Question

A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?

Answer 1

Correct Answers:

Notify the health care provider (HCP)

Rationale :

🧠 The child with a brain tumor exhibiting decreased responsiveness and reduced respiratory rate is showing signs of increased intracranial pressure (ICP).

🧠 These are acute neurological changes, requiring immediate provider notification for potential intervention.

🧠 Raising the head of the bed is helpful for ICP, but the priority is to alert the HCP for evaluation and treatment orders.

🧠 Oximetry and seizure precautions may be useful, but they do not address the urgent neurologic status.

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Answer 2

Correct Answers:

Feelings of isolation and depression

Rationale :

⚠️ Isotretinoin (Accutane) carries a black box warning for severe psychiatric effects, including depression and suicidal ideation.

⚠️ Mood changes must be reported immediately, as they may lead to self-harm.

⚠️ Back pain, nosebleeds, and itching are known side effects but not emergencies.

⚠️ Monitoring for emotional well-being is a critical aspect of isotretinoin therapy in adolescents.

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Answer 3

Correct Answers:

Absent bowel sounds

Rationale :

🩺 After Wilms’ tumor surgery, absent bowel sounds indicate paralytic ileus, which requires continued NPO status.

🩺 Resumption of oral intake before return of bowel function can cause vomiting or bowel perforation.

🩺 Passing flatus is a sign that GI motility is returning.

🩺 Mild pain or slight increase in abdominal girth may be expected post-op, not reasons to keep NPO.

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Answer 4

Correct Answers:

Pain

Rationale :

🔥 Pain is the hallmark symptom of sickle cell crisis due to vessel occlusion by sickled cells.

🔥 Other common symptoms include swelling, fever, and fatigue.

🔥 Bradycardia and constipation are not expected findings.

🔥 Fever may occur if there's infection, but pain is most consistent with vaso-occlusive events.

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Answer 5

Correct Answers:

No Correct Answers Available !

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Answer 6

Correct Answers:

Avoid bubble baths
Wipe perineal area front to back
Complete the course of prescribed antibiotics
Encourage frequent voiding
Wear cotton underwear
Encourage frequent fluids by mouth

Rationale :

A. Avoid bubble baths

💧 Bubble baths are a known irritant to the urethral mucosa, especially in young children.

💧 They can alter the normal pH and allow bacteria easier access to the urinary tract.

💧 Eliminating bubble baths helps reduce recurrent UTIs in children with a history of infection.

B. Wipe front to back

💧 Proper perineal hygiene is critical, especially in females, due to their short urethra.

💧 Wiping front to back prevents contamination of the urethral area with enteric (fecal) bacteria, such as E. coli.

💧 Teaching this habit reduces the incidence of ascending infections.

C. Finish all prescribed antibiotics

💧 Completing the entire antibiotic course ensures that the infection is fully eradicated.

💧 Stopping early can lead to bacterial resistance and recurrent infection.

💧 This teaching is essential for caregiver compliance and long-term health.

D. Encourage frequent voiding

💧 Frequent urination helps flush bacteria from the urinary tract, reducing the time pathogens stay in the bladder.

💧 It also prevents urinary stasis, which is a risk factor for UTI development.

💧 Encourage voiding every 2–3 hours, even if the child doesn’t feel urgency.

E. Encourage the child to wear cotton underwear

💧 Cotton is breathable and absorbent, reducing moisture build-up in the perineal area.

💧 Nylon and tight fabrics trap heat and moisture, creating an ideal environment for bacterial growth.

💧 Loose-fitting, cotton underwear is best for preventing irritation and infection.

F. Encourage increased oral fluid intake

💧 Fluids help dilute urine and increase urine output, which helps eliminate bacteria.

💧 Dehydration leads to concentrated urine, which irritates the bladder and promotes bacterial growth.

💧 Offer water and limit sugary or caffeinated beverages, which can worsen bladder symptoms.

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Answer 7

Correct Answers:

"Bring your baby in to the clinic today.”

Rationale :

🚼 Projectile vomiting in a 2-month-old may indicate pyloric stenosis, a surgical emergency.

🚼 It causes dehydration and electrolyte imbalance, requiring immediate medical evaluation.

🚼 Changing formula or giving oral rehydration is inappropriate without proper assessment.

🚼 This is not typical infant spit-up—delayed care could worsen the condition.

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Answer 8

Correct Answers:

Encourage frequent fluids by mouth
Encourage frequent voiding
Wipe perineal area front to back
Complete the course of prescribed antibiotics

Rationale :

A. Increase fluid intake

🦠 Hydration is key to flushing out bacteria from the urinary tract.

