Question

A nurse is preparing to apply lidocaine and prilocaine cream to a child prior to the insertion of an IV catheter.Which of the following actions should the nurse plan to take?

Answer 1

Correct Answers:

Apply the cream 1 hr. before the procedure

Rationale :

🕒Topical anesthetics such as lidocaine and prilocaine cream require adequate time to penetrate the skin and reach maximum effectiveness.

🧴Application should be done at least 1 hour prior to the procedure to ensure sufficient dermal absorption and local anesthetic effect.

🚫The nurse should not rub the cream into the skin, as this can alter absorption and increase the risk of skin irritation or systemic absorption.

🧼The area should be clean and dry, but not prepped with alcohol, as alcohol may cause stinging and affect the skin barrier.

🩹A transparent dressing is usually applied over the cream to keep it in place and ensure proper absorption until removal before the procedure.

📌Core Message

Apply lidocaine-prilocaine cream at least 1 hour before IV insertion to allow for maximum skin numbing and ensure a less painful procedure. Avoid rubbing or using alcohol before application.

Answer 2

Correct Answers:

Maintain an Ng tube for decompression

Rationale :

🧪Meckel diverticulum repair involves surgical correction of a congenital anomaly that can cause intestinal obstruction or bleeding.

🧷After surgery, it is essential to decompress the gastrointestinal tract using a nasogastric (NG) tube to prevent abdominal distention and reduce pressure on the surgical site.

🛌Postoperative care includes monitoring for signs of infection and bowel function return, but long-term antibiotics are not typically necessary unless complications arise.

🚫Ostomy care is not relevant unless there is a stoma, which is not a standard outcome of Meckel diverticulum repair.

📌Core Message

Post-op care for Meckel diverticulum repair includes NG tube decompression to support bowel rest and healing.

Answer 3

Correct Answers:

hyperpyrexia

Rationale :

🔥Acute acetylsalicylic acid (aspirin) poisoning causes central nervous system stimulation, which can lead to hyperpyrexia (very high fever).

🧪The overdose disrupts metabolic processes, particularly leading to metabolic acidosis, which further raises body temperature.

🧍This condition can present with vomiting, confusion, restlessness, tachypnea, and fever, especially in children.

🚫Jaundice, neck vein distension, and polyuria are not hallmark features of acute aspirin poisoning and suggest different diagnoses.

📌Core Message

Hyperpyrexia is a critical sign of aspirin toxicity due to CNS excitation and metabolic acidosis.

Answer 4

Correct Answers:

initiate bleeding precautions

Rationale :

🩸Children with acute lymphocytic leukemia (ALL) often experience thrombocytopenia due to bone marrow suppression, which increases bleeding risk.

🚫Procedures such as rectal temperatures or using hard toothbrushes should be avoided to reduce trauma to mucous membranes.

🧼Bleeding precautions include soft-bristle toothbrush use, avoiding injections when possible, and careful monitoring for petechiae or bruising.

🧃Viscous lidocaine is contraindicated in young children due to risk of aspiration and seizures if swallowed.

📌Core Message

Children with ALL must follow bleeding precautions because of their reduced platelet counts and fragile mucosal integrity.

Answer 5

Correct Answers:

Encourage the adolescent to perform incentive spirometry to maintain lung capacity

Rationale :

🫁Muscular dystrophy weakens skeletal and respiratory muscles, which compromises ventilation and lung expansion.

📈Incentive spirometry encourages deep breathing and maintains pulmonary function, reducing the risk of atelectasis.

💉Routine vaccines should be encouraged, not avoided, as infections can further worsen respiratory health.

🧴Excessive chest physiotherapy or unnecessary wheelchair use could reduce independence and isn’t preventive unless clinically indicated.

📌Core Message

Incentive spirometry preserves lung capacity in clients with progressive respiratory muscle weakness from muscular dystrophy.

Answer 6

Correct Answers:

Your child should walk the bicycle through intersections

Rationale :

🚸Walking the bicycle across intersections reduces the risk of accidents and improves visibility to drivers.

🚳Children are more vulnerable in intersections where rapid decisions are needed, so dismounting is safest.

🚴‍♂️Feet should be able to touch the ground while seated—elevation of 3–6 inches is not safe.

🚫Riding against traffic is dangerous; children should always ride with traffic and stay near the curb.

📌Core Message

Children should walk bicycles through intersections to improve safety and visibility in traffic environments.

Answer 7

Correct Answers:

Provide a pacifier coated with an oral sucrose prior to injections

Rationale :

🍬Oral sucrose has an analgesic effect in infants by promoting endogenous opioid release, making procedures like injections less distressing.

👶This method is simple, safe, and highly effective for atraumatic care in infants under 6 months.

💉The deltoid muscle is not appropriate for intramuscular injections in infants—vastus lateralis is preferred.

🧴EMLA cream needs to be applied 30–60 minutes in advance, so immediate application would not provide benefit.

