Question

A nurse is assessing a child who has nephrotic syndrome. The nurse should expect which of the following findings?

Answer 1

Correct Answers:

Edema with normal or low BP

Rationale :

💧 Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema.

💧 Because of reduced plasma oncotic pressure, fluid shifts into tissues, causing edema.

💧 Despite the fluid retention, blood pressure is typically normal or low due to hypovolemia.

💧 Hypertension is more common in conditions like acute glomerulonephritis, not nephrotic syndrome.

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Answer 2

Correct Answers:

Frequent diaper changes and keeping the incision site clean and dry

Rationale :

🍼 After myelomeningocele closure, protecting the surgical site from infection and moisture is essential.

🍼 Frequent diaper changes reduce the risk of urinary or fecal contamination of the incision.

🍼 The infant should not lie on their back as it may place pressure on the surgical area.

🍼 Feeding and bleeding management should follow standard protocols, but skin care is priority.

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Answer 3

Correct Answers:

Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management
Restriction of weight-bearing activities to prevent further damage
Prescription of crutches for mobility assistance
Application of ice packs to reduce inflammation

Rationale :

A. NSAIDs

🦴 Nonsteroidal anti-inflammatory drugs (NSAIDs) are appropriate for initial pain management in SCFE.

🦴 The condition often presents with gradual onset of hip, groin, thigh, or knee pain, and children may have difficulty walking.

🦴 NSAIDs reduce inflammation and discomfort, aiding in symptom control while awaiting definitive treatment.

🦴 They are not a cure but a helpful supportive measure before surgical intervention.

B. Restriction of weight-bearing

🦴 Weight-bearing on the affected limb can worsen the slip of the femoral head, potentially leading to complications such as avascular necrosis.

🦴 The child should be placed on strict bedrest or non-weight-bearing status as soon as SCFE is suspected.

🦴 This helps stabilize the hip and prevents further displacement before surgery.

🦴 Weight-bearing may only be resumed after surgical stabilization and recovery.

C. Crutches

🦴 Crutches provide safe mobility without placing weight on the affected leg.

🦴 They are essential in supporting the child’s non-weight-bearing status until surgical correction is achieved.

🦴 Proper crutch training also prevents falls and minimizes joint strain.

🦴 Using crutches helps maintain independence and mobility while protecting the injured hip.

D. Ice packs

🦴 Ice therapy can help reduce localized inflammation and swelling, particularly in acute or painful presentations.

🦴 Applying cold compresses may ease discomfort while awaiting further orthopedic evaluation.

🦴 It is a non-pharmacologic method to enhance pain control and complement NSAID use.

🦴 Ice should be used intermittently (e.g., 20 minutes on/off) with a barrier to prevent frostbite.

E. Orthopedic referral

🦴 SCFE is a surgical condition that requires urgent evaluation by an orthopedic surgeon.

🦴 Timely referral is crucial to plan pinning or screw fixation, which stabilizes the femoral head.

🦴 Delay in treatment increases risk for long-term complications, including joint deformity, osteoarthritis, or avascular necrosis.

🦴 Early surgical correction offers the best prognosis for hip function.

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Answer 4

Correct Answers:

Increased somnolence

Rationale :

🧠 Lethargy or increased drowsiness in an infant after trauma suggests elevated intracranial pressure (ICP).

🧠 Other signs include bulging fontanel, high-pitched cry, irritability, and poor feeding.

🧠 Brisk pupil reaction and increased HR are normal or compensatory findings, not ICP-specific.

🧠 Depressed fontanels usually suggest dehydration—not elevated ICP.

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Answer 5

Correct Answers:

"I will give my child a non-steroid anti-inflammatory drug (NSAID) for pain relief if needed."

Rationale :

🩸 NSAIDs like ibuprofen can inhibit platelet aggregation, increasing bleeding risk in hemophilia.

🩸 Preferred medications for pain include acetaminophen, which doesn’t affect clotting.

🩸 Encouraging non-contact sports, protective gear, and injury prevention is correct teaching.

🩸 Misuse of NSAIDs may lead to uncontrolled bleeding even from minor injuries.

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Answer 6

Correct Answers:

Cardiovascular

Rationale :

❤️ Kawasaki disease causes systemic vasculitis, primarily affecting the coronary arteries.

❤️ Children are at risk of coronary aneurysms, MI, and myocarditis if not treated promptly.

❤️ Monitoring includes ECG, echocardiogram, and cardiac enzymes.

❤️ Though the disease affects multiple systems, cardiac complications are the most serious.

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Answer 7

Correct Answers:

Negative Prehn's sign

Rationale :

⚠️ Testicular torsion is a surgical emergency often seen in prepubescent and adolescent males.

⚠️ A negative Prehn's sign means no relief with elevation of the scrotum, supporting torsion diagnosis.

⚠️ Torsion presents with sudden, severe scrotal pain, nausea, vomiting, and possibly abdominal symptoms.

⚠️ Rapid recognition and emergency surgical intervention are critical to preserve testicular function.

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Answer 8

Correct Answers:

Clean the face gently with a mild soap once or twice each day.

Rationale :

🧼 Acne management involves gentle skin care—harsh soaps or scrubbing worsens inflammation.

🧼 Antibacterial soaps and alcohol can dry and irritate the skin, worsening breakouts.

🧼 Dietary restriction (e.g., chocolate) lacks strong evidence and isn’t standard advice.

🧼 Popping pimples spreads bacteria and should be strongly discouraged.

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Answer 9

Correct Answers:

Administer an antiemetic before chemotherapy begins.

