ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a 1-month-old infant who has manifestations of severe dehydration and a prescription for parenteral fluid therapy. The guardian asks, 'What are the indications that my baby needs an IV?' Which of the following responses should the nurse make?
Correct Answer: A
Rationale: The correct response is A: Your baby needs an IV because she is not producing tears. In infants, the inability to produce tears is a sign of severe dehydration, indicating a deficit in body fluids. Tears are composed of water and electrolytes, and the absence of tears suggests a significant fluid imbalance. This makes it crucial to administer parenteral fluid therapy via an IV to restore hydration levels.
Choices B, C, and D are incorrect because they do not directly correlate with the need for IV fluid therapy in this scenario. A decreased heart rate, slower breathing, and bulging fontanels may be signs of distress or other issues but do not specifically indicate the need for immediate IV fluid administration due to dehydration.
Therefore, option A is the most appropriate and relevant response given the infant's presentation of severe dehydration.
Question 2 of 5
A nurse is caring for a school-age child who has sickle cell anemia and is in vaso-occlusive crisis. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Increase oral fluid intake. During a vaso-occlusive crisis in sickle cell anemia, there is a blockage of blood flow leading to tissue ischemia and pain. Increasing oral fluid intake helps to hydrate the child and improve blood flow, potentially reducing the severity of the crisis. Cold compresses (
A) can worsen vasoconstriction, platelet transfusion (
B) is not indicated for vaso-occlusive crisis, and active range of motion exercises (
C) can exacerbate pain and further compromise blood flow. Increasing fluid intake is the most appropriate intervention to help manage the crisis.
Question 3 of 5
A nurse is preparing to measure the temperature of an infant. Which of the following actions should the nurse take?
Correct Answer: B
Rationale:
Correct
Answer: B - Place the tip of the thermometer under the center of the infant's axilla.
Rationale: The axillary temperature is a common method for measuring an infant's temperature. Placing the thermometer under the center of the axilla ensures an accurate reading without causing discomfort or harm to the infant.
Incorrect
Choices:
A: Pulling the pinna of the infant's ear forward before inserting the probe is not necessary for measuring temperature.
C: Inserting the probe 3.8 cm (1.5 in) into the infant's rectum is invasive and not appropriate for routine temperature measurement.
D: Inserting the oral thermometer in front of the infant's tongue is incorrect as oral thermometers are not suitable for infants due to the risk of choking.
Question 4 of 5
A home health nurse is teaching a new parent about caring for his 1-week-old infant. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: B
Rationale: The correct answer is B: "I will hang a pastel-colored mobile 24 inches above my baby's crib." This statement indicates an understanding of the teaching because hanging a mobile can provide visual stimulation for the infant, promoting cognitive development. It also helps in soothing and calming the baby.
Incorrect choices:
A: Incorrect because picking up the baby frequently is not spoiling and is important for bonding and meeting the baby's needs.
C: Incorrect because using a firm pillow to prop up the bottle can be a choking hazard and is not recommended for feeding infants.
D: Incorrect because placing a ticking clock nearby can actually be a suffocation risk and is not recommended for soothing babies.
Question 5 of 5
A nurse is preparing to administer eye drops to a school-age child. Identify the actions the nurse should take.
Order the Items
Source Container
Correct Answer: B,C,D,E
Rationale: The correct order is B, C, D, E. First, placing the child in a sitting position ensures safety and easy access to the eyes. Next, instilling the drops of medication into the conjunctival sac is essential for proper administration.
Then, pulling the lower eyelid downward helps to create a pocket for the drops to be placed. Finally, asking the child to look upward aids in the proper distribution of the medication.
Choice A is incorrect as applying pressure to the lacrimal punctum is not necessary for administering eye drops.
Choices F and G are not applicable in this scenario.