Question

A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

Answer 1

Correct Answers:

Rice

Rationale :

🌾 Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye.

🌾 When a child with celiac disease consumes gluten, it causes an inflammatory response in the small intestine, leading to villous atrophy, malabsorption, diarrhea, abdominal pain, and growth issues.

🌾 Rice is a naturally gluten-free grain, making it a safe and nutritious alternative for children with celiac disease.

🌾 Dietary management of celiac disease requires lifelong adherence to a strict gluten-free diet to avoid complications like failure to thrive, iron-deficiency anemia, or delayed puberty.

🌾 The nurse should educate the parent to avoid foods and products containing wheat, barley, rye, bulgur, semolina, and many processed foods unless labeled gluten-free.

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Answer 2

Correct Answers:

13% weight loss

Rationale :

💧 In infants, dehydration severity is classified by the percentage of body weight lost due to fluid loss.

💧 A 13% weight loss is indicative of severe dehydration, which requires immediate IV fluid replacement, close monitoring, and electrolyte management.

💧 Other signs of severe dehydration may include sunken fontanels, dry mucous membranes, lethargy, delayed capillary refill (>4 seconds), and tachypnea, not bradypnea.

💧 A bulging fontanel would suggest increased intracranial pressure, not dehydration.

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Answer 3

Correct Answers:

Oral rehydration solution

Rationale :

🧃 Oral Rehydration Solutions (ORS) are specially formulated fluids that contain balanced glucose and electrolytes (sodium, potassium, chloride, bicarbonate).

🧃 They are the first-line treatment for children with mild to moderate dehydration who are able to take fluids orally.

🧃 Fluids like broth, water, or diluted juices may worsen diarrhea or fail to adequately replace lost electrolytes.

🧃 ORS prevents progression to severe dehydration and supports safe recovery at home or in outpatient care.

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Answer 4

Correct Answers:

Elbow

Rationale :

🙅 After cleft lip and palate repair, it is critical to protect the surgical site from being disturbed by the infant’s hands.

🙅 Elbow restraints (also called "no-no's") prevent the child from bending their elbows and reaching their mouth, reducing the risk of suture disruption or infection.

🙅 These restraints allow for mobility of the shoulders and should be removed regularly for skin checks and gentle ROM exercises.

🙅 Other restraints, like mummy or jacket restraints, are either too restrictive or not appropriate for preventing hand-to-mouth contact.

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Answer 5

Correct Answers:

Adjusting fluid replacement based on weight and age.

Rationale :

⚖️ Pediatric fluid replacement must be calculated based on body weight (in kilograms) and sometimes adjusted further based on age or developmental needs.

⚖️ Children have a higher metabolic rate and larger extracellular fluid volume per kilogram than adults, making them more vulnerable to rapid fluid loss and electrolyte imbalance.

⚖️ The 100-50-20 rule is often used to calculate daily fluid maintenance: 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kg over 20.

⚖️ Using adult guidelines or over-replacing fluids in children may result in fluid overload, hyponatremia, or heart strain.

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Answer 6

Correct Answers:

"I'm glad that my child's ostomy is only temporary!'

Rationale :

🩺 In Hirschsprung disease, the initial surgical intervention often includes creating a temporary ostomy to allow decompression and rest of the bowel.

🩺 Later, the definitive repair (pull-through procedure) is performed, and the ostomy is closed.

🩺 It is important for parents to understand that the ostomy is a staged approach, not permanent.

🩺 The other statements are inaccurate—there can be complications, and follow-up care is essential for bowel function and surgical outcomes.

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Answer 7

Correct Answers:

Assess the surgical site for signs of infection

Rationale :

🩺 Omphalocele is a congenital abdominal wall defect where the intestines and sometimes other organs protrude into a sac outside the body. After surgical repair, the infant is at high risk for infection, particularly at the surgical incision site, due to the prior exposure of abdominal contents and the complexity of the closure.

🩺 The priority for the nurse postoperatively is to closely assess the surgical site for signs of infection such as redness, warmth, swelling, purulent drainage, or increased temperature, which could signal the onset of wound infection or sepsis.

🩺 Although pain management, parental education, and age-appropriate stimulation are all important aspects of care, infection prevention and early detection are life-saving and take priority in the immediate postoperative period.