🦠 Increased oral fluids—especially water—promote frequent and complete voiding, which reduces urinary stasis and bacterial multiplication.

🦠 Diluted urine is less irritating to the bladder mucosa and makes bacterial colonization more difficult.

🦠 Dehydration, on the other hand, can lead to concentrated urine, increasing the risk of urinary tract infections (UTIs).

B. Encourage the child to void frequently

🦠 Holding urine for long periods promotes bacterial overgrowth in the bladder.

🦠 Frequent urination helps mechanically eliminate bacteria that may have entered the urinary tract before they can multiply or ascend.

🦠 This also prevents urinary stasis, which is a known risk factor for developing UTIs, especially in children who are toilet trained but reluctant to take bathroom breaks.

🦠 Teach the child to void every 2–3 hours, even if they do not feel a strong urge.

C. Wipe from front to back

🦠 Proper perineal hygiene, especially in female children, is crucial to prevent fecal bacteria such as E. coli from migrating to the urethra.

🦠 Front-to-back wiping minimizes the risk of contaminating the vaginal and urethral openings with stool.

🦠 This simple hygienic practice significantly lowers the recurrence of ascending urinary tract infections in children.

🦠 It’s especially important to reinforce this during toilet training and early school years.

E. Wear cotton underwear

🦠 Cotton is a breathable fabric that allows airflow, keeps the genital area dry, and helps reduce moisture accumulation.

🦠 Moist, warm environments—common with nylon or tight-fitting underwear—encourage bacterial growth and increase UTI risk.

🦠 Cotton underwear helps maintain a drier and less hospitable environment for pathogens, reducing recurrence.

🦠 It also minimizes skin irritation in children prone to perineal rashes or dermatitis.

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Answer 9

Correct Answers:

10

Rationale :

🧮 Weight = 44 lbs = 20 kg

🧮 Dose = 0.5 mg/kg → 0.5 × 20 = 10 mg

🧮 This is within the safe dose limit (5 mg/kg).

🧮 No further conversion needed as question asks mg only, not mL.

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Answer 10

Correct Answers:

Weighing on the same scale each day

Rationale :

⚖️ Nephrotic syndrome causes massive fluid retention, making daily weight the best indicator of fluid balance.

⚖️ Monitoring for sudden gains helps detect edema or worsening condition.

⚖️ Glucose testing is not directly relevant; it's protein that is lost in urine.

⚖️ Fluid restriction or increased ambulation is not a standard intervention unless prescribed.

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RN ATI Nur 270 Paediatrics Exam

No.

1 :
A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?

2 :
A nurse is providing teaching to a 17-year-old female client who has severe acne about the use of isotretinoin. Which of the following adverse effects should the nurse instruct the client is the priority to report immediately to the provider?

3 :
A nurse is caring for a child who is postoperative following surgical removal of a Wilms' tumor. Which of the following assessments sacation.co continue NPO status?

4 :
A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?

5 :
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

6 :
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

7 :
A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is having projectile vomiting immediately after eating Which of the following responses should the nurse make?

8 :
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

10 :
In caring for a child with nephrotic syndrome, which intervention will be most important to be included in the child's plan of care?

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RN ATI Nur 270 Paediatrics Exam

No.

1 : A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?

2 : A nurse is providing teaching to a 17-year-old female client who has severe acne about the use of isotretinoin. Which of the following adverse effects should the nurse instruct the client is the priority to report immediately to the provider?

3 : A nurse is caring for a child who is postoperative following surgical removal of a Wilms' tumor. Which of the following assessments sacation.co continue NPO status?

4 : A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?

5 : A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

6 : A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

7 : A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is having projectile vomiting immediately after eating Which of the following responses should the nurse make?

8 : A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

10 : In caring for a child with nephrotic syndrome, which intervention will be most important to be included in the child's plan of care?

1 :
A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?

2 :
A nurse is providing teaching to a 17-year-old female client who has severe acne about the use of isotretinoin. Which of the following adverse effects should the nurse instruct the client is the priority to report immediately to the provider?

3 :
A nurse is caring for a child who is postoperative following surgical removal of a Wilms' tumor. Which of the following assessments sacation.co continue NPO status?

4 :
A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?

5 :
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

6 :
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

7 :
A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is having projectile vomiting immediately after eating Which of the following responses should the nurse make?

8 :
A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply

10 :
In caring for a child with nephrotic syndrome, which intervention will be most important to be included in the child's plan of care?