ATI LPN
LPN Pediatrics
1. 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.
2. A client is receiving phenytoin for management of grand mal seizures and has a new prescription for isoniazid and rifampin. Which of the following should the nurse conclude if the client develops ataxia and incoordination?
- A. The client is experiencing an adverse reaction to rifampin.
- B. The client's seizure disorder is no longer under control.
- C. The client is showing evidence of phenytoin toxicity.
- D. The client is having adverse effects due to combination antimicrobial therapy.
Correct answer: C
Rationale: Ataxia and incoordination are signs of phenytoin toxicity rather than adverse reactions to rifampin or isoniazid. These symptoms indicate that the client is experiencing an adverse effect of phenytoin, requiring a dose adjustment. Choice A is incorrect because rifampin is not typically associated with ataxia and incoordination. Choice B is incorrect as the development of ataxia and incoordination does not necessarily mean the seizure disorder is no longer under control. Choice D is incorrect as the symptoms are more indicative of phenytoin toxicity rather than adverse effects of combination antimicrobial therapy.
3. A patient scheduled for cataract surgery tells the nurse, 'I see just fine and have decided to cancel my surgery.' Which response should the nurse make?
- A. Tell the patient they need the surgery
- B. Encourage the patient to express their thoughts
- C. Ignore the comment and proceed
- D. Insist the patient needs to proceed with the surgery
Correct answer: B
Rationale: Encouraging the patient to express their thoughts is the best response in this situation. It allows the patient to voice their concerns or reasons for canceling the surgery, which can help the healthcare team address any misunderstandings or fears the patient may have. Choices A and D are too directive and do not consider the patient's autonomy and right to make informed decisions about their care. Choice C is inappropriate as it disregards the patient's expressed decision and fails to address the underlying issue.
4. A healthcare professional is preparing to administer an intramuscular (IM) injection to a client. Which of the following actions should the healthcare professional take?
- A. Use a 1-inch needle.
- B. Insert the needle at a 45-degree angle.
- C. Aspirate before injecting the medication.
- D. Administer the injection in the deltoid muscle.
Correct answer: C
Rationale: Aspirating before injecting the medication is a crucial step in IM injections to check for blood return, ensuring that the needle is not in a blood vessel. This technique helps prevent accidental intravascular injection of the medication, reducing the risk of complications such as inadvertent intravenous administration of the substance.
5. A client with a history of seizures is being cared for by a nurse. Which of the following interventions should the nurse prioritize?
- A. Ensure the environment is safe
- B. Administer medications as prescribed
- C. Monitor for signs of infection
- D. Educate the client about triggers
Correct answer: A
Rationale: The nurse should prioritize ensuring the environment is safe for a client with a history of seizures. This intervention is crucial to prevent injury during a seizure. Administering medications as prescribed is important but ensuring a safe environment takes precedence to prevent harm. Monitoring for signs of infection and educating the client about triggers are also essential aspects of care but are not the priority when considering the immediate safety of the client during a seizure.
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