusion.

✅ Lab results indicate hypokalemia: The potassium level is 3.2 mEq/L, below the normal range (3.5–5.0), which increases the risk for cardiac arrhythmias and muscle dysfunction. Electrolyte replacement, especially potassium, is crucial for safe recovery.

✅ Vital signs and assessment reveal hypovolemia: Tachycardia (130 bpm), borderline low blood pressure (90/60 mmHg), and delayed capillary refill time (3 seconds) further confirm moderate to severe dehydration that requires urgent IV rehydration.

✅ Losses from vomiting and diarrhea deplete both fluids and electrolytes: Replacing both is the standard of care in pediatric gastroenteritis with significant dehydration. Without correction, complications like shock or metabolic derangements may occur.

✅ Addressing the underlying dehydration and electrolyte imbalance is the priority: Other interventions (antiemetics, antibiotics, analgesics) do not correct the acute, life-threatening deficits evident in this scenario.

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Answer 4

Correct Answers:

Report recurrence of urinary frequency
Avoid bubble bath
Empty bladder completely with each void.

Rationale :

◆ Reporting recurrence of urinary frequency is vital since it may signal unresolved or recurrent UTI requiring further evaluation. ◆ Avoiding bubble baths helps prevent urethral irritation, a known risk factor for pediatric UTIs. ◆ Emptying the bladder completely with each void prevents urine stasis, reducing bacterial growth risk. ◆ Educating parents on these practices supports UTI prevention and recurrence reduction.

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Answer 5

Correct Answers:

“I’m glad that the ostomy is only temporary.”

Rationale :

🔴 Temporary ostomy is the goal of the initial surgery for Hirschsprung’s disease; it allows the bowel to heal and decompress before a later definitive repair.

🔴 The parent’s statement shows understanding that the surgery is a staged process and not a permanent change, which is key in family education.

🔴 This temporary ostomy prevents complications like infection, perforation, and enterocolitis during the healing phase, supporting the child’s overall recovery.

🔴 Later, a second surgery will reconnect healthy bowel sections so that the child can have normal bowel movements without the ostomy.

🔴 Recognizing that the ostomy is not permanent reduces parental anxiety and sets realistic expectations for the child’s future care plan.

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Answer 6

Correct Answers:

Corticosteroids

Rationale :

🟢 Prednisone is classified as a corticosteroid, which is essential for treating nephrotic syndrome in children.

🟢 Corticosteroids reduce inflammation in the glomeruli and help decrease proteinuria (loss of protein in the urine).

🟢 By suppressing the immune response, corticosteroids decrease swelling (edema) and help restore normal fluid balance.

🟢 Prednisone is the mainstay of therapy, unlike ACE inhibitors, loop diuretics, or NSAIDs, which play secondary or unrelated roles in this context.

🟢 Correct identification of drug classification ensures appropriate treatment and effective parent/patient education.

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Answer 7

Correct Answers:

Maintain elbow restraints on the toddler

Rationale :

🟣 Elbow restraints are essential post–cleft palate repair to prevent the child from touching or disrupting the surgical site with their hands.

🟣 This protection is critical for optimal healing and to prevent wound dehiscence or infection.

🟣 Children at this age are naturally curious and may unintentionally damage sutures or introduce bacteria by putting objects or fingers in their mouth.

🟣 The use of restraints is a temporary but standard pediatric practice, monitored to prevent skin breakdown or circulatory issues.

🟣 Proper restraint use gives the surgical repair the best chance to heal without complications.

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Answer 8

Correct Answers:

Mucus in stools

Rationale :

🔵 Intussusception often presents with "currant jelly stools," which are stools containing mucus and blood due to bowel wall inflammation and obstruction.

🔵 This finding is a classic indicator and helps distinguish intussusception from other causes of abdominal pain in children.

🔵 The presence of mucus results from sloughing of the intestinal mucosa as it becomes compressed and ischemic.

🔵 Early recognition is critical because prompt diagnosis and intervention can prevent severe complications like bowel necrosis or perforation.

🔵 Other symptoms, such as jaundice or increased appetite, are not typically associated with intussusception.

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Answer 9

Correct Answers:

Determine if the toddler is voiding

Rationale :

🟠 Assessing urine output is the first priority in a toddler with acute gastroenteritis to evaluate hydration status and renal function.

🟠 Determining if the child is voiding confirms that the kidneys are perfused and can safely handle potassium replacement if needed.

🟠 Potassium should never be added to IV fluids until adequate kidney function and urine output are confirmed, due to the risk of hyperkalemia.

🟠 This step takes precedence over collecting labs or starting fluids, guiding safe, effective fluid management.

