you are dispatched to a residence for a 4 year old female who is sick your assessment reveals that she has increased work of breathing and is making a

ATI LPN

LPN Pediatrics

1. You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be:

A. determining if the child has a history of croup.
B. preparing to treat her for a febrile seizure.
C. assessing the need for ventilation assistance.
D. taking her temperature to see how high it is.

Correct answer: C

Rationale: In a child with increased work of breathing, a high-pitched sound during inhalation, and a high fever, upper airway obstruction should be suspected. The child's condition may require immediate ventilation assistance to ensure adequate oxygenation and ventilation. Therefore, the most immediate concern in this scenario is to assess the need for ventilation assistance.

2. Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?

A. Supine with legs elevated
B. Supine with hips elevated
C. Left lateral recumbent
D. Left side with legs elevated

Correct answer: B

Rationale: The most appropriate position for a mother in labor with a prolapsed umbilical cord is supine with hips elevated. This position helps reduce pressure on the cord, preventing further complications and ensuring optimal blood flow to the fetus.

3. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?

A. Give the child honey (simple sugar)
B. Give the child milk (complex sugar)
C. Contact the healthcare provider before doing anything
D. Give the child nothing by mouth

Correct answer: A

Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.

4. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

A. The child should be allowed to play because doing so can foster healthy self-esteem
B. The risk for fractures is increased because GH deficiency results in fragile bones
C. Activity could aggravate insulin sensitivity, causing hyperglycemia
D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

5. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

A. begin ventilations with a bag-mask device.
B. gently flick the soles of their feet for up to 60 seconds.
C. immediately suction their mouth and nose.
D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.