ATI LPN
LPN Pediatrics
1. You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:
- A. begin positive-pressure ventilations and reassess the child.
- B. lower the extremities and reassess the child.
- C. listen to the lungs with a stethoscope for abnormal breath sounds.
- D. insert a nasopharyngeal airway and increase the oxygen flow.
Correct answer: B
Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.
2. The nurse is assisting in the care of a client with a history of angina pectoris who is receiving nitroglycerin patches. Which instruction should the nurse reinforce with the client?
- A. Apply the patch to a different site each time.
- B. Remove the patch at night to prevent tolerance.
- C. Use more than one patch if chest pain occurs.
- D. Shower with caution while wearing the patch.
Correct answer: B
Rationale: Removing the nitroglycerin patch at night is crucial to prevent the development of tolerance. Tolerance can occur when the body becomes accustomed to a constant level of the medication, reducing its effectiveness. By removing the patch at night, the client experiences a drug-free period, which helps prevent tolerance and maintains the effectiveness of the nitroglycerin for angina relief. Choices A, C, and D are incorrect because applying the patch to a different site each time helps prevent skin irritation, using more than one patch is not recommended unless instructed by the healthcare provider, and showering with caution is important to prevent dislodging the patch, but it is not the most critical instruction to prevent tolerance development.
3. A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?
- A. Hypertension
- B. Hypothermia
- C. Constipation
- D. Muscle weakness
Correct answer: A
Rationale: The correct answer is A: Hypertension. Carboprost is a vasoconstrictor medication used to control postpartum hemorrhage by contracting the uterus. One of the adverse effects of carboprost is hypertension due to its vasoconstrictive properties. Hypertension can occur as a result of increased peripheral vascular resistance. Choices B, C, and D are incorrect. Hypothermia, constipation, and muscle weakness are not typically associated with the administration of carboprost. It is crucial for the nurse to monitor the client's blood pressure closely while on carboprost to promptly detect and manage hypertension.
4. A client with a diagnosis of angina pectoris is prescribed nitroglycerin tablets. How should the nurse instruct the client to take the medication?
- A. Swallow the tablet whole with water
- B. Place the tablet under the tongue and let it dissolve
- C. Chew the tablet and then swallow
- D. Place the tablet between the cheek and gum
Correct answer: B
Rationale: Nitroglycerin is most effective when administered sublingually (under the tongue) as it is rapidly absorbed into the bloodstream. Placing the tablet under the tongue allows for quick absorption and faster relief of angina symptoms. Chewing the tablet, swallowing it, or placing it between the cheek and gum would not provide the same rapid onset of action needed during an angina episode. Therefore, the correct instruction for the client is to place the nitroglycerin tablet under the tongue and let it dissolve for optimal effectiveness.
5. A nurse is reinforcing home safety instructions with the parent of a newborn. Which of the following statements should the nurse include in the instructions?
- A. Place your baby's crib away from heat vents
- B. Place the crib close to a heater
- C. Place the crib near a window
- D. Place soft toys in the crib
Correct answer: A
Rationale: The correct answer is A: 'Place your baby's crib away from heat vents.' Placing the crib away from heat vents is essential to prevent the baby from becoming overheated and to reduce the risk of Sudden Infant Death Syndrome (SIDS). Choice B is incorrect because placing the crib close to a heater increases the risk of overheating and poses a fire hazard. Choice C is incorrect as placing the crib near a window exposes the baby to drafts and temperature fluctuations. Choice D is incorrect as soft toys in the crib can pose a suffocation risk to the newborn.
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