Question

The school-based nurse is working with the local school district to promote health and wellness in a school with a large proportion of minority and underprivileged students. Which of the following will be included in the planning? Select all that apply.

Answer 1

Correct Answers:

Adding a school breakfast program.
Reducing saturated fat in the school lunch offering.
Making fruits or vegetables available with all meals-
Offering after school physical fitness activities-

Rationale :

Adding a school breakfast program

🔹 Children from low-income families often come to school without having eaten. A school breakfast program ensures all students start their day with adequate nutrition, which is essential for learning, concentration, and energy levels.

🔹 Research shows that school breakfast participation is linked to improved academic performance, reduced absenteeism, and better classroom behavior.

🔹 This initiative also helps bridge nutritional disparities seen in minority and underprivileged populations.

🔹 Nutritional programs are aligned with the Centers for Disease Control and Prevention (CDC) guidelines to address health inequities in vulnerable groups.

🔹 It supports both educational success and physical health, making it a cornerstone in public school wellness promotion.

Reducing saturated fat in the school lunch offering

🔹 High intake of saturated fat is associated with childhood obesity, heart disease, and poor dietary patterns that can persist into adulthood.

🔹 Implementing low-saturated fat meals helps in establishing healthy eating habits early, especially among populations already at risk for chronic diseases.

🔹 The U.S. Department of Agriculture (USDA) sets standards for Healthy School Meals, encouraging limits on saturated fats.

🔹 This step addresses diet-related health disparities among students from lower-income backgrounds who rely heavily on school meals.

🔹 Promoting balanced meals with healthy fats, lean proteins, and whole grains is a key part of health education and chronic disease prevention.

Making fruits or vegetables available with all meals

🔹 Access to fruits and vegetables enhances intake of essential vitamins, minerals, and fiber that support immunity, growth, and cognitive function.

🔹 Children from underprivileged backgrounds may not receive these nutrients at home due to cost or availability, making school-based access critical.

🔹 Daily exposure to fruits and vegetables encourages healthy eating habits and increases the likelihood of long-term consumption.

🔹 Offering these with every meal aligns with USDA MyPlate guidelines and improves overall meal quality.

🔹 It also supports obesity prevention efforts in minority communities disproportionately affected by poor dietary options.

Offering after-school physical fitness activities

🔹 Physical activity contributes to weight management, cardiovascular fitness, bone health, and stress reduction in children.

🔹 Minority and underprivileged students often have limited access to safe recreational areas outside of school, making after-school programs crucial.

🔹 Structured physical activities reduce sedentary behaviors and also promote teamwork, discipline, and mental wellness.

🔹 The CDC recommends at least 60 minutes of physical activity per day for children, which school-based programs can help fulfill.

🔹 These initiatives close the gap in activity levels between low-income and higher-income children, promoting long-term health equity.

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Answer 2

Correct Answers:

Keep plastic bags and plastic grocery bags in a secure place.
Serve food in small pieces no larger than a cheerio.
Use plastic covers on all electrical outlets.

Rationale :

✅ A. Keep plastic bags and plastic grocery bags in a secure place

🛡️ Plastic bags are a suffocation hazard for infants who may pull them over their faces during play.

🛡️ At 10 months, infants are increasingly mobile, making it important to store such items in high or locked cabinets.

🛡️ Safe home environments require anticipating developmental behaviors like grabbing and exploring.

🛡️ Storing plastic bags away helps reduce risks related to accidental injury or death.

🛡️ Parental education should emphasize removing common household items that pose hidden dangers.

✅ B. Serve food in small pieces no larger than a cheerio

🛡️ Cheerios are an ideal size and dissolve easily, making them safe for infants learning to chew.

🛡️ At 10 months, most infants lack molars and cannot adequately grind larger or tougher food.

🛡️ This practice reduces the risk of choking, which is a leading cause of injury in this age group.

🛡️ Parents should cut soft fruits, steamed vegetables, or meats into tiny, manageable pieces.