🟠 Immediate assessment of voiding can prevent life-threatening complications in a dehydrated child.

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Answer 10

Correct Answers:

Assist with initiating oral rehydration therapy

Rationale :

🟢 Oral rehydration therapy (ORT) is the gold standard for treating dehydration from diarrhea in children, as recommended by pediatric guidelines.

🟢 ORT provides the correct balance of fluids and electrolytes to safely and efficiently replace losses from the GI tract.

🟢 Alternatives like chicken broth or keeping NPO do not provide the necessary electrolyte balance and may worsen the child’s condition.

🟢 Early rehydration reduces the risk of further complications, promotes rapid recovery, and usually prevents hospitalization.

🟢 It is evidence-based, cost-effective, and can be started promptly in most care settings.

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ATI LPN Pediatric Nursing Exam IV

No.

2 :
A 5-year-old child is admitted to the hospital with acute glomerulonephritis. In taking the child’s history, what does the nurse recognize as the probable cause?

3 :
A nurse is assisting in the care of a preschool aged child in the emergency department.

Correct Answers

4 :
A nurse is reinforcing teaching with the parents of a child who has a urinary tract infection (UTI). Which of the following should the nurse include? Select all that apply.

5 :
A nurse is reinforcing teaching with a parent of a 1 month old infant who is to undergo the initial surgery to treat Hirschsprung’s disease. Which of the following statements should indicate to the nurse that the parent understands the goal of the surgery.

6 :
A child with nephrotic syndrome is being treated with prednisone to reduce proteinuria and edema. The nurse is aware that prednisone belongs to what medication classification?

7 :
A nurse is contributing to the plan of care of a 14-month old toddler who is 24 hr postoperative following a cleft palate repair. Which of the following interventions should the nurse include in the plan.

8 :
A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?

9 :
A nurse is assisting with the admission of a 2-year-old toddler who has acute gastroenteritis. Which of the following actions should the nurse take first?

10 :
A nurse is caring for a child who has watery diarrhea for the past 3 days. Which of the following is an action for the nurse to take?

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ATI LPN Pediatric Nursing Exam IV

No.

2 : A 5-year-old child is admitted to the hospital with acute glomerulonephritis. In taking the child’s history, what does the nurse recognize as the probable cause?

3 : A nurse is assisting in the care of a preschool aged child in the emergency department.

Correct Answers

4 : A nurse is reinforcing teaching with the parents of a child who has a urinary tract infection (UTI). Which of the following should the nurse include? Select all that apply.

5 : A nurse is reinforcing teaching with a parent of a 1 month old infant who is to undergo the initial surgery to treat Hirschsprung’s disease. Which of the following statements should indicate to the nurse that the parent understands the goal of the surgery.

6 : A child with nephrotic syndrome is being treated with prednisone to reduce proteinuria and edema. The nurse is aware that prednisone belongs to what medication classification?

7 : A nurse is contributing to the plan of care of a 14-month old toddler who is 24 hr postoperative following a cleft palate repair. Which of the following interventions should the nurse include in the plan.

8 : A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?

9 : A nurse is assisting with the admission of a 2-year-old toddler who has acute gastroenteritis. Which of the following actions should the nurse take first?

10 : A nurse is caring for a child who has watery diarrhea for the past 3 days. Which of the following is an action for the nurse to take?

2 :
A 5-year-old child is admitted to the hospital with acute glomerulonephritis. In taking the child’s history, what does the nurse recognize as the probable cause?

3 :
A nurse is assisting in the care of a preschool aged child in the emergency department.

4 :
A nurse is reinforcing teaching with the parents of a child who has a urinary tract infection (UTI). Which of the following should the nurse include? Select all that apply.

5 :
A nurse is reinforcing teaching with a parent of a 1 month old infant who is to undergo the initial surgery to treat Hirschsprung’s disease. Which of the following statements should indicate to the nurse that the parent understands the goal of the surgery.

6 :
A child with nephrotic syndrome is being treated with prednisone to reduce proteinuria and edema. The nurse is aware that prednisone belongs to what medication classification?

7 :
A nurse is contributing to the plan of care of a 14-month old toddler who is 24 hr postoperative following a cleft palate repair. Which of the following interventions should the nurse include in the plan.

8 :
A nurse is caring for a toddler who has intussusception. Which of the following manifestations should the nurse expect?

9 :
A nurse is assisting with the admission of a 2-year-old toddler who has acute gastroenteritis. Which of the following actions should the nurse take first?

10 :
A nurse is caring for a child who has watery diarrhea for the past 3 days. Which of the following is an action for the nurse to take?