ATI RN
ATI Nur 223a Sect 4 Pediatrics Final Exam Questions
Extract:
5-year-old child has a cardiac catheterization via the femoral artery.
Question 1 of 5
A 5-year-old child has a cardiac catheterization via the femoral artery. Which assessment would be most important to complete after the procedure?
Correct Answer: D
Rationale: Checking pedal pulses ensures adequate blood flow post-catheterization.
Extract:
6-year-old child who has bacterial meningitis.
Question 2 of 5
A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care?
Correct Answer: A
Rationale: Measuring head circumference is unnecessary in a 6-year-old, as it is relevant for infants to monitor intracranial pressure.
Extract:
6-month-old infant.
Question 3 of 5
A nurse is caring for a 6-month-old infant. Which of the following findings should indicate to the nurse that the client is experiencing pain following a procedure?
Correct Answer: A
Rationale: Increased crying episodes are a common indicator of pain in infants.
Extract:
Vital Signs (0700 hrs): Temperature: 36.7°C (98.0°F), Pulse rate: 114/min, Respiratory rate: 30/min, Blood pressure: 92/66 mm Hg, Oxygen saturation: 90%. Medication Administration Record (0700 hrs): Furosemide 40 mg IV every 6 hr. Administered at 0600. Digoxin 250 mcg IV now. Administered at 0600. Physical Examination Results (0700 hrs): Jugular vein distention noted. Lower extremity edema 2+ bilaterally. Extremities cool with decreased skin pigmentation. Peripheral pulses weak bilaterally. Lung sounds with wheezing noted throughout. Diagnostic Results (0700 hrs): Chest X-ray: Cardiomegaly noted. Echocardiogram: Left ventricular hypertrophy, mitral valve stenosis. BNP: 1200 pg/mL.
Question 4 of 5
Based on the information provided, what is the most appropriate initial nursing action?
Correct Answer: D
Rationale: Repositioning to high Fowler's position improves lung expansion and reduces breathing effort, addressing immediate respiratory distress due to fluid overload.
Extract:
Nurses Notes: Emergency Department - 0900: Two-year-old toddler brought in by parents due to concerns about child's breathing. Parents report child has a history of asthma and woke up today with a bad asthma attack. Parents state child has had a runny nose and occasional cough for 2 days and has not been eating or drinking well. Child is restless and crying intermittently while clinging to parent. Appears ill with flushed face. Large amount of clear thick nasal drainage from bilateral nares and marked nasal flaring noted. Oral mucosa pink and slightly dry. Moderate to severe suprasternal and substernal retractions. Bilateral wheezes in upper lobes throughout inspiration and expiration. Diminished breath sounds in bilateral bases. Frequent dry hacking cough when crying. Pediatric Unit - 1200: Two-year-old toddler admitted from the emergency department due to exacerbation of asthma. Child currently asleep in parent's arms but rouses easily when touched. Oral mucosa pink and moist. No nasal flaring noted. Mid substernal retractions noted. Mild bilateral expiratory wheezes auscultated in upper lobes with breath sounds diminished in bilateral bases. No cough noted. O2 at 2 L/min via nasal cannula. Vital Signs 0900: Temperature: 38.3°C (100.9°F), Heart rate: 130 bpm, Respiratory rate: 40 breaths/min, Oxygen saturation: 88% on room air. 1200: Temperature: 37.8°C (100.0°F), Heart rate: 120 bpm, Respiratory rate: 32 breaths/min, Oxygen saturation: 94% on 2 L/min O2 via nasal cannula. Physical Examination Results 0900: Child appears ill with flushed face. Large amount of clear thick nasal drainage from bilateral nares. Marked nasal flaring noted. Oral mucosa pink and slightly dry. Moderate to severe suprasternal and substernal retractions. Bilateral wheezes in upper lobes throughout inspiration and expiration. Diminished breath sounds in bilateral bases. Frequent dry hacking cough when crying. 1200: Child currently asleep in parent's arms but rouses easily when touched. Oral mucosa pink and moist. No nasal flaring noted. Mid substernal retractions noted. Mild bilateral expiratory wheezes auscultated in upper lobes with breath sounds diminished in bilateral bases. No cough noted. Diagnostic Results 0900: Chest X-ray: Hyperinflation of lungs, no focal consolidation. Blood gas analysis: pH 7.35, PaCO2 45 mmHg, PaO2 60 mmHg, HCO3 24 mEq/L. 1200: Chest X-ray: No significant change from previous. Blood gas analysis: pH 7.38, PaCO2 42 mmHg, PaO2 75 mmHg, HCO3 24 mEq/L. Provider's Prescriptions 0900: Albuterol nebulizer treatment every 4 hours. Prednisolone 2 mg/kg/day PO divided into two doses. Oxygen therapy at 2 L/min via nasal cannula. IV fluids at maintenance rate. 1200: Continue Albuterol nebulizer treatment every 4 hours. Continue Prednisolone 2 mg/kg/day PO divided into two doses. Continue oxygen therapy at 2 L/min via nasal cannula. Continue IV fluids at maintenance rate.
Question 5 of 5
Which of the following findings should the nurse on the pediatric unit identify as an indication that the treatment plan is effective? (Select all that apply)
Correct Answer: C,D,F
Rationale:
Choice A: Nasal flaring is a sign of respiratory distress. The absence of nasal flaring indicates improvement.
Choice B: Retractions are a sign of respiratory distress. Their presence indicates ongoing distress.
Choice C: Oxygen saturation improvement (88% to 94%) indicates effective treatment.
Choice D: Decreased respiratory rate (40 to 32 breaths/min) shows reduced distress.
Choice E: Pulse rate is not a specific indicator of respiratory function.
Choice F: Improved breath sounds indicate better lung function.
Choice G: Heart rate is not a specific indicator of respiratory function.