🛡️ Education on age-appropriate food texture and size is critical for infant feeding safety.

✅ E. Use plastic covers on all electrical outlets

🛡️ Infants at this age often crawl and explore, making exposed outlets a major electrocution risk.

🛡️ Plastic outlet covers are essential in preventing fingers or objects from being inserted into sockets.

🛡️ They are a simple, low-cost intervention to reduce home injury.

🛡️ Teaching parents to assess their home from the infant’s eye level helps identify such hazards.

🛡️ This is a core principle of infant-proofing in health promotion and home safety education.

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Answer 3

Correct Answers:

Pulse of 150, poor skin turgor, oliguria, and an admission weight of 296 lbs.

Rationale :

💧 A heart rate of 150 in a 3-year-old is above normal and consistent with moderate dehydration, where the body compensates by increasing heart rate.

💧 Poor skin turgor indicates fluid loss and decreased interstitial fluid volume.

💧 Oliguria (reduced urine output) is a hallmark of dehydration due to reduced renal perfusion.

💧 Weight loss (from baseline) supports fluid volume deficit; tracking admission weight is essential.

💧 These findings collectively match the clinical criteria for moderate dehydration in a preschool-age child.

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Answer 4

Correct Answers:

The medication is a bronchodilator, which opens airways.
The medication will reduce wheezing.
The medication will decrease coughing and shortness of breath.

Rationale :

✅ A. The medication is a bronchodilator, which opens airways

🌬️ Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that stimulates beta-2 receptors in the bronchial smooth muscle. This stimulation leads to bronchodilation, or the widening of the airways, which allows air to flow more freely into and out of the lungs.

🌬️ In asthma, the airways are narrowed due to inflammation and muscle constriction. Albuterol directly relieves the bronchospasm, which is one of the primary causes of acute symptoms.

🌬️ Onset of action is rapid, usually within 5–10 minutes, making it ideal for acute relief during asthma exacerbations.

🌬️ This mechanism is essential for treating wheezing, chest tightness, and difficulty breathing during flare-ups.

🌬️ Educating caregivers on how bronchodilators function helps them recognize the importance of using this medication during early symptom onset.

✅ C. The medication will reduce wheezing

🌬️ Wheezing is caused by narrowed or obstructed airways, leading to high-pitched sounds during breathing.

🌬️ By dilating the bronchial passages, albuterol restores airway patency, decreasing airway resistance and reducing turbulent airflow—the primary cause of wheezing.

🌬️ Once the airway is more open, the airflow becomes smoother and more efficient, leading to the gradual resolution of wheezing.

🌬️ The reduction in wheezing also serves as a measurable indicator of treatment effectiveness, helping both caregivers and nurses assess symptom improvement.

🌬️ Proper use of a spacer ensures optimal delivery of the medication to the lower airways, maximizing the bronchodilatory effect.

✅ D. The medication will decrease coughing and shortness of breath

🌬️ Asthma often causes coughing due to airway irritation and constriction, especially at night or during exercise. Albuterol opens the airways, reducing the mechanical stimulation that triggers cough reflexes.

🌬️ As airflow improves and gas exchange becomes more efficient, the sensation of shortness of breath diminishes, allowing the child to breathe more comfortably.

🌬️ The decreased respiratory distress can lead to improved activity tolerance and sleep, which are important quality-of-life factors for children with asthma.

🌬️ This symptom relief also prevents panic or anxiety, which can further exacerbate shortness of breath during asthma attacks.

🌬️ Proper instruction on administration technique enhances symptom management and overall asthma control.

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Answer 5

Correct Answers:

A needleless syringe and a doll.

Rationale :

🧸 Using a needleless syringe with a doll is a therapeutic play technique that helps children understand and feel in control of medical procedures.

🧸 Play-based learning is appropriate for toddlers and young children, helping them process new experiences.

