ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Question 1 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 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 assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: The correct answer is C: Apply pressure just above the insertion site. This is the first action the nurse should take as it helps to control the bleeding and prevent further blood loss. By applying pressure, the nurse can help stop the bleeding and stabilize the child's condition. Reinforcing the dressing (
Choice
A) may not address the immediate issue of active bleeding. Monitoring the pulse distal to the insertion site (
Choice
B) is important but should come after controlling the bleeding. Obtaining vital signs (
Choice
D) is also important but not the priority when dealing with active bleeding.
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 4 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:
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 5 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.