ATI RN
RN ATI Pediatric Proctored Exam 2023 with NGN Questions
Extract:
Question 1 of 5
A 36 pound almost 3-year-old arrives to the ED with dehydration. The provider orders an IV fluid bolus, 15 ml/kg over 30 minutes. How many ml will the nurse administer?
Correct Answer: B
Rationale: The correct answer is B: 246 ml.
To calculate the IV fluid bolus amount, first, we need to determine the child's weight in kilograms: 36 lbs รท 2.2 = 16.36 kg. Next, multiply the weight in kg by the ordered dose of 15 ml/kg: 16.36 kg x 15 ml/kg = 245.4 ml. Since it is recommended to round up in pediatric dosing, the nurse will administer 246 ml.
Choice A is incorrect as it underestimates the dose.
Choices C and D are incorrect as they overestimate the dose.
Question 2 of 5
The nurse is providing education to parents of a toddler that will receive an iron supplement to treat iron deficiency anaemia. Which statement indicates the parents need further teaching?
Correct Answer: C
Rationale: The correct answer is C. If parents notice dark green stools after giving iron supplements, it is actually a common and harmless side effect due to the iron's color. They do not need to immediately notify the doctor unless there are other concerning symptoms. Rinsing the baby's mouth after giving iron (
A) is important to prevent staining. Storing iron safely (
B) is crucial to prevent accidental ingestion. Limiting milk consumption (
D) is recommended as excessive milk can hinder iron absorption.
Question 3 of 5
A nurse is caring for a newborn whose mother was taking methadone during her pregnancy, which of the following findings indicates the newborn is experiencing withdrawal?
Correct Answer: D
Rationale: The correct answer is D: Hypertonicity. Newborns exposed to opioids in utero often exhibit symptoms of withdrawal, known as Neonatal Abstinence Syndrome (NAS). Hypertonicity, or increased muscle tone, is a common sign of NAS. This occurs due to the withdrawal effects of methadone on the central nervous system. Bulging fontanels (
A) are not typically associated with NAS. Acrocyanosis (
B) is a common finding in newborns and not specific to NAS. Bradycardia (
C) refers to a slow heart rate and is not a typical sign of NAS.
Question 4 of 5
A 4-year-old, 44-pound Autistic patient is admitted to the ED with concerns of dehydration. He has been ordered to receive a 20ml/kg fluid bolus of normal saline over 30 minutes. At what rate would you set the IV pump?
Correct Answer: A
Rationale: The correct answer is A: 880 ml/hour.
To calculate the IV pump rate, first, determine the total volume to be infused: 20 ml/kg x 44 lbs = 880 ml. Next, divide the total volume by the total time in hours: 880 ml / 1 hour = 880 ml/hour. This rate ensures the patient receives the prescribed fluid bolus over 30 minutes.
Choice B is incorrect as it does not account for the specific weight of the patient.
Choices C and D are incorrect as they do not follow the correct calculation based on the patient's weight.
Question 5 of 5
Which is the most definitive diagnosis of leukemia?
Correct Answer: D
Rationale: The correct answer is D: A bone marrow biopsy will show an infiltrate of blast cells. A bone marrow biopsy is the gold standard for diagnosing leukemia as it provides direct visualization of the bone marrow cells. In leukemia, there is an abnormal proliferation of immature cells called blast cells.
Therefore, the presence of blast cells in the bone marrow biopsy confirms the diagnosis.
A: A detailed history may provide valuable information, but it is not definitive for diagnosing leukemia.
B: A lumbar puncture is more relevant for diagnosing central nervous system involvement in leukemia, not for confirming the diagnosis itself.
C: A CBC with differential can show abnormalities in blood cell counts, but it does not provide direct visualization of blast cells in the bone marrow.
E, F, G: No additional options provided.
In summary, the most definitive diagnosis of leukemia is confirmed through a bone marrow biopsy, which directly shows the presence of blast cells, distinguishing it from the other choices.