🧸 It reduces fear and anxiety by allowing safe role-playing, especially for conditions like diabetes that involve daily injections.

🧸 This strategy also improves cooperation and trust between the child and healthcare provider.

🧸 It is a developmentally appropriate tool that supports emotional adjustment to chronic illness.

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Answer 6

Correct Answers:

Seizures, confusion, and weakness.

Rationale :

🧠 Sodium levels below 114 mEq/L indicate severe hyponatremia, which leads to cerebral edema and increased intracranial pressure.

🧠 Neurological signs like seizures, confusion, and muscle weakness are common due to sodium’s role in nerve conduction.

🧠 This condition is a medical emergency, requiring rapid but careful correction of sodium.

🧠 The brain is most sensitive to changes in serum sodium, especially in pediatric clients.

🧠 Monitoring neurological status is a priority in these patients due to the risk of seizure progression or coma.

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Answer 7

Correct Answers:

Advise swaddling the baby and placing the baby on its back at a 30- degree angle in the crib.

Rationale :

🌡️ RSV bronchiolitis causes airway inflammation and mucus production, which can worsen in a flat position due to gravity and airway narrowing.

🌡️ Elevating the head of the bed improves lung expansion and decreases the work of breathing in infants with respiratory distress.

🌡️ Swaddling promotes comfort and security, which may reduce irritability and conserve energy in a tachypneic infant.

🌡️ The semi-upright (30-degree) supine position is safe for infants and helps manage breathing without compromising airway safety.

🌡️ Nurses should always teach safe sleep and airway support measures that align with evidence-based respiratory care.

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Answer 8

Correct Answers:

"The quality of food I provide him is more important than the quantity."

Rationale :

🥦 Toddlers commonly go through physiologic anorexia, where appetite decreases due to slower growth, so nutrient-dense foods are more critical than high-calorie intake.

🥦 Providing variety and balanced nutrition ensures the child meets developmental needs even if intake is small.

🥦 Encouraging healthy food exposure without force supports long-term eating habits and reduces picky eating.

🥦 Toddlers need 800–1,000 calories daily, not 3,000, making quality more relevant than quantity.

🥦 Teaching parents to prioritize iron, calcium, and vitamins through food rather than relying on supplements is ideal.

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Answer 9

Correct Answers:

The child is worried about the pain associated with the procedure-

Rationale :

🔥 At age 2, children have a strong association between previous painful experiences and upcoming procedures, leading to anticipatory anxiety.

🔥 Increased heart rate and distress before dressing changes indicate the child remembers prior pain and fears recurrence.

🔥 Developmentally, toddlers lack verbal coping skills and express fear through physical and behavioral cues like crying and tachycardia.

🔥 Preparing the child with comfort strategies and analgesia is critical to reduce procedure-related trauma.

🔥 This response is age-appropriate and expected in repeat painful interventions like burn care.

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Answer 10

Correct Answers:

"l will administer albuterol prior to vest therapy.".

Rationale :

🫁 Albuterol is a bronchodilator that opens the airways, making secretion clearance easier during chest physiotherapy (vest therapy).

🫁 Administering it before the vest therapy loosens secretions enhances mucus mobilization from smaller airways.

🫁 This sequencing improves the effectiveness of postural drainage and reduces respiratory effort.

🫁 In cystic fibrosis, airway clearance routines are structured to begin with bronchodilation → airway clearance → mucolytics or antibiotics.

🫁 Teaching the child this sequence encourages independence and understanding of disease management.

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RN ATI Pediatrics Nurs 243 Exam(Spring 2024)

No.

1 :
The school-based nurse is working with the local school district to promote health and wellness in a school with a large proportion of minority and underprivileged students. Which of the following will be included in the planning? Select all that apply.

2 :
A nurse is teaching parents of a 10-month-old infant about home safety. Which of the following information should the nurse include in the teaching? Select all that apply.

3 :
A 3-year-old child is admitted to a pediatric unit with moderate dehydration. The nurse would expect to see which of the following assessment findings in this child?