🩺 Early recognition allows for prompt intervention, including antibiotics, wound cultures, or surgical revision if needed, to prevent complications like peritonitis or septicemia.

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Answer 8

Correct Answers:

Facial edema

Rationale :

😯 In nephrotic syndrome, facial (periorbital) edema is one of the earliest and most noticeable symptoms caused by massive proteinuria and hypoalbuminemia.

😯 Loss of albumin reduces plasma oncotic pressure, leading to fluid shift into interstitial tissues.

😯 The edema typically begins around the eyes in the morning and progresses to generalized edema throughout the day.

😯 Polyuria is rare in this condition, and though hypertension or dark urine may occur, edema is the most characteristic finding.

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Answer 9

Correct Answers:

Check the child's daily weight

Rationale :

⚖️ In acute glomerulonephritis, there is impaired kidney filtration, leading to fluid retention, edema, and potential hypertension.

⚖️ Daily weight monitoring is the most sensitive and non-invasive way to assess fluid balance and determine if fluid restriction or diuretics are effective.

⚖️ Sudden increases in weight can signal worsening fluid overload, even before clinical signs appear.

⚖️ While a no-salt diet and parental education are part of care, monitoring weight takes priority for immediate safety.

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Answer 10

Correct Answers:

Monitor the child's hydration status closely

Rationale :

💧 Watery diarrhea for 3 days places a child at significant risk for dehydration, especially due to their higher body water content and limited fluid reserves compared to adults.

💧 The priority nursing action is to assess and monitor for signs of dehydration, including dry mucous membranes, sunken eyes or fontanels, decreased urine output, lethargy, and tachycardia.

💧 Administering antibiotics is often not appropriate, especially if the diarrhea is viral in origin, and doing so may worsen symptoms or cause resistance.

💧 Over-the-counter antidiarrheals are generally contraindicated in children, as they can lead to toxic megacolon or delay the clearance of pathogens.

💧 A high-fiber diet is not recommended during active diarrhea; instead, the focus should be on small, frequent meals, and oral rehydration using appropriate solutions.

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RN ATI Pediatrics Exam II

No.

1 :
A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

2 :
A nurse is admitting an infant who has severe dehydration from acute gastroenteritis. Which of the following findings should the nurse expect?

3 :
A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid?

4 :
A nurse is caring for a 2-month-old infant who is postoperative following repair of a cleft lip and palate. The provider prescribes restraints. The nurse should apply which of the following types of restraints for this infant?

5 :
Which of the following is an appropriate consideration for pediatric fluid replacement?

6 :
A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements by the parent indicates an understanding of the teaching?

7 :
A nurse is caring for an infant following surgical repair of omphalocele. What is the nurse's priority?

8 :
A nurse is assessing a child who has nephrotic syndrome. Which of the following actions is the nurse's priority?

9 :
A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions is the nurse's priority?

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

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RN ATI Pediatrics Exam II

No.

1 : A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

2 : A nurse is admitting an infant who has severe dehydration from acute gastroenteritis. Which of the following findings should the nurse expect?

3 : A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid?

4 : A nurse is caring for a 2-month-old infant who is postoperative following repair of a cleft lip and palate. The provider prescribes restraints. The nurse should apply which of the following types of restraints for this infant?

5 : Which of the following is an appropriate consideration for pediatric fluid replacement?

6 : A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements by the parent indicates an understanding of the teaching?

7 : A nurse is caring for an infant following surgical repair of omphalocele. What is the nurse's priority?

8 : A nurse is assessing a child who has nephrotic syndrome. Which of the following actions is the nurse's priority?

9 : A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions is the nurse's priority?

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

1 :
A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

2 :
A nurse is admitting an infant who has severe dehydration from acute gastroenteritis. Which of the following findings should the nurse expect?

3 :
A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid?

4 :
A nurse is caring for a 2-month-old infant who is postoperative following repair of a cleft lip and palate. The provider prescribes restraints. The nurse should apply which of the following types of restraints for this infant?

5 :
Which of the following is an appropriate consideration for pediatric fluid replacement?

6 :
A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements by the parent indicates an understanding of the teaching?

7 :
A nurse is caring for an infant following surgical repair of omphalocele. What is the nurse's priority?

8 :
A nurse is assessing a child who has nephrotic syndrome. Which of the following actions is the nurse's priority?

9 :
A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions is the nurse's priority?

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