ATI LPN
LPN Pediatrics
1. You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation?
- A. Inform the parents of your suspicions.
- B. Transport the child to the hospital regardless of the parents' wishes.
- C. Call the police and have the parents arrested.
- D. Advise the parents that the child needs to be transported.
Correct answer: D
Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported for further evaluation and care is the appropriate initial step. This ensures that the child receives necessary medical attention while also addressing the suspicion of abuse through proper channels. It is essential to involve appropriate authorities and follow established procedures to protect the child and investigate any potential abuse further.
2. The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage does the nurse instruct the client to select from the menu?
- A. Tea
- B. Cola
- C. Coffee
- D. Lemonade
Correct answer: D
Rationale: Lemonade is the correct choice as it is caffeine-free, unlike tea, cola, and coffee, which contain caffeine that can potentially affect the client's heart rhythm. Caffeine can increase heart rate and blood pressure, which may not be advisable for a client with a recent MI. Tea, cola, and coffee should be avoided due to their caffeine content, which can have stimulant effects on the heart and may not be beneficial for a client recovering from a myocardial infarction.
3. A client has been taking levothyroxine for 6 months. Which of the following findings indicates that the medication is effective?
- A. Weight gain
- B. Increased heart rate
- C. Decreased TSH levels
- D. Elevated blood pressure
Correct answer: C
Rationale: In a client taking levothyroxine for thyroid hormone replacement, decreased TSH levels indicate that the medication is effective. TSH levels decrease as the thyroid hormone levels are adequately replaced by levothyroxine, signaling a positive response to treatment. Choices A, B, and D are incorrect because weight gain, increased heart rate, and elevated blood pressure are not expected findings indicating the effectiveness of levothyroxine therapy. Weight gain may suggest inadequate dosing, while increased heart rate and elevated blood pressure could indicate over-replacement or side effects of the medication.
4. After returning the client to bed following a cardiac catheterization procedure with the left femoral vessel as the access site, the nurse places a sign above the bed instructing the client to remain on bed rest and in which position?
- A. In semi-Fowler's position
- B. With the head of the bed elevated 45 degrees
- C. With the head of the bed elevated no more than 15 degrees
- D. With the foot of the bed elevated as much as tolerated by the client
Correct answer: C
Rationale: After cardiac catheterization via the femoral vessel, it is crucial to keep the head of the bed elevated no more than 15 degrees to prevent bleeding at the access site. This position helps maintain pressure on the femoral artery, reducing the risk of bleeding and complications post-procedure. Choices A, B, and D are incorrect because they do not provide the necessary pressure on the femoral artery to prevent bleeding, which is essential after a cardiac catheterization procedure with a femoral access site.
5. A client in active labor has 7 cm of cervical dilation, 100% effacement, and the fetus at 1+ station. The client's amniotic membranes are intact, but she suddenly expresses the need to push. What should the nurse do?
- A. Assist the client into a comfortable position.
- B. Observe the perineum for signs of crowning.
- C. Have the client pant during the next contractions.
- D. Help the client to the bathroom to void.
Correct answer: C
Rationale: Having the client pant during contractions is crucial to prevent premature pushing, particularly when the cervix is not fully dilated. Premature pushing can lead to cervical swelling and may impede the progress of labor. It is important to allow the cervix to fully dilate before active pushing to prevent complications. Assisting the client into a comfortable position (Choice A) may not address the urge to push and can lead to premature pushing. Observing the perineum for signs of crowning (Choice B) is important but does not address the immediate need to prevent premature pushing. Helping the client to the bathroom to void (Choice D) does not address the urge to push and may not be appropriate at this stage of labor.
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