a 30 year old woman is 22 weeks pregnant with her first child she tells you that her rings are not fitting as loosely as they usually do and that her
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LPN Pediatrics

1. A 30-year-old woman is 22 weeks pregnant with her first child. She tells you that her rings are not fitting as loosely as they usually do and that her ankles are swollen. Her blood pressure is 150/86 mm Hg. She is MOST likely experiencing:

Correct answer: D

Rationale: The symptoms of swollen ankles, tight rings, and elevated blood pressure in a pregnant woman at 22 weeks gestation are concerning for preeclampsia. Preeclampsia is characterized by high blood pressure and signs of organ damage, commonly seen with symptoms such as swelling (edema) and protein in the urine. It is crucial to monitor and manage preeclampsia promptly as it can lead to severe complications for both the mother and the baby.

2. During the pediatric assessment process, which scenario would be the LEAST appropriate for the transition phase?

Correct answer: B

Rationale: During a pediatric assessment, the transition phase is a critical period where care is handed over from prehospital providers to the hospital team. If the child is unstable and requires rapid transport, it is not appropriate to delay for a transition phase. In such cases, immediate transport to a higher level of care is paramount to ensure the child's safety and well-being. Choice A is appropriate as having a parent present can help keep the child calm during the transition. Choice C is also appropriate as transitioning a stable child allows for a smoother handover. Choice D, while indicating a longer transport time, does not necessarily affect the need for a transition phase as long as the child's condition remains stable.

3. Which type of diabetes mellitus (DM) is most likely the result of heterogeneous risk factors, making it preventable?

Correct answer: B

Rationale: Type 2 diabetes mellitus is most likely the result of heterogeneous risk factors, such as lifestyle choices and genetics, making it preventable. Type 1 diabetes, on the other hand, is an autoimmune condition that is not preventable. Gestational diabetes occurs during pregnancy and is not entirely preventable. Type 1 and 2 diabetes are distinct conditions, with Type 2 being the type associated with preventable risk factors.

4. Where is the most appropriate location to perform a procedure on a preschooler?

Correct answer: B

Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.

5. A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. Her father is blaming the mother for neglecting the child while she was cooking. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?

Correct answer: A

Rationale: In this scenario, the priority is to assess the child's vital signs first, including heart rate, respiratory rate, and blood pressure. These data will provide critical information on the child's current physiological status and guide further interventions. Option B, recent exposure to communicable diseases, is not the priority in an acute ingestion situation. Option C, number of immunizations received, and option D, height and weight, are important but not as critical as assessing vital signs in this immediate situation.

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