NGN ATI PEDS PROCTORED EXAMS NEWEST
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
Preschool-Aged Children
Body-Integrity - ANSWER-- Preschool-aged children are very concerned about
their body integrity
- They believe that their insides can leak out from even a small wound.
- Explains reason for their preoccupation with bandages
Preschool (3-6 Years) - ANSWER-- IMITATION of adults: providing a
stethoscope allows child an opportunity for THERAPEUTIC play.
- Time based on events, magical thinking, animism, centration.
- Stress = Regression; may still be picky eaters , sleep 12 hours average, pedestrian
safety
- Keep a consistent bedtime routine
Pyloromyotomy - ANSWER-- Release of hypertrophied muscle around the pyloric
sphincter that causes narrowing of the pyloric canal.
- Infants will be fed shortly postoperative (with return of bowel sounds) in small,
frequent oral feeds.
- There is no incision to the gastric walls or mucosa and NPO is not required.
Chemotherapy - ANSWER-- Low WBC count places the child at risk for infection
and isolation with monitoring of fever is priority.
↓RBC - ANSWER-- Quiet play and best rest, administer O2
↓ Platelet - ANSWER-- Protect child from injury and monitor for bleeding.
- Quiet play should be encouraged, it will lessen the R/F injury and ↓ hemorrhage
Dehydration - ANSWER-- Assessment, response to parenteral fluids.
the nurse should weigh the patient daily because weight is the most sensitive
indicator of hydration status in clients of all ages.
,- Weight is the only measurement the reflects both measurable fluid balance
changes (I/O) and insensible fluid loss (skin and respiratory)
Skeletal Traction - ANSWER-The most effective means of traction, applying to a
bone with wire pins or tongs
Compartment Syndrome - ANSWER-Involves the compression of nerves and
blood vessels due to swelling within the enclosed space created by the fascia that
separates groups of muscles
Acute Glomerulonephritis - ANSWER-- ASO titer will indicate if the child has had
a recent strep infection. In determining a definitive diagnosis for acute
glomerulonephritis.
- Elevated RBCs is expected and the presence of hematuria
- Monitor B.P. Q4hr due to ↑HTN
Myelomeningocele - ANSWER-- Hydrocephalus; is a post-operative risk because
the pathway for the cerebral spinal fluid has been altered.
- Infants --> Measure the head circumference Q shift.
- children with NTDs usually produce too much cerebral spinal fluid and once the
sac is removed, there is nowhere for this additional CSF to accumulate except in
the ventricles of the brain.
Intussusception - ANSWER-- Diagnosed with a barium enema, which may also
correct the condition; the telescoping of the bowel may be reduced by the
hydrostatic pressure of the barium enema.
Nephrotic Syndrome
Prednisone - ANSWER-- In nephrotic syndrome it acts on the body to decrease the
excretion of protein, and thus helps flush fluids back to their normal spaces.
- Extra fluid is excreted in the urine and decreases edema that can be measured in
weight loss.
Spinal Fusion - ANSWER-- Log rolling Q2hr promotes good pulmonary,
gastrointestinal and genitourinary functioning. It also allows the nurse the
opportunity to assess the clients lengthy posterior spinal dressing for drainage or
bleeding.
,- Pt. doesn't ambulate until fusion stabilizes about 4-5 days post-op, elevated HOB
@ 2-3 days post-op
Milwaukee brace - ANSWER-- Worn for scoliosis , stabilizes the spine from the
neck to the pelvis. It must be removed daily for hygiene care, but that is all. Once
the curves has stabilized and spinal growth is nearly complete the ortho surgeon
will begin to wean the client out of the brace, but continues to wear it in the
evening and at night. The brace will often be worn at night several years after
growth is complete to maintain the spinal correction.
Steroid Inhaler - ANSWER-- Help manage asthma be decreasing reactivity of the
airways by preventing or lessening the inflammatory process when the pt. is
exposed to a trigger, so even when manifestation free it is critical to continue using
it.
- They have no immediate bronchodilator effect and are not used for prophylactic
measures.
Urine Specific gravity - ANSWER-Expected finding is 1.010-1.020
↑ = concentration
Anaphylaxis - ANSWER-- Nausea, Tachycardia, Urticaria (hives), Stridor
- Histamine is a vasodilator = Tachycardia and ↓B.P.
