ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
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 1 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.
Extract:
Question 2 of 5
A nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?
Correct Answer: C
Rationale: The correct answer is C: Your child should walk the bicycle through intersections. This instruction is important for bicycle safety as walking the bicycle through intersections reduces the risk of accidents with vehicles. By walking the bicycle, the child can maintain better control and visibility at intersections, decreasing the likelihood of collisions.
Choice A is incorrect because the height of the child off the ground when seated on the bicycle is not a critical safety instruction.
Choice B is incorrect as children should ride their bicycles with the flow of traffic, not against it, to follow traffic rules and prevent accidents.
Choice D is incorrect as keeping the bicycle at least 3 feet from the curb is not as important as safely navigating intersections.
Question 3 of 5
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a nonpharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
Correct Answer: A
Rationale: The correct answer is A: FLACC. This scale is suitable for evaluating pain in toddlers and individuals with cognitive impairments as it assesses Facial expression, Leg movement, Activity level, Cry, and Consolability. It is effective in capturing pain cues in nonverbal or limited verbal individuals. The other options, B: Visual Analog Scale, C: CRIES, and D: FACES, are not as appropriate for toddlers with cognitive impairments due to their reliance on self-reporting or limited applicability in this population. The FLACC scale is specifically designed to assess pain in nonverbal or cognitively impaired individuals, making it the most suitable choice in this scenario.
Extract:
A nurse is caring for a school-age child who has cystic fibrosis. 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. Vital Signs: Temperature: 38.4°C (101.1°F). Heart rate: 100/min. Respiratory rate: 40/min. Blood pressure: 100/57 mm Hg. 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 (normal range: 5,000 to 10,000/mm³).
Question 4 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: B,D,E
Rationale: The correct answer is B, D, and E. Dornase alfa is a medication used for cystic fibrosis, often prescribed for children with this condition. Water-soluble vitamins are commonly given to children to meet their nutritional needs. Pancreatic lipase is used to aid digestion in children with pancreatic insufficiency. Meperidine is not typically prescribed for children due to its potential for toxicity and adverse effects. Acetaminophen is a common over-the-counter medication but may not necessarily be part of the child's prescription regimen.
Therefore, A and C are less likely to be prescribed or reconciled from the child's medication list compared to B, D, and E.
Extract:
Question 5 of 5
A nurse is teaching the parent of an infant who has a new diagnosis of heart failure about nutrition. Which of the following instructions should the nurse include in the teaching?
Correct Answer: D
Rationale: The correct answer is D: Place the infant in an upright position during feeding. This position helps prevent regurgitation and aspiration, common issues in infants with heart failure. Placing the infant upright also facilitates easier breathing and digestion. Option A is incorrect because rigid feeding schedules may not be suitable for infants with heart failure. Option B does not address the specific needs of an infant with heart failure. Option C is inappropriate as it may cause distress to the infant and worsen their condition.