4 :
A nurse is caring for a child with asthma who is prescribed to use an albuterol inhaler with a spacer. The parents ask how albuterol helps the child's breathing. Which of the following responses will the nurse include? Select all that apply.

5 :
A nurse is caring for a year-old child who has a new diagnosis of diabetes mellitus and is distressed. The nurse recognizes that which of the following therapeutic actions will help improve the child's cooperation?

6 :
The nurse is caring for a child who is suffering from hypotonic hyponatremia with a sodium level below 114 mEq/L. Which of the following symptoms will the nurse anticipate when assessing the child?

8 :
A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

9 :
A 2-year-old child admitted to a burn unit with second and third- degree burns is scheduled for another wound dressing change. The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?

10 :
A nurse is reviewing the care plan with a school-aged child who has cystic fibrosis and a prescription to receive vest therapy to mobilize respiratory secretions. Which of the following statements by the child indicates an understanding of the plan?

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RN ATI Pediatrics Nurs 243 Exam(Spring 2024)

No.

1 : The school-based nurse is working with the local school district to promote health and wellness in a school with a large proportion of minority and underprivileged students. Which of the following will be included in the planning? Select all that apply.

2 : A nurse is teaching parents of a 10-month-old infant about home safety. Which of the following information should the nurse include in the teaching? Select all that apply.

3 : A 3-year-old child is admitted to a pediatric unit with moderate dehydration. The nurse would expect to see which of the following assessment findings in this child?

4 : A nurse is caring for a child with asthma who is prescribed to use an albuterol inhaler with a spacer. The parents ask how albuterol helps the child's breathing. Which of the following responses will the nurse include? Select all that apply.

5 : A nurse is caring for a year-old child who has a new diagnosis of diabetes mellitus and is distressed. The nurse recognizes that which of the following therapeutic actions will help improve the child's cooperation?

6 : The nurse is caring for a child who is suffering from hypotonic hyponatremia with a sodium level below 114 mEq/L. Which of the following symptoms will the nurse anticipate when assessing the child?

8 : A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

9 : A 2-year-old child admitted to a burn unit with second and third- degree burns is scheduled for another wound dressing change. The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?

10 : A nurse is reviewing the care plan with a school-aged child who has cystic fibrosis and a prescription to receive vest therapy to mobilize respiratory secretions. Which of the following statements by the child indicates an understanding of the plan?

1 :
The school-based nurse is working with the local school district to promote health and wellness in a school with a large proportion of minority and underprivileged students. Which of the following will be included in the planning? Select all that apply.

2 :
A nurse is teaching parents of a 10-month-old infant about home safety. Which of the following information should the nurse include in the teaching? Select all that apply.

3 :
A 3-year-old child is admitted to a pediatric unit with moderate dehydration. The nurse would expect to see which of the following assessment findings in this child?

4 :
A nurse is caring for a child with asthma who is prescribed to use an albuterol inhaler with a spacer. The parents ask how albuterol helps the child's breathing. Which of the following responses will the nurse include? Select all that apply.

5 :
A nurse is caring for a year-old child who has a new diagnosis of diabetes mellitus and is distressed. The nurse recognizes that which of the following therapeutic actions will help improve the child's cooperation?

6 :
The nurse is caring for a child who is suffering from hypotonic hyponatremia with a sodium level below 114 mEq/L. Which of the following symptoms will the nurse anticipate when assessing the child?

8 :
A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

9 :
A 2-year-old child admitted to a burn unit with second and third- degree burns is scheduled for another wound dressing change. The child is anticipating the painful procedure and is anxious and tachycardic as the time approaches. The nurse recognizes that which of the following is likely?

10 :
A nurse is reviewing the care plan with a school-aged child who has cystic fibrosis and a prescription to receive vest therapy to mobilize respiratory secretions. Which of the following statements by the child indicates an understanding of the plan?