Rationale :

🤢 Pre-treatment with antiemetics like ondansetron helps prevent nausea, rather than reacting to it.

🤢 Nausea from chemotherapy is often anticipated and conditioned, especially after initial sessions.

🤢 Waiting for nausea to begin reduces effectiveness and increases distress.

🤢 Hydration and nutrition are also important, but timing of meds is key.

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Answer 10

Correct Answers:

Frequent lung infections.
Dyspnea.
Heart murmur.

Rationale :

B. Frequent lung infections

💓 In VSD, blood flows abnormally from the left to right ventricle, increasing pulmonary blood flow.

💓 This excess blood in the lungs can lead to congestion, resulting in increased susceptibility to infections like bronchitis and pneumonia.

💓 Infants and young children may experience recurrent respiratory illnesses because the lungs are consistently overloaded with blood.

💓 These infections can delay growth and contribute to overall poor health and fatigue.

D. Dyspnea

💓 With VSD, the heart pumps extra blood to the lungs, leading to pulmonary overcirculation and fluid buildup.

💓 This manifests as shortness of breath, especially during activities like feeding in infants or exertion in older children.

💓 Dyspnea may also be noticed as tachypnea, nasal flaring, or retractions in infants.

💓 Persistent dyspnea can contribute to feeding intolerance and failure to thrive if not managed properly.

E. Heart murmur

💓 A loud holosystolic murmur, best heard at the left lower sternal border, is a hallmark sign of a VSD.

💓 It is caused by turbulent blood flow through the septal opening from the higher-pressure left ventricle into the right.

💓 Murmur intensity often correlates with the size of the defect—smaller defects may produce louder murmurs due to higher velocity flow.

💓 Detection of a murmur often prompts echocardiographic evaluation to confirm the diagnosis and assess defect size.

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RN ATI NSG 234 Paediatrics Nursing Exam

No.

1 :
A nurse is assessing a child who has nephrotic syndrome. The nurse should expect which of the following findings?

2 :
A nurse is caring for an infant post operative closure of a myelomeningocele. Which intervention is essential for providing basic care and comfort following myelomeningocele sac closure?

3 :
A Nurse is caring for a child with Slipped Capital Femoral Epiphysis (SCFE). Which interventions should be prioritized for a child with SCFE? SELECT ALL THAT APPLY.

4 :
A nurse is assessing an infant following a motor vehicle crash. Which of the following findings indicate increased intracranial pressure in an Infant?

5 :
A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent Indicates a need for further teaching?

6 :
A nurse is caring for a child who has Kawasaki disease. Which of the following systems should the nurse monitor in response to this diagnosis?

7 :
A Nurse is caring for a 7-year-old child with sudden onset of testicular pain.

Answer Options

8 :
A school nurse is providing teaching to an adolescent client about the management of acne. Which of the following should the nurse include in the Instructions?

9 :
A nurse notices a school-age child with leukemia experiencing severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

10 :
The nurse is caring for a newborn with a Ventricular-Septal Defect (VSD). The nurse should recognize that the signs and symptoms of this defect are? (Select All That Apply.)

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RN ATI NSG 234 Paediatrics Nursing Exam

No.

1 : A nurse is assessing a child who has nephrotic syndrome. The nurse should expect which of the following findings?

2 : A nurse is caring for an infant post operative closure of a myelomeningocele. Which intervention is essential for providing basic care and comfort following myelomeningocele sac closure?

3 : A Nurse is caring for a child with Slipped Capital Femoral Epiphysis (SCFE). Which interventions should be prioritized for a child with SCFE? SELECT ALL THAT APPLY.

4 : A nurse is assessing an infant following a motor vehicle crash. Which of the following findings indicate increased intracranial pressure in an Infant?

5 : A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent Indicates a need for further teaching?

6 : A nurse is caring for a child who has Kawasaki disease. Which of the following systems should the nurse monitor in response to this diagnosis?

7 : A Nurse is caring for a 7-year-old child with sudden onset of testicular pain.

Answer Options

8 : A school nurse is providing teaching to an adolescent client about the management of acne. Which of the following should the nurse include in the Instructions?

9 : A nurse notices a school-age child with leukemia experiencing severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

10 : The nurse is caring for a newborn with a Ventricular-Septal Defect (VSD). The nurse should recognize that the signs and symptoms of this defect are? (Select All That Apply.)

1 :
A nurse is assessing a child who has nephrotic syndrome. The nurse should expect which of the following findings?

2 :
A nurse is caring for an infant post operative closure of a myelomeningocele. Which intervention is essential for providing basic care and comfort following myelomeningocele sac closure?

3 :
A Nurse is caring for a child with Slipped Capital Femoral Epiphysis (SCFE). Which interventions should be prioritized for a child with SCFE? SELECT ALL THAT APPLY.

4 :
A nurse is assessing an infant following a motor vehicle crash. Which of the following findings indicate increased intracranial pressure in an Infant?

5 :
A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent Indicates a need for further teaching?

6 :
A nurse is caring for a child who has Kawasaki disease. Which of the following systems should the nurse monitor in response to this diagnosis?

7 :
A Nurse is caring for a 7-year-old child with sudden onset of testicular pain.

8 :
A school nurse is providing teaching to an adolescent client about the management of acne. Which of the following should the nurse include in the Instructions?

9 :
A nurse notices a school-age child with leukemia experiencing severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

10 :
The nurse is caring for a newborn with a Ventricular-Septal Defect (VSD). The nurse should recognize that the signs and symptoms of this defect are? (Select All That Apply.)