you arrive at the scene shortly after a 3 year old female experienced a seizure the child who is being held by her mother is conscious and crying the

ATI LPN

ATI Pediatrics Proctored Test

1. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Correct answer: D

Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.

2. Jaundice in children can be either pathological or physiological. Which of these will you consider as more serious?

A. Jaundice seen within 24 hours of life
B. Jaundice seen at the palms and soles
C. Jaundice appearing after 24 hours of life
D. Jaundice seen after 14 days of life

Correct answer: A

Rationale: Jaundice seen within 24 hours of life is considered more serious in children as it can indicate pathological causes such as hemolytic disease or sepsis, which require prompt evaluation and management to prevent complications. Jaundice appearing within 24 hours of life is concerning due to the higher likelihood of severe conditions, while jaundice seen at the palms and soles is more likely due to physiological causes such as breast milk jaundice. Jaundice appearing after 24 hours or after 14 days of life may still require evaluation but is less urgent compared to jaundice within the first 24 hours.

3. 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.

4. Which of the following is a more reliable indicator of perfusion in children than in adults?

A. Blood pressure
B. Heart rate
C. Respiratory rate
D. Capillary refill

Correct answer: D

Rationale: Capillary refill is a more reliable indicator of perfusion in children than in adults. This is because children have more compliant vessels, making capillary refill a more sensitive indicator of perfusion status in this population. In contrast, while blood pressure, heart rate, and respiratory rate are important indicators, they may not be as reliable in children as capillary refill. Blood pressure can be affected by various factors such as anxiety or pain, heart rate can be influenced by emotions or temperature, and respiratory rate may vary with activity levels. Therefore, capillary refill is preferred in children for a more accurate assessment of perfusion.

5. During the 'Provide practical treatment' phase, what is the nurse expected to do?

A. Greet the mother and inquire about the history
B. Assess for danger signs
C. Give appropriate treatment
D. Check vital signs

Correct answer: C

Rationale: During the 'Provide practical treatment' phase, the nurse is expected to give appropriate treatment to address the patient's needs. This involves implementing the necessary medical interventions or care based on the assessment findings and treatment plan. While greeting the mother, assessing for danger signs, and checking vital signs are important aspects of patient care, the focal point during this phase is to administer the specific treatment required to manage the patient's condition effectively.