- GI response due to increase of histamine release = Nausea
Superficial Partial-Thickness Burn - ANSWER-- High Carbohydrates and Protein
with adequate fat for healing.
- Administer medication 30min. before dressing changes
- Do not change dressings close to feedings therefore perform at least 1 hour before
or after meals.
Autistic - ANSWER-Characteristics include engagement in repetitive activities and
stereotyped movements, resistance to environmental change or change in daily
routines and unusual responses to sensory experiences. The child with autism has
unusual responses to painful stimuli and may engage in self-injurious behaviors as
a form of auto-stimulation.
, Bone Marrow Aspiration - ANSWER-- Lie on abdomen because the specimen is
obtained from the iliac crest.
Iliac crest - ANSWER-Bone marrow aspiration.
Iron Supplement - ANSWER-- Best time is between meals because it is best
absorbed on an empty stomach and in concomitant intake of vitamin C will
increase the bio-availability of the iron.
PICC Line - ANSWER-Preferred venous access device for moderate term IV
therapy, can remain in place for 6 Months or longer with proper care, it is meant to
remain in place for duration of the entire treatment, the catheters designed are
highly flexible and there is no need to immobilize the client, movement is
encouraged to stimulate blood flow and decrease the risk of phlebitis. PICC lines
are inserted at bedside and only local anesthesia is required.
Intussusception - ANSWER-Contraindication: RV (Rotavirus)
Immunocompromised - ANSWER-Contraindication: RV (Rotavirus), MMR, VAR
(Varicella)
School Aged Child
Hospitalization - ANSWER-- Experiences stress related to separation from peers
and regular routines--> try and maintain a normal routine for long hospitalizations
including time for school work, encourage contact with peer group
Infant
Hospitalized - ANSWER-- Stranger anxiety, physical behaviors = pain, sleep
deprivation --> Infants whose parents aren't present place close to nurses’ station,
consistency in caregivers.
Toddler
Hospitalized - ANSWER-- Separation anxiety, intrusion of boundaries = intense
reaction and behavior regression --> Encourage parents to provide routine care,
child autonomy with choices, consistency in caregivers.
Preschooler
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
Preschool-Aged Children
Body-Integrity - ANSWER-- Preschool-aged children are very concerned about
their body integrity
- They believe that their insides can leak out from even a small wound.
- Explains reason for their preoccupation with bandages
Preschool (3-6 Years) - ANSWER-- IMITATION of adults: providing a
stethoscope allows child an opportunity for THERAPEUTIC play.
- Time based on events, magical thinking, animism, centration.
- Stress = Regression; may still be picky eaters , sleep 12 hours average, pedestrian
safety
- Keep a consistent bedtime routine
Pyloromyotomy - ANSWER-- Release of hypertrophied muscle around the pyloric
sphincter that causes narrowing of the pyloric canal.
- Infants will be fed shortly postoperative (with return of bowel sounds) in small,
frequent oral feeds.
- There is no incision to the gastric walls or mucosa and NPO is not required.
Chemotherapy - ANSWER-- Low WBC count places the child at risk for infection
and isolation with monitoring of fever is priority.
↓RBC - ANSWER-- Quiet play and best rest, administer O2
↓ Platelet - ANSWER-- Protect child from injury and monitor for bleeding.
- Quiet play should be encouraged, it will lessen the R/F injury and ↓ hemorrhage
Dehydration - ANSWER-- Assessment, response to parenteral fluids.
the nurse should weigh the patient daily because weight is the most sensitive
indicator of hydration status in clients of all ages.
,- Weight is the only measurement the reflects both measurable fluid balance
changes (I/O) and insensible fluid loss (skin and respiratory)
Skeletal Traction - ANSWER-The most effective means of traction, applying to a
bone with wire pins or tongs
Compartment Syndrome - ANSWER-Involves the compression of nerves and
blood vessels due to swelling within the enclosed space created by the fascia that
separates groups of muscles
Acute Glomerulonephritis - ANSWER-- ASO titer will indicate if the child has had
a recent strep infection. In determining a definitive diagnosis for acute
glomerulonephritis.
- Elevated RBCs is expected and the presence of hematuria
- Monitor B.P. Q4hr due to ↑HTN
Myelomeningocele - ANSWER-- Hydrocephalus; is a post-operative risk because
the pathway for the cerebral spinal fluid has been altered.
- Infants --> Measure the head circumference Q shift.
- children with NTDs usually produce too much cerebral spinal fluid and once the
sac is removed, there is nowhere for this additional CSF to accumulate except in
the ventricles of the brain.
Intussusception - ANSWER-- Diagnosed with a barium enema, which may also
correct the condition; the telescoping of the bowel may be reduced by the
hydrostatic pressure of the barium enema.
Nephrotic Syndrome
Prednisone - ANSWER-- In nephrotic syndrome it acts on the body to decrease the
excretion of protein, and thus helps flush fluids back to their normal spaces.
- Extra fluid is excreted in the urine and decreases edema that can be measured in
weight loss.
Spinal Fusion - ANSWER-- Log rolling Q2hr promotes good pulmonary,
gastrointestinal and genitourinary functioning. It also allows the nurse the
opportunity to assess the clients lengthy posterior spinal dressing for drainage or
bleeding.
,- Pt. doesn't ambulate until fusion stabilizes about 4-5 days post-op, elevated HOB
@ 2-3 days post-op
Milwaukee brace - ANSWER-- Worn for scoliosis , stabilizes the spine from the
neck to the pelvis. It must be removed daily for hygiene care, but that is all. Once
the curves has stabilized and spinal growth is nearly complete the ortho surgeon
will begin to wean the client out of the brace, but continues to wear it in the
evening and at night. The brace will often be worn at night several years after
growth is complete to maintain the spinal correction.
Steroid Inhaler - ANSWER-- Help manage asthma be decreasing reactivity of the
airways by preventing or lessening the inflammatory process when the pt. is
exposed to a trigger, so even when manifestation free it is critical to continue using
it.
- They have no immediate bronchodilator effect and are not used for prophylactic
measures.
Urine Specific gravity - ANSWER-Expected finding is 1.010-1.020
↑ = concentration
Anaphylaxis - ANSWER-- Nausea, Tachycardia, Urticaria (hives), Stridor
- Histamine is a vasodilator = Tachycardia and ↓B.P.
- GI response due to increase of histamine release = Nausea
Superficial Partial-Thickness Burn - ANSWER-- High Carbohydrates and Protein
with adequate fat for healing.
- Administer medication 30min. before dressing changes
- Do not change dressings close to feedings therefore perform at least 1 hour before
or after meals.
Autistic - ANSWER-Characteristics include engagement in repetitive activities and
stereotyped movements, resistance to environmental change or change in daily
routines and unusual responses to sensory experiences. The child with autism has
unusual responses to painful stimuli and may engage in self-injurious behaviors as
a form of auto-stimulation.
, Bone Marrow Aspiration - ANSWER-- Lie on abdomen because the specimen is
obtained from the iliac crest.
Iliac crest - ANSWER-Bone marrow aspiration.
Iron Supplement - ANSWER-- Best time is between meals because it is best
absorbed on an empty stomach and in concomitant intake of vitamin C will
increase the bio-availability of the iron.
PICC Line - ANSWER-Preferred venous access device for moderate term IV
therapy, can remain in place for 6 Months or longer with proper care, it is meant to
remain in place for duration of the entire treatment, the catheters designed are
highly flexible and there is no need to immobilize the client, movement is
encouraged to stimulate blood flow and decrease the risk of phlebitis. PICC lines
are inserted at bedside and only local anesthesia is required.
Intussusception - ANSWER-Contraindication: RV (Rotavirus)
Immunocompromised - ANSWER-Contraindication: RV (Rotavirus), MMR, VAR
(Varicella)
School Aged Child
Hospitalization - ANSWER-- Experiences stress related to separation from peers
and regular routines--> try and maintain a normal routine for long hospitalizations
including time for school work, encourage contact with peer group
Infant
Hospitalized - ANSWER-- Stranger anxiety, physical behaviors = pain, sleep
deprivation --> Infants whose parents aren't present place close to nurses’ station,
consistency in caregivers.
Toddler
Hospitalized - ANSWER-- Separation anxiety, intrusion of boundaries = intense
reaction and behavior regression --> Encourage parents to provide routine care,
child autonomy with choices, consistency in caregivers.
Preschooler
