ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Question 1 of 5
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Weigh the child once per day. In the acute stage of nephrotic syndrome, daily weight monitoring is crucial to assess fluid status and renal function. It helps in evaluating response to treatment and detecting complications like fluid overload or dehydration promptly. Limiting calorie intake (
B) is not appropriate as children with nephrotic syndrome often need increased calories due to protein loss. Increasing fluid intake (
C) to 2 L/day may exacerbate edema, a common symptom of nephrotic syndrome. Positioning the child supine at bedtime (
D) is not relevant to managing nephrotic syndrome.
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 2 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 3 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.
Extract:
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. History and Physical: 15-year-old adolescent admitted for a vaso-occlusive crisis. The parent reports low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and lower 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 mmHg. Respiratory rate: 20/min. Oxygen saturation: 95% on room air. Assessment: Awake, alert, and oriented ×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. Laboratory Results: Hct: 28% (32% to 44%). Hgb: 6 g/dL (10 to 15.5 g/dL). WBC count: 20,000/mm³ (6,200 to 17,000/mm³). ALT: 50 units/L (4 to 36 units/L). AST: 62 units/L (10 to 40 units/L). Total bilirubin: 3.0 mg/dL (0.3 to 1.0 mg/dL). Chest radiographic examination indicates cardiomegaly and left flow murmur.
Question 4 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include:
Correct Answer: A,B,C,G
Rationale:
Correct
Answer: A, B, C, G
Rationale:
A: Instruct the parent to ensure the pneumococcal vaccine is current to prevent pneumococcal infections in the adolescent.
B: Monitor oxygen saturation continuously to assess respiratory status and detect any potential respiratory issues.
C: Administer folic acid as prescribed to support the adolescent's growth and development.
G: Give Oral Hydroxyurea to manage conditions like sickle cell anemia in adolescents.
Incorrect
Choices:
D: Applying cold compresses to the affected joints is not relevant to the care of an adolescent unless specifically indicated for a certain condition.
E: Placing the client on strict bed rest is not typically recommended for adolescents as it can lead to deconditioning and other complications.
F: Administering meperidine (Demerol) for pain is not a standard intervention for adolescents and may have adverse effects.
Extract:
Question 5 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.