ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Extract:
A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI). Nurses' Notes: 0700: 7-year old client who weighs 18.1kg (39.9lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor. Vital Signs: 0715: Temperature: 38 °C (100.4° F). Heart rate: 80/min. Respiratory rate: 22/min. Blood pressure: 106/65 mm Hg. 0930: Temperature: 38.4°C (101.1° F). Heart rate: 90/min. Respiratory rate: 23/min. Blood pressure: 105/65 mm Hg. Provider Prescriptions: sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO. salicylic acid 20mg/kg/dose every 4hr as needed for pain and fever.
Question 1 of 5
The nurse is planning care for the client. For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Potential Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Administer sulfamethoxazole and trimethoprim | ||
| Administer salicylic acid for pain and fever | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluids. | ||
| Advise the child's guardian about the use of cotton underwear. |
Correct Answer: A,B,E
Rationale: [1, 0, 1]
The correct answer is A, B, and E.
- A: Educating the child about proper perineal hygiene is anticipated to prevent infections.
- B: Administering sulfamethoxazole and trimethoprim is anticipated for treating infections.
- E: Advising the child's guardian about the use of cotton underwear can help maintain proper hygiene.
C: Administering salicylic acid for pain and fever is contraindicated as it is not suitable for treating infections.
D: Ensuring the child receives a maximum of 1,200 mL/day of fluids is not relevant to preventing infections.
Extract:
A nurse is caring for a 3-year-old child. Nurse's Notes: 0730: Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted. 0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, nonproductive cough present. Vital Signs: 0730: Tympanic Temperature: 38.1°C (100.6° F). Heart Rate: 95/min. Respiratory Rate: 20/min. Oxygen Saturation: 98% on room air. 0800: Tympanic Temperature: 38.2°C (100.1°F). Heart Rate: 112/min. Respiratory Rate: 24/min. Oxygen Saturation: 96% on room air.
Question 2 of 5
The nurse is planning care for the client. For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia.
| Assessment finding | Acute Laryngotracheobronchitis | Pneumonia |
|---|---|---|
| Irritability | ||
| Cough (barking at times) | ||
| Stridor | ||
| Temperature |
Correct Answer: A,B,C
Rationale:
To determine if the finding is consistent with acute laryngotracheobronchitis or pneumonia, we need to consider the characteristic symptoms of each condition.
A: Irritability is a common symptom seen in both conditions due to respiratory distress.
B: Cough is specific to acute laryngotracheobronchitis, known as croup.
C: Stridor, a high-pitched sound on inspiration, is a hallmark of acute laryngotracheobronchitis.
D: Temperature is a non-specific symptom and can be present in both conditions.
Therefore, the correct answer is A, B, C as irritability, cough , and stridor are more indicative of acute laryngotracheobronchitis compared to pneumonia.
Extract:
A nurse in the emergency department is caring for a toddler. Nurse's 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 wheezing in bilateral upper lobes. Preparing child for diagnostic testing. Vital Signs: 0915: Blood Pressure: 88/45 mm Hg. Heart Rate: 90/min. Respiratory Rate: 30/min. Axillary Temperature: 36.9°C (98.4°F). Oxygen Saturation: 96%. 0930: Blood Pressure: 85/46 mm Hg. Heart Rate: 88/min. Respiratory Rate: 28/min. Axillary Temperature: 36.9°C (98.4°F). Oxygen Saturation: 95%. Assessment: 0915: Child awake and sobbing, asking parent for €˜sippy cup' with excessive drooling and occasionally gagging. Breath sounds with small expiratory wheezing noted in bilateral upper lobes. Respirations slightly elevated as child continues to cry and sob. Oxygen saturation 96% on room air. Penlight used to inspect throat with no visual signs of foreign object. No visual objects in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation. Abdomen soft and nontender with active bowel sounds in all four quadrants. Skin warm, pink, and smooth. Yellow urine noted in child's diaper. Provider notified of assessment findings. Laboratory Results: 0930: X-ray of the neck, chest, and abdomen completed. Barium radiography study identifies object in the esophagus. No foreign objects visualized in the chest or abdomen.
Question 3 of 5
Complete the following sentence using the list of options: 'The nurse should first select _____, followed by _____.'
Correct Answer: C,E
Rationale: The correct answer is C and E. First, keeping the child NPO is important to prevent complications during the flexible endoscopy procedure (E). This ensures the child's stomach is empty and reduces the risk of aspiration. Second, preparing the child for the procedure (E) is essential for their comfort and cooperation. Obtaining informed consent (
A) may be necessary but is not the first step in this scenario. Teaching parents about inspecting play areas (
B) and toys for safety, and monitoring the child's gag reflex (F) are important, but not the immediate priorities before a flexible endoscopy.
Extract:
A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?
Question 4 of 5
A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Reposition the client using a turning sheet. Repositioning the client using a turning sheet helps prevent skin breakdown and pressure ulcers, which are common risks associated with prolonged immobilization in a halo vest. Turning the client also promotes circulation and respiratory function.
Choice A is incorrect because tightening the screws on the halo device should be done by a healthcare provider as per specific instructions, not by the nurse.
Choice C is incorrect as encouraging flexion and extension of the neck can destabilize the cervical spine and interfere with the healing process.
Choice D is incorrect because assessing the pin sites for infection should be done daily, not every other day, to promptly detect and treat any signs of infection.
Extract:
A nurse in the emergency department is preparing to discharge a 3-year-old child. Nurse's Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. The guardian expresses concern about the child's atopic dermatitis worsening, and the child scratching excessively, which results in bleeding areas. The guardian states the child has a history of allergies and rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO, 4 times per day. Pimecrolimus 1% cream, apply to skin lesions daily. Assessment: Child is alert and responsive. Respiratory rate is even and monitored at 24/min. No adventitious sounds auscultated. Heart rate: 108/min. Generalized small clusters of reddish, scaly patches with lichenification and depigmentation on the child's bilateral upper and lower extremities.
Question 5 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian?
Correct Answer: A,B,C,E,F
Rationale: The correct answers are A, B, C, E, and F.
A: Applying emollients after bathing helps moisturize the skin, which is beneficial for the child's condition.
B: Cutting and filing fingernails frequently can prevent scratching and potential skin damage.
C: Informing the guardian about occasional flare-ups helps manage expectations and preparedness.
E: Applying gloves can protect the child's hands from irritants or scratching, aiding in the healing process.
F: Applying a thin layer of prescription cream to lesions as instructed by a healthcare provider helps manage the condition effectively.
These choices promote skin care, prevention of skin damage, awareness of condition management, protection of skin, and proper medication application.