ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
Nurses' Notes
4 weeks ago:
21-year-old client reports increased stress and worry for the last 3 months. Client is worried about academic performance due to Inability to focus on studies. School performance is suffering. Denies illicit drug use and drinks in moderation socially on the weekends.
Discussed lifestyle modifications to reduce stress. Instructed client to return in 1 month to reevaluate symptoms.
Today:
Client reports a slight improvement in stress but is now having loss of appetite and difficulty sleeping.
Instructed client to begin trazodone per provider's prescription.
Question 1 of 5
A nurse is caring for a client in the outpatient health clinic. For each potential nursing Intervention, click to specify if the intervention is indicated or not indicated.
| Nursing intervention | Indicated | Not indicated |
|---|---|---|
| Encourage naps during the day when client is tired. | ||
| Encourage a regular sleep-wake schedule. | ||
| Encourage high-calorie finger foods. | ||
| Advise client to notify provider if pregnant. | ||
| Instruct client to avoid foods that have been fermented or aged. | ||
| Advise client to rise slowly from sitting position. | ||
| Encourage client to sleep until later in the morning. |
Correct Answer:
Rationale:
Correct
Answer:
Rationale:
- Encouraging naps during the day when the client is tired is indicated for managing fatigue.
- Encouraging a regular sleep-wake schedule helps promote better sleep hygiene.
- Advising the client to notify the provider if pregnant is crucial for appropriate prenatal care.
- Other options are not indicated: high-calorie finger foods may not be suitable for all clients, avoiding fermented or aged foods is specific dietary advice, rising slowly is for orthostatic hypotension, and sleeping until later in the morning may disrupt the sleep-wake cycle.
Extract:
A nurse is caring for a recently admitted 18-year-old client:
Nurses' Notes
1000:
Client admitted to behavioral health unit for prolonged weight loss and refusal to eat. Client collapsed at school. The client's parents were called. They contacted the primary care provider, who arranged for a direct admission.
Weight 37.2 kg (82 lb)
Height 157.5 cm (62 inches)
BMI 15
1200:
Client observed during noon meal. Client pushed food around the plate. Intake 10% of meal. Offered nutritional supplement. Client declined. Reports feeling anxious due to admission and mealtime. Client states, "I cannot eat this with you watching me."
1500:
Snack provided. Client observed throwing snack into the trash can. When realized they had been observed, they admitted to their action and asked for a second snack. Client ate 10% of their snack.
Question 2 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: A[2,4],B[2],C[0,4]
Rationale: Action to Take: Provide the client with foods that have a variety of textures, Encourage the client to limit fasting; Potential Condition: Anorexia nervosa; Parameter to Monitor: Weight on a daily basis, Behavior 15 minutes after meals.
Rationale: In anorexia nervosa, the client typically has a fear of gaining weight, leading to restrictive eating habits. Providing foods with different textures can help normalize eating habits and improve nutrition. Encouraging the client to limit fasting can help address the underlying issue of restricted food intake. Weight monitoring is crucial in assessing nutritional status, while monitoring behavior post-meals can provide insights into the client's relationship with food. Bulimia nervosa and binge eating disorder are not the most likely conditions based on the client's symptoms. Monitoring cardiac function with ECG and calcium level are not the primary parameters for assessing progress in anorexia nervosa.
Extract:
Question 3 of 5
A nurse is teaching a group of school-age children about healthy snack options. Which of the following snacks should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Air-popped popcorn. It is a healthy snack option for school-age children because it is low in calories and high in fiber, making it a satisfying and nutritious choice. Popcorn is a whole grain snack that provides essential nutrients like fiber and antioxidants. It is a good alternative to sugary or high-fat snacks. Cheesecake (
A) is high in sugar and saturated fat, not a healthy choice. Milkshake made with whole milk (
C) is high in calories, sugar, and saturated fat. Baked potato chips (
D) may be lower in fat than regular chips but are still high in calories and lack the fiber content of popcorn.
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 4 of 5
A nurse is caring for a 9-year-old at a clinic. The nurse reviews the assessment findings. Select findings that require immediate follow up. Select all that apply.
Correct Answer: A,C,E,F
Rationale: The correct answers are A, C, E, and F.
A: Edematous right forearm and fingers can indicate a potential circulatory issue requiring immediate follow-up.
C: Fingers slightly cool to touch suggest poor circulation, requiring further assessment.
E: Heart rate of 102/min in a 9-year-old is above normal, indicating possible distress.
F: Respiratory rate of 22/min is slightly elevated and could indicate respiratory distress.
B, D, G are not immediate concerns as a non-distended abdomen, oxygen saturation of 98% on room air, and an ecchymotic area on the forearm do not require immediate follow-up in this context.
Question 5 of 5
A nurse is caring for a 9-year-old child at a clinic. The nurse should determine that the assessment findings are consistent with which of the following conditions?
| Assessment Findings | Sprain | Fracture | Dislocation |
|---|---|---|---|
| Edema | |||
| Ecchymosis | |||
| Pain Level | |||
| Sensation |
Correct Answer: B
Rationale: The correct answer is B: Ecchymosis. Ecchymosis is the presence of bruising, which is commonly seen in cases of trauma such as sprains, fractures, and dislocations. In a 9-year-old child, ecchymosis may indicate underlying injury or trauma. Edema can also be present in sprains, fractures, and dislocations, but it is not specific to these conditions. Pain level is subjective and can vary depending on the individual, so it is not as definitive as ecchymosis in identifying a specific condition. Sensation is important to assess in cases of injury, but it is not as indicative of a specific condition as ecchymosis.
Therefore, the presence of ecchymosis is the most specific assessment finding to determine the underlying condition in this case. (0, 1, 0)