ATI RN
RN ATI Pediatric Nursing Exam (70 NGN Questions with Answers) Questions
Extract:
A nurse is caring for a 6-week-old infant. History and Physical
Infant was full-term at birth. Birth weight was 3.5 kg (7.7 lb). Infant is not gaining weight as expected. One week ago at outpatient visit, weight was 3.6 kg (7.9 lb).
Parent reports for past 2 days infant is breathing faster during feedings and does not finish feedings. Parent also reports decreased appetite and puffiness around the infant's eyes. Parent states that the last wet diaper was about 10 hr ago. Infant admitted for diagnostic evaluation, failure to thrive, and nutritional/fluid support.
Vital Signs Admission:
Temperature 37.7° C (99.9° F) Heart rate 174/min while sleeping Respiratory rate 72/min while sleeping
Assessment:
Admission:
Respirations: Tachypneic with moderate retractions and nasal flaring. Upon auscultation, crackles heard in all lung fields. No nasal drainage noted. Dry cough noted periodically. Skin: Pallor, scalp is diaphoretic, lower extremities are cool to touch.
Cardiac: Tachycardic, regular rhythm, no murmur is heard. Peripheral pulses are full and bounding in the upper extremities and weak bilateral pedal pulses are noted.
Fluids: Mucous membranes are slightly dry and pink. Skin turgor is slightly decreased. Capillary refill is 3 seconds. Noted periorbital edema and nonpitting edema of feet.
Anterior fontanel is soft and slightly depressed. Diaper remains dry. Abdomen: Soft, full, round, bowel sounds are present and active.
Blood pressure in right upper extremity 60/39 mm Hg Oxygen saturation 90% Laboratory Results
Admission:
Chest x-ray: mild left ventricular hypertrophy is noted. Increased pulmonary vascular markings are noted in all lobes.
Question 1 of 5
Specify 2 parameters the nurse should monitor to assess the client's progress.
Correct Answer: B,C
Rationale: The correct parameters for the nurse to monitor to assess the client's progress are intake and output (
B) and respiratory status (
C). Monitoring intake and output is crucial to assess fluid balance and kidney function. Changes in these values can indicate dehydration or fluid overload. Respiratory status should be monitored to assess oxygenation and ventilation, which are essential for tissue perfusion and overall health.
The incorrect choices are A, D, E, F, and G. A (Number of steatorrhea stools) is not directly related to assessing overall client progress. D (Presence of periorbital edema) may be indicative of fluid retention but is not as direct as intake and output monitoring.
Choices E, F, and G are not provided, thus not applicable to the question.
Extract:
Nurses' Notes 0915:
Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent heard the child crying. they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual
and witnessed them gagging periodically. 0930:
Child is lying on parent's chest with eyes open and requesting sippy cup. Continues to have expiratory wheezing in bilateral upper lobes. Preparing child for diagnostic testing.
Exhibit 4
Laboratory Results 0930:
X- ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies objects in esophagus. No foreign objects visualized in the chest or abdomen.
Question 2 of 5
Complete the following sentence by using the list of options. The nurse should first----- followed by -------
Correct Answer: E,F
Rationale: The correct answer is E, F. Firstly, keeping the child NPO (nothing by mouth) is essential before a flexible endoscopy to prevent aspiration during the procedure. Secondly, preparing the child for the flexible endoscopy involves informing them about the procedure and ensuring they are physically and emotionally ready.
Choice A is incorrect as it does not directly relate to the procedure; B is not the immediate priority before the endoscopy; C is important post-procedure, not first; D is relevant but not the initial step.
Extract:
A nurse in a provider's office is caring for a 1-year-old toddler. Exhibit 1
0930
Nurse Notes
Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic.
0945:
Notified provider of parent reports and child's fever. New prescriptions received.
1000:
Urine sample obtained via sterile straight catheter. Exhibit 2
Vital Signs 0930:
Temperature 38.4° C (101.1° F) Heart rate 128/min
Respiratory rate 28/min Exhibit 3
Diagnostic Results
1030:
Urinalysis:
Appearance: cloudy and dark amber (clear) Specific gravity 1.035 (1.005 to 1.030)
Leukocyte esterase: positive (negative)
Nitrites: present (none)
WBCS: 10 (0 to 4)
Question 3 of 5
What is a 1-year-old with history of UTIs and diagnosed with vesicoureteral reflux s tachycardia at risk for?
Correct Answer: B,E
Rationale: The correct answers for a 1-year-old with history of UTIs and diagnosed with vesicoureteral reflux at risk for are B: Renal Scarring and E: Pyelonephritis. Vesicoureteral reflux increases the risk of recurrent UTIs, leading to pyelonephritis. Renal scarring can result from repeated pyelonephritis episodes. Nephrotic syndrome (
A) is not typically associated with UTIs or reflux. Polycystic kidney (
C) is a congenital condition, not related to the scenario. Acute glomerulonephritis (
D) is usually caused by post-streptococcal infection, not UTIs.
Extract:
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.
History and Physical
A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports
having right- sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10.
Vital Signs
Temperature 37.8° C (100° F) Heart rate 100/min
Blood pressure 110/72 mm Hg Respiratory rate 20/min Oxygen saturation 95% on room air
Assessment
Awake, alert, and oriented x 3
Yellow sclera of eyes noted bilaterally
Right upper quadrant tender to palpation Hands painful to touch and swollen bilaterally
Right knee is swollen, warm to palpation, and the client reports pain as 8 on a scale of 0 to 10.
Client is tearful and grimacing during the examination.
Question 4 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: B,C,E,F,H
Rationale: The correct interventions for the adolescent are B, C, E, F, and H. Administering folic acid (
B) is important for growth and development. Monitoring oxygen saturation (
C) ensures respiratory function. Applying cold compresses (E) helps reduce inflammation in affected joints. Administering meperidine IV (F) addresses pain management. The rationale for excluding other choices: A is irrelevant for adolescent care, D may worsen joint symptoms, and G is incomplete.
Extract:
A nurse is caring for a school-age child who has cystic fibrosis. Exhibit 1
History and Physical
School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul- smelling stools. The child has deficient levels of vitamin A, D, E, and K.
Barrel-shaped chest
Clubbing of the fingers bilaterally
Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough
Exhibit 2 Vital Signs
Temperature 38.4° C (101.1° F) Heart rate 100/min Respiratory rate 40/min Blood pressure 100/57 mm Hg
Exhibit 3 Laboratory Results
Sputum culture positive for Pseudomonas aeruginosa Stool analysis positive for presence of fat and enzymes Chest x-ray indicates obstructive emphysema WBC count 20,000/mm3 (5,000 to 10,000/mm3)
Question 5 of 5
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list?
Correct Answer: A,C,E
Rationale: The correct answers are A, C, and E. A nurse reviewing a child's medical record should expect the provider to prescribe or reconcile water-soluble vitamins (
A) for essential nutrients, Dornase alfa (
C) for cystic fibrosis to help clear mucus, and Pancreatic lipase (E) for pancreatic insufficiency to aid in digestion. Acetaminophen (
B) is a common over-the-counter pain reliever but may not be specifically required based on the child's condition. Meperidine (
D) is a narcotic analgesic with potential side effects and is not typically used in pediatric patients.