📌Core Message

Oral sucrose with a pacifier provides safe, effective pain relief during immunizations for young infants.

Answer 8

Correct Answers:

Keep staff visits with the child brief

Rationale :

🤯Children with autism spectrum disorder (ASD) often experience sensory overload, so short, predictable interactions help reduce distress.

🧩Maintaining consistent routines is essential—unexpected changes or prolonged interactions can provoke anxiety or behavioral outbursts.

📺Leaving background noise like a TV on can increase overstimulation and confusion for a child with ASD.

🚫Semiprivate rooms expose the child to more uncontrolled stimuli, which may hinder progress or comfort.

📌Core Message

Children with autism benefit from brief, structured interactions and minimized sensory input to promote comfort and cooperation.

Answer 9

Correct Answers:

Sunken anterior fontanel

Rationale :

💧A sunken fontanel is a late and serious sign of severe dehydration in infants and signals urgent fluid loss.

⚠️Infants with heart failure are already hemodynamically vulnerable, so dehydration can quickly lead to shock or organ hypoperfusion.

📉Heart rate of 162/min is elevated but expected in distress; it is not as immediately life-threatening as dehydration signs.

🧪Potassium of 5.1 mEq/L is mildly elevated but would not take priority unless associated with ECG changes.

📌Core Message

A sunken fontanel indicates severe dehydration and requires immediate fluid management in vulnerable infants.

Answer 10

Correct Answers:

I will elevate my broken arm on pillows a tonight

Rationale :

🛏️Elevation reduces swelling and pain, improving comfort and circulation during the early healing phase.

🖐️Movement of fingers is encouraged to maintain mobility and prevent stiffness, not restricted.

🚫Persistent swelling should not be expected for several days and may indicate compartment syndrome.

💨Baby powder inside a cast can trap moisture, leading to skin breakdown or infection.

📌Core Message

Elevation of a casted limb reduces swelling and discomfort and promotes better circulation during recovery.

ATI Pediatrics Proctored Exam

No.

1 :
A nurse is preparing to apply lidocaine and prilocaine cream to a child prior to the insertion of an IV catheter.Which of the following actions should the nurse plan to take?

2 :
A nurse is planning care for an adolescent following repair of Meckel Diverticulum.Which of the following actions should the nurse include in the plan of care?

3 :
A nurse in an emergency department is caring for a preschool- age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect?

4 :
A nurse is reviewing the medical record of a 24-month-old child who has acute lymphocytic leukemia.Which of the following actions should the nurse take?

5 :
A nurse is creating a plan of care for an adolescent who has muscular dystrophy.Which of the following interventions should the nurse include in the plan?

6 :
A nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?

7 :
A nurse is preparing to administer immunizations to a 3- month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care?

8 :
A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care?

9 :
A nurse is caring for a 2-month-old infant who has heart failure and is receiving furosemide. Which of the following findings is the nurse's priority?

10 :
A nurse is educating an adolescent following this application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching?

ATI Pediatrics Proctored Exam

No.

1 : A nurse is preparing to apply lidocaine and prilocaine cream to a child prior to the insertion of an IV catheter.Which of the following actions should the nurse plan to take?

2 : A nurse is planning care for an adolescent following repair of Meckel Diverticulum.Which of the following actions should the nurse include in the plan of care?

3 : A nurse in an emergency department is caring for a preschool- age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect?

4 : A nurse is reviewing the medical record of a 24-month-old child who has acute lymphocytic leukemia.Which of the following actions should the nurse take?

5 : A nurse is creating a plan of care for an adolescent who has muscular dystrophy.Which of the following interventions should the nurse include in the plan?

6 : A nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?

7 : A nurse is preparing to administer immunizations to a 3- month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care?

8 : A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care?

9 : A nurse is caring for a 2-month-old infant who has heart failure and is receiving furosemide. Which of the following findings is the nurse's priority?

10 : A nurse is educating an adolescent following this application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching?

1 :
A nurse is preparing to apply lidocaine and prilocaine cream to a child prior to the insertion of an IV catheter.Which of the following actions should the nurse plan to take?

2 :
A nurse is planning care for an adolescent following repair of Meckel Diverticulum.Which of the following actions should the nurse include in the plan of care?

3 :
A nurse in an emergency department is caring for a preschool- age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect?

4 :
A nurse is reviewing the medical record of a 24-month-old child who has acute lymphocytic leukemia.Which of the following actions should the nurse take?

5 :
A nurse is creating a plan of care for an adolescent who has muscular dystrophy.Which of the following interventions should the nurse include in the plan?

6 :
A nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?

7 :
A nurse is preparing to administer immunizations to a 3- month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care?

8 :
A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care?

9 :
A nurse is caring for a 2-month-old infant who has heart failure and is receiving furosemide. Which of the following findings is the nurse's priority?

10 :
A nurse is educating an adolescent following this application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching?