ATI Pediatrics Test Bank

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Olympic gymnast Ms. Slovenski sufferd a great fall and suffered a great fall and fractured her femur. Approximately after 20 hours in the hospital she became dyspneic, tachypneic, and with scattered crackles in her lung fields. She is coughing up large amounts of thick, white sputum. The nurse correctly interprets this as:

  • A. respiratory compromise related to inhalation of smoke
  • B. pneumonia related to prolonged bedrest
  • C. fat embolism syndrome related to femur fracture
  • D. hypovolemic shock related to multiple trauma
Correct Answer: C

Rationale: The symptoms described in the scenario - dyspnea, tachypnea, crackles in lung fields, and coughing up thick, white sputum - are indicative of fat embolism syndrome (FES), which occurs as a complication of long bone fractures like the femur fracture in this case. FES is characterized by the release of fat droplets into the bloodstream, which can then travel to the lungs and cause respiratory distress. The onset of symptoms typically occurs within 24-72 hours after the initial injury, making it a likely cause for Ms. Slovenski's condition. This is a medical emergency that requires prompt recognition and intervention to prevent further complications. The other options (A, B, and D) do not align with the clinical picture presented in the scenario and are less likely causes of her current symptoms.

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A few minutes after beginning a blood transfusion, the nurse notes that the client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem?

  • A. A hemolytic reaction to mismatched blood
  • B. A hemolytic reaction to Rh-incompatible blood
  • C. A hemolytic allergic reaction caused by bacterial contamination of donor blood
  • D. None of the above
Correct Answer: A

Rationale: The client is likely experiencing a hemolytic reaction to mismatched blood due to the symptoms of chills, dyspnea, and urticaria occurring shortly after beginning the blood transfusion. These symptoms are classic signs of a transfusion reaction, especially a hemolytic reaction where the recipient's immune system attacks the transfused red blood cells. This can happen if the donor blood is not compatible with the recipient's blood type, leading to a severe reaction. It is crucial to report this immediately to the physician to halt the transfusion and provide appropriate treatment to the client.

Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?

  • A. Thirst
  • B. Irritability
  • C. Apprehension
  • D. Confusion and somnolence
Correct Answer: D

Rationale: As shock progresses and becomes decompensated in a child, profound perfusion abnormalities lead to inadequate oxygen and nutrient delivery to the brain. This can result in altered mental status such as confusion and somnolence. As the body struggles to maintain adequate perfusion to vital organs, the brain may be one of the first organs to demonstrate signs of inadequate perfusion. Thirst, irritability, and apprehension are more commonly seen in the early stages of shock. Confusion and somnolence indicate a more severe and critical state of shock where the child's body is struggling to maintain adequate blood flow to vital organs, including the brain.

Bell's palsy is a ___ cranial nerve disorder characterized by weakness or paralysis of the facial muscles.

  • A. 3rd
  • B. 7th
  • C. 5th
  • D. 8th
Correct Answer: B

Rationale: Bell's palsy is a cranial nerve disorder characterized by weakness or paralysis of the facial muscles due to inflammation, compression, or damage to the seventh cranial nerve - the facial nerve. The facial nerve controls the muscles responsible for facial expressions and functions like smiling, closing the eyes, and raising the eyebrows. Symptoms of Bell's palsy can include drooping of one side of the face, difficulty in closing one eye, drooling, impaired taste, and difficulty in smiling.

Which screening test is a neonatal nurse likely to use to detect developmental dysplasia of the hip (DDH)?

  • A. Barlow's maneuver
  • B. Pavlik's maneuver
  • C. Gower's maneuver
  • D. Allis's maneuver
Correct Answer: B

Rationale: Neonatal nurses are likely to use Pavlik's maneuver to detect developmental dysplasia of the hip (DDH) in newborns. Pavlik's maneuver is a technique used to diagnose, treat, and manage DDH in infants. It involves positioning the infant's hips in a flexed and abducted position to help stabilize the hip joint and promote proper development. This technique is gentle and non-invasive, making it suitable for screening infants for hip dysplasia. Other maneuvers listed, such as Barlow's, Gower's, and Allis's maneuvers, are different techniques used to assess hip stability or alignment and are not specific to DDH screening in newborns.

An adult who has gastroenteritis and is on digitalis ha lab values of: K 3.2 mEq/L, Na 136 mEq/L, Ca 8.8 mg/dl, and Cl 98 mEq/L. the nurse puts which of the following on the client's plan of care?

  • A. Stop digitalis therapy
  • B. Observe for trousseau's and chovestek's
  • C. Avoid foods rich in potassium signs
  • D. Observe for digitalis toxicity
Correct Answer: C

Rationale: The client's low potassium level (K 3.2 mEq/L) is a cause for concern, especially in a patient on digitalis therapy. Digitalis (such as digoxin) can potentiate the effects of hypokalemia, leading to an increased risk of digitalis toxicity. Therefore, in this scenario, it is important to avoid foods rich in potassium to prevent further lowering of the potassium level. It is essential to address the electrolyte imbalance promptly to prevent potential complications related to digitalis therapy.

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