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. Physical abuse of a 4-year-old child should be suspected if you observe:

A. purple and yellow bruises on the thighs.
B. bruises on the anterior tibial area.
C. the child clinging to his or her parent.
D. curious siblings watching you.

Correct answer: A

Rationale: Purple and yellow bruises on protected areas like the thighs are concerning as they indicate bruises in various stages of healing, which is a red flag for physical abuse. Bruises on the anterior tibial area or a child clinging to a parent are not specific signs of physical abuse. Siblings watching you is unrelated to the suspicion of physical abuse in this scenario.

3. Why should small children ride in the backseat of a vehicle?

A. They are much less likely to be ejected from the vehicle.
B. The back of the front seat will provide a cushion during a crash.
C. They can experience severe injury or death if the airbag deploys.
D. Their legs are highly prone to injury from striking the dashboard.

Correct answer: C

Rationale: Small children should ride in the backseat of a vehicle primarily to avoid severe injury or death that may occur if the airbag deploys. In the event of a crash, the force of an airbag deployment can be dangerous for a child seated in the front seat. Placing them in the backseat reduces the risk of serious harm from airbag impact and is a safer seating position for young passengers.

4. When evaluating a client's fluid intake and output record, how should fluid intake and urine output relate?

A. Fluid intake should double the urine output
B. Fluid intake should be approximately equal to the urine output
C. Fluid intake should be half the urine output
D. Fluid intake should be inversely proportional to the urine output

Correct answer: B

Rationale: In assessing a client's fluid intake and output record, it is essential for fluid intake to be approximately equal to the urine output. This balance indicates proper hydration and renal function. Deviations from this balance could signify potential issues that need further investigation and management.

5. The provider is educating the parents of a newborn about circumcision care. Which of the following instructions should be included?

A. Cleanse the penis with each diaper change using alcohol wipes.
B. Avoid using petroleum jelly on the circumcision site.
C. Report any yellowish exudate around the head of the penis.
D. Use warm water to clean the penis gently during diaper changes.

Correct answer: D

Rationale: The correct instruction for circumcision care is to use warm water to gently clean the penis during diaper changes. Alcohol wipes should be avoided as they can cause irritation. Yellowish exudate around the head of the penis is a normal part of the healing process and does not require reporting unless accompanied by other concerning symptoms. Avoiding petroleum jelly on the circumcision site is important to prevent trapping moisture and bacteria, which can lead to infection.