ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
History and physical 0830: Pharyngitis 3 weeks ago. Prescribed 5-day course of azithromycin. Antibiotic discontinued on day 3 due to gastrointestinal upset. Current on all recommended immunizations.
Question 1 of 5
A nurse in the emergency department is caring for a 10-year-old child. The nurse is assessing the child. Which of the following findings require follow-up? Select the 5 findings that require follow-up.
Correct Answer: A,B,C,D,E,F
Rationale: The correct answer includes all options (A, B, C, D, E, F) because they are essential vital signs and key indicators of the child's health status. Temperature (
A), heart rate (
B), respiratory rate (
D), and oxygen saturation (F) are crucial physiological parameters that can indicate underlying health issues if abnormal. Report of pain (
C) is important to assess the child's comfort and potential underlying conditions.
Tonsillar findings (E) could indicate infections or other throat issues. Follow-up on all these findings is necessary for a comprehensive assessment of the child's health.
Extract:
Question 2 of 5
A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?
Correct Answer: A
Rationale:
Correct Answer: A - Weak femoral pulses
Rationale: Coarctation of the aorta results in narrowing of the aorta, leading to decreased blood flow to the lower extremities. This causes weak or absent femoral pulses due to reduced blood supply. The other choices are incorrect as coarctation of the aorta typically does not directly cause increased intracranial pressure, upper extremity hypotension, or frequent nosebleeds. These symptoms are more commonly associated with other conditions such as head trauma, vascular issues, or nasal conditions.
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 3 of 5
The nurse is continuing to care for the child. After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the discharge teaching?
| Parent Statement | Reflects Understanding | Needs Reinforcement |
|---|---|---|
| We should notify the provider if the cast becomes loose over time. | ||
| It is important that our child avoids placing anything inside the cast. | ||
| We should prop the casted arm on pillows for the next 24 hours. | ||
| We should expect the swelling to get better. | ||
| We need to be very careful about how we handle the cast for the first 2 days while it dries. |
Correct Answer: A,B,C,D,E
Rationale: [1,1,1,1,1]
Parent Statement: We should notify the provider if the cast becomes loose over time.
Reflects Understanding: This statement shows awareness of the need for prompt action in case of an issue with the cast, ensuring proper care.
Needs Reinforcement: None. This statement is crucial for the child's well-being.
Parent Statement: It is important that our child avoids placing anything inside the cast.
Reflects Understanding: This statement highlights the importance of maintaining the integrity of the cast to prevent complications.
Needs Reinforcement: None. Preventing foreign objects from entering the cast is essential.
Parent Statement: We should prop the casted arm on pillows for the next 24 hours.
Reflects Understanding: Proper elevation helps reduce swelling and promotes healing.
Needs Reinforcement: None. Elevation is a standard practice in cast care.
Parent Statement: We should expect the swelling to get better.
Reflects Understanding: Knowing that swelling should improve indicates awareness of the expected healing process
Question 4 of 5
The nurse is continuing to care for the child. The nurse should anticipate a prescription for pain medication.
Correct Answer: B,D
Rationale: The correct answers are B and D. A surgical consultation (
B) may be needed to address the underlying cause of the child's pain. Pain medication (
D) is essential to provide comfort and manage the child's pain. Skin traction (
A) and limb immobilization (E) are interventions for orthopedic issues, not for immediate pain relief. Antibiotics (
C) are not indicated unless there is an infection. Bed rest (F) is not a proactive measure for pain management.
Extract:
History and Physical
6-year-old child
Vomited 3 times in the past 24 hr
Irritable behavior for the past 24 hr
Respiratory infection started 3 days ago
Brudzinski's and Kernig's signs positive
Question 5 of 5
A nurse is planning care for a child during admission to the facility. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Initiate seizure precautions. This should be the first action as it prioritizes the safety of the child. Seizure precautions involve ensuring a safe environment, such as removing any potential hazards and providing padding to prevent injury during a seizure. Collecting blood cultures (
B) and obtaining a prescription for pain medication (
A) can be important but are not as urgent as ensuring the child's safety in case of a seizure. Transporting the child for a CT scan (
C) is not an immediate priority unless there is a critical need.