a nurse in the emergency department is caring for a toddler who has partial thickness burns on his right arm which of the following actions should the a nurse in the emergency department is caring for a toddler who has partial thickness burns on his right arm which of the following actions should the
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ATI Pediatrics Proctored Exam 2023 Quizlet

1. A toddler in the emergency department has partial thickness burns on his right arm. Which of the following actions should the nurse take?

Correct answer: C

Rationale: When a toddler has partial thickness burns, the nurse should cleanse the affected area with mild soap and water. This action helps remove any loose tissue that could lead to infection and prepares the area for appropriate wound care. Inserting a nasogastric tube (Choice A) is not indicated for a toddler with burns. Initiating prophylactic antibiotic therapy (Choice B) is not necessary for partial thickness burns unless there are signs of infection. Applying a topical corticosteroid (Choice D) is not recommended for initial management of burns as it can delay wound healing.

2. Health practitioners evaluate disease progression in HIV-infected patients by measuring the concentrations of helper T cells and circulating virus, called _____.

Correct answer: D

Rationale: The viral load is the measure of the amount of circulating virus in the blood and is used to evaluate the progression of HIV infection.

3. A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?

Correct answer: C

Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.

4. Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?

Correct answer: C

Rationale: Choosing option C, 'We will watch for skin irritation around the stoma,' demonstrates understanding of proper colostomy stoma care. Monitoring for skin irritation is crucial as it can indicate issues such as leakage, improper sealing, or infection. Options A, B, and D are incorrect. Changing the colostomy bag with each wet diaper (option A) is unnecessary unless indicated by a healthcare provider to prevent skin breakdown. Expecting bleeding after cleansing (option B) is not normal and may signal a problem that requires medical attention. Using adhesive enhancers (option D) should be done based on specific recommendations and not necessarily with every bag change.

5. James is an 18-month-old child who has had a cough for 7 days with no general danger signs. He has a temperature of 37.5°C and a respiratory rate of 41 breaths/minute. How will you classify James' breathing?

Correct answer: C

Rationale: James' breathing is classified as normal because his respiratory rate falls within the expected range for his age group, and there are no general danger signs present. In this case, his breathing is considered normal based on the provided information.

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