LPN LPN
ATI Pediatric Medications Test
1. How will a ventricular septal defect affect blood flow?
- A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
- B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
- C. No shunting occurs due to high pressure in the left ventricle.
- D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.
Correct answer: A
Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.
2. How would you classify a child at two years of age who has fast breathing without chest indrawing or stridor when calm?
- A. Very severe disease
- B. Pneumonia
- C. No pneumonia
- D. Local infection
Correct answer: B
Rationale: In pediatric clinical assessment, a child at two years of age with fast breathing but without chest indrawing or stridor when calm is classified as having pneumonia. Fast breathing in this context is a key symptom used in the Integrated Management of Childhood Illness (IMCI) guidelines to diagnose pneumonia in children under five years old. The absence of chest indrawing or stridor when the child is calm helps differentiate this case from other respiratory conditions, making pneumonia the likely classification. Choices A, C, and D are incorrect. 'Very severe disease' is too broad and not specific to the symptoms described. 'No pneumonia' is also incorrect as the symptoms match the presentation of pneumonia. 'Local infection' is too vague and does not specifically address the respiratory symptoms observed.
3. The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?
- A. He should increase his fluid intake regularly to thin secretions.
- B. We'll make sure he avoids exercise to prevent attacks.
- C. He is to use his bronchodilator inhaler before the steroid inhaler.
- D. We need to identify what triggers his attacks.
Correct answer: B
Rationale: The correct answer is B. Avoiding exercise entirely is not recommended for asthma management. Regular exercise can actually help strengthen the lungs and improve overall respiratory function. Teaching should focus on appropriate exercise routines that are suitable for individuals with asthma to prevent attacks. Choices A, C, and D are all appropriate and indicate good understanding of asthma management. Increasing fluid intake helps thin secretions, using the bronchodilator inhaler before the steroid inhaler follows the correct order of inhaler administration, and identifying triggers is essential for asthma control.
4. When does the rash in typhoid fever typically appear?
- A. On the second day after symptoms appear
- B. On the third day after symptoms appear
- C. On the fourth day after symptoms appear
- D. On the seventh day after symptoms appear
Correct answer: B
Rationale: In typhoid fever, the rash typically appears on the third day after symptoms first appear. This rash can help in diagnosing the disease along with other symptoms such as fever, malaise, and abdominal pain. Choices A, C, and D are incorrect because the rash in typhoid fever usually appears on the third day, not the second, fourth, or seventh day after the symptoms begin.
5. Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess?
- A. Mild cough
- B. Slight fever
- C. Chest pain
- D. Bulging fontanel
Correct answer: C
Rationale: Chest pain is a common symptom seen in patients with pneumococcal pneumonia. It can result from inflammation of the pleura or irritation of the diaphragm due to the infection. While cough and fever are also common symptoms, chest pain is particularly significant in pneumonia cases as it can be a distressing symptom for the patient and may indicate complications or severity of the infection. Bulging fontanel, on the other hand, is more indicative of conditions affecting infants and is not typically associated with pneumococcal pneumonia in a 12-year-old boy.
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