ATI RN
ATI RN Pediatrics Nursing 2023 I Questions
Extract:
Flow Sheet Day 1, 1030: Temperature 38.7° C (101.7° F), Heart rate 114/min, Respiratory rate 26/min, Blood pressure 114/80 mm Hg, SpO2 97% on room air, Height 122 cm (48 in), Weight 29 kg (64 lb); Provider Prescriptions Day 1, 1020: Admit directly to pediatric unit, Keep child NPO, Obtain comprehensive metabolic panel and blood cultures STAT, Vital signs every 30 min, then every hr x 4, then every 4 hr; Diagnostic Results Day 1, 1040: Potassium 3.8 mEq/L (3.4 to 4.7 mEq/L), Hemoglobin 9.5 g/dL (10 to 15.5 g/dL), Hematocrit 30% (32% to 44%), RBC count 4.2 x 10°/μL (4.0 to 5.5 x 10/μL), WBC count 14,000 mm3 (5,000 to 10,000 mm3), Platelets 350,000/mm3 (150,000 to 400,000/mm3), Glucose 90 mg/dL (< 200 mg/dL), Blood cultures pending; Nurses' Notes Day 1, 1020: Child is a direct admit from a pediatric clinic with fever, chills, irritability for 2 days, prior URI 2 weeks ago, no prior conditions, fully immunized. 1030: Child reports nausea, headache (7/10), lethargic, nuchal rigidity, petechiae on face and trunk.
Question 1 of 5
A nurse is admitting an 8-year-old child to the pediatric unit. For each potential condition, click to specify if the child's assessment findings are consistent with Hodgkin Lymphoma, Bacterial Meningitis, or Acute Lymphoblastic Leukemia (ALL).
Correct Answer: A: Pain - Bacterial Meningitis, B: Lymph nodes - Hodgkin Lymphoma, C: Skin - Bacterial Meningitis & ALL, D: Neurologic - Bacterial Meningitis
Rationale:
To determine the correct assessment findings associated with each condition for the 8-year-old child, we need to consider the typical symptoms of Hodgkin Lymphoma, Bacterial Meningitis, and Acute Lymphoblastic Leukemia .
1. Pain (Correct for Bacterial Meningitis): Bacterial Meningitis often presents with symptoms such as severe headache and neck stiffness, which can be interpreted as pain.
2. Lymph nodes (Correct for Hodgkin Lymphoma): Hodgkin Lymphoma is characterized by the painless enlargement of lymph nodes, particularly in the neck, armpits, or groin.
3. Skin (Correct for Bacterial Meningitis & ALL): Skin findings like petechiae or purpura may indicate meningococcal meningitis or ALL, as both conditions can present with skin manifestations.
4. Neurologic (Correct for Bacterial Meningitis): Neurologic symptoms like altered mental status, seizures, or focal deficits are
Extract:
A nurse is caring for a child who is to receive the first dose of IV gentamicin.
Question 2 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Maintain strict I&O. This is essential to monitor the patient's fluid balance accurately, crucial in preventing complications such as dehydration or fluid overload. Monitoring intake and output helps assess renal function and fluid status.
Choices A, C, and D are incorrect. A - Monitoring for constipation is important but not the priority in this scenario. C - Initiating airborne precautions is not relevant to maintaining fluid balance. D - Encouraging bed rest is not appropriate without knowing the patient's condition, as some patients may need mobility for circulation and respiratory function.
Extract:
Nurses' Notes Day 1, 1020: Child is a direct admit from a pediatric clinic with fever, chills, irritability for 2 days, prior URI 2 weeks ago, no prior conditions, fully immunized. 1030: Child reports nausea, headache (7/10), lethargic, nuchal rigidity, cervical lymph slightly enlarged, capillary refill 4 seconds.
Question 3 of 5
A nurse is admitting an 8-year-old child to the pediatric unit. The nurse suspects the child has bacterial meningitis. Select words from the choices to fill in each blank in the following sentence: The child is at greatest risk for developing ___ and ___.
Correct Answer: A
Rationale:
Rationale: The correct answer is A: Disseminated intravascular coagulation and hydrocephalus. In bacterial meningitis, the inflammatory response can lead to disseminated intravascular coagulation, causing widespread blood clotting and potential bleeding. Additionally, inflammation in the brain can obstruct the flow of cerebrospinal fluid, leading to hydrocephalus.
Incorrect
Choices:
B: Hypothermia and seizures - While seizures can occur in bacterial meningitis, hypothermia is not a common complication.
C: Sepsis and respiratory failure - While sepsis can occur, it is not the primary risk in bacterial meningitis. Respiratory failure is not a common complication.
D: Shock and hearing loss - Shock is not a common complication of bacterial meningitis, and while hearing loss can occur, it is not the primary risk in this case.
Extract:
Provider Prescriptions: Pancrelipase 8,000 units PO with each meal and snack, Chest physiotherapy three times daily; Diagnostic Results: HbA1c 8.5% (4% to 5.9%), Hgb 13.5 mg/dL (10 to 15.5 g/dL), Hct 39% (32% to 44%), WBC count 9,600/mm3 (5,000 to 10,000/mm3)
Question 4 of 5
A nurse is reviewing the medical record of a school-age child who has cystic fibrosis. Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: The correct answer is B: HbA1c. In cystic fibrosis, monitoring blood glucose levels is crucial due to the potential for developing cystic fibrosis-related diabetes. HbA1c reflects average blood sugar levels over 2-3 months, providing insight into long-term glucose control. Reporting abnormal HbA1c levels can help the provider adjust treatment plans to prevent complications.
Choice A (heart rate) is not directly related to cystic fibrosis.
Choice C (WBC count) is more indicative of infection, which is not the primary concern in cystic fibrosis.
Choice D (oxygen saturation) is important but usually monitored continuously in patients with cystic fibrosis and does not require immediate reporting unless significantly low.
Extract:
A nurse is assessing a child who has bacterial pneumonia.
Question 5 of 5
Which of the following findings should the nurse identify as a potential risk for aspiration?
Correct Answer: B
Rationale: The correct answer is B: Neurological deficit. Neurological deficits can impair the ability to protect the airway and coordinate swallowing, increasing the risk of aspiration. Elevated temperature (
A) does not directly indicate aspiration risk. Inspiratory wheezing (
C) suggests airway narrowing but not necessarily aspiration risk. Rapid respirations (
D) can be a sign of respiratory distress, but not specifically aspiration risk.