ATI RN
RN ATI Pediatric Proctored Exam 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is planning care for a school-age child who is 4 hr postoperative following appendicitis. Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Administer analgesics on a scheduled basis for the first 24 hr. Postoperative pain management is crucial for a child recovering from surgery. By administering analgesics on a scheduled basis, the nurse ensures that the child's pain is effectively managed, promoting comfort and facilitating recovery. Cromolyn nebulized solution (choice
A) is not indicated for pain management post-appendectomy. Applying a warm compress once daily (choice
C) may not provide adequate pain relief. Offering small amounts of clear liquids 6 hr following surgery (choice
D) is important for hydration but does not address pain management directly in the immediate postoperative period.
Question 2 of 5
A nurse is caring for a school-age child who is 2 hr postoperative following a cardiac catheterization. The nurse observes blood on the child's dressing. Which of the following actions should the nurse take?
Correct Answer: C
Rationale:
Correct
Answer: C
Rationale: Applying continuous pressure 2.5 cm below the percutaneous skin site will help control bleeding by promoting clot formation at the catheter insertion site. This pressure point is closer to the source of bleeding, ensuring better hemostasis and preventing further complications.
Summary:
A: Applying intermittent pressure below the site is incorrect as continuous pressure is more effective in achieving hemostasis.
B: Applying continuous pressure above the site is incorrect as it does not target the bleeding source directly.
D: Applying intermittent pressure above the site is incorrect as continuous pressure is preferred for controlling bleeding.
E, F, G: No information provided.
Question 3 of 5
Your patient has just returned from the OR following an arterial septal defect repair. You are reviewing your orders and question the fluid rate ordered. Your patient is 6 years old and weighs 50 pounds. Select the appropriate hourly maintenance fluid rate for your patient.
Correct Answer: A
Rationale: The appropriate hourly maintenance fluid rate for a 6-year-old patient weighing 50 pounds can be calculated using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for each additional kg. Converting the patient's weight from pounds to kg (50 lbs / 2.2 = 22.73 kg), the calculation would be:
100 ml x 10 kg + 50 ml x 10 kg + 20 ml x 2.73 kg = 1000 ml + 500 ml + 54.6 ml = 1554.6 ml/day
To convert this to an hourly rate, divide by 24 hours: 1554.6 ml/day / 24 hours = 64.775 ml/hr, which rounds down to 63 ml/hr (Option
A).
The other choices are incorrect because
Question 4 of 5
Which is the correct positioning of a child experiencing epistaxis:
Correct Answer: D
Rationale: The correct positioning for a child experiencing epistaxis (nosebleed) is option D: the child should sit up and lean forward. This position helps prevent blood from flowing down the throat, reducing the risk of choking or aspiration. Sitting up also helps to reduce blood pressure in the vessels of the nose, aiding in the clotting process. Placing the child in a prone position (option
A) can lead to blood flowing down the throat, causing potential airway obstruction. Placing the child in a supine position (option
B) can also lead to blood going down the throat and may increase the risk of aspiration. Sitting with the head tilted back (option
C) is not recommended as it can lead to blood running down the back of the throat and potentially into the airway.
Therefore, option D is the correct choice for managing epistaxis in a child.
Question 5 of 5
A 15-year-old with type 1 diabetes mellitus presents with a fever and 48-hour history of vomiting. As the nurse, you note the child's breath has a fruity odour, his breathing is deep and rapid, and mom states he has become less arousable. You recognize these are the signs of:
Correct Answer: B
Rationale: The correct answer is B: Diabetic Ketoacidosis (DK
A). The fruity odor of breath, deep and rapid breathing (Kussmaul breathing), and altered mental status are classic signs of DKA. In DKA, the body produces excess ketones due to lack of insulin, leading to metabolic acidosis. Acute Hypoglycemia (
A) presents with low blood sugar levels, not high as in DKA. Hyperglycemia (
C) is a general term for high blood sugar without the specific ketone production seen in DKA. Polydipsia (
D) refers to excessive thirst, not the symptoms described in the scenario.