ATI RN
ATI RN Pediatric Nursing 2023 I Questions
Extract:
Question 1 of 4
A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider?
Correct Answer: D
Rationale: The correct answer is D: Tachypnea. In infants with respiratory syncytial virus (RSV), tachypnea (rapid breathing) is a concerning sign indicating respiratory distress and potential respiratory failure. Reporting this finding promptly to the provider is crucial for timely intervention. Rhinorrhea (
A), pharyngitis (
B), and coughing (
C) are common symptoms of RSV but do not signify immediate danger. Tachypnea (
D) requires urgent attention due to its association with respiratory compromise.
Extract:
Infant was full-term at birth. Birth weight was 3.5 kg (7.7 lb). Infant is not gaining weight as expected. One week ago at outpatient visit, weight was 3.6 kg (7.9 lb). Parent reports for past 2 days infant is breathing faster during feedings and does not finish feedings. Parent also reports decreased appetite and puffiness around the infant's eyes. Parent states that the last wet diaper was about 10 hr ago. Infant admitted for diagnostic evaluation, failure to thrive, and nutritional/fluid support. Vital Signs Admission: Temperature 37.7° C (99.9° F), Heart rate 174/min while sleeping, Respiratory rate 72/min while sleeping. Assessment: Respirations: Tachypneic with moderate retractions and nasal flaring. Upon auscultation, crackles heard in all lung fields. No nasal drainage noted. Dry cough noted periodically. Skin: Pallor, scalp is diaphoretic, lower extremities are cool to touch. Cardiac: Tachycardic, regular rhythm, no murmur is heard. Peripheral pulses are full and bounding in the upper extremities and weak bilateral pedal pulses are noted. Fluids: Mucous membranes are slightly dry and pink. Skin turgor is slightly decreased. Capillary refill is 3 seconds. Noted periorbital edema and nonpitting edema of feet. Anterior fontanel is soft and slightly depressed. Diaper remains dry. Abdomen: Soft, full, round, bowel sounds are present and active. Blood pressure in right upper extremity 60/39 mm Hg, Oxygen saturation 90%. Laboratory Results: Chest x-ray: mild left ventricular hypertrophy is noted. Increased pulmonary vascular markings are noted in all lobes.
Question 2 of 4
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: C (Condition), A,B (Actions), B,C (Parameters)
Rationale: Action to Take: Provide chest physiotherapy and postural drainage, Elevate the head of the bed to a 45° angle; Potential Condition: Respiratory syncytial virus bronchiolitis; Parameter to Monitor: Intake and output, Respiratory status.
Rationale: For a client most likely experiencing respiratory syncytial virus bronchiolitis, the nurse should provide chest physiotherapy and postural drainage to help clear secretions and elevate the head of the bed to improve breathing. Monitoring intake and output helps assess hydration status, and monitoring respiratory status is crucial in evaluating the client's response to treatment and progression of the condition.
Incorrect choices: A includes conditions unrelated to the client's symptoms. B involves actions for different conditions and medications. C includes parameters not directly related to the potential condition.
Extract:
Question 3 of 4
A nurse is planning to administer diphenhydramine 1.25 mg/kg IV to a school-age child who weighs 55 lb. Available is diphenhydramine 50 mg/mL. How many ml should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 0.6
Rationale:
To calculate the dose of diphenhydramine for the child:
Step 1: Convert weight to kg: 55 lb ÷ 2.2 = 25 kg
Step 2: Calculate the dose: 1.25 mg/kg x 25 kg = 31.25 mg
Step 3: Determine the volume: 31.25 mg ÷ 50 mg/mL = 0.625 mL
Step 4: Round to the nearest tenth = 0.6 mL
Therefore, the correct answer is 0.6 mL. Other choices are incorrect because they do not follow the correct calculation steps or rounding procedure.
Extract:
Nurses' Notes 0930: Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic. 0945: Notified provider of parent reports and child's fever. New prescriptions received. 1000: Urine sample obtained via sterile straight catheter. Vital Signs 0930: Temperature 38.4° C (101.1° F), Heart rate 128/min, Respiratory rate 28/min. Diagnostic Results 1030: Urinalysis: Appearance: cloudy and dark amber (clear), Specific gravity 1.035 (1.005 to 1.030), Leukocyte esterase: positive (negative), Nitrites: present (none), WBCS: 10 (0 to 4).
Question 4 of 4
Select words from the choices to fill in each blank in the following sentence. The child is at risk for developing ______ and _______.
Correct Answer: A,D
Rationale: The correct answer is A (Nephrotic syndrome) and D (Acute glomerulonephritis). Nephrotic syndrome is a kidney disorder characterized by proteinuria and edema, common in children. Acute glomerulonephritis is inflammation of the kidney's glomeruli often caused by infections. Both conditions put the child at risk for kidney damage and long-term complications.
Choices B, C, and E are not directly related to the child's risk of developing kidney issues. Renal scarring is typically a result of past infections or injuries, not a direct risk factor. Polycystic kidney disease is a genetic condition, and pyelonephritis is a bacterial infection of the kidney.
Therefore, A and D are the most appropriate choices given the context of the sentence.
Question 5 of 4
Select words from the choices below to fill in each blank in the following sentence. The child is at risk for developing _______ and ______.
Correct Answer: A,D
Rationale: The correct answer is A (Nephrotic syndrome) and D (Acute glomerulonephritis) because both conditions are common kidney disorders in children. Nephrotic syndrome is characterized by proteinuria, hypoalbuminemia, edema, and hyperlipidemia, putting the child at risk for fluid imbalances and infections. Acute glomerulonephritis is an inflammation of the glomeruli causing hematuria, proteinuria, and hypertension, leading to potential renal damage and long-term complications.
Choices B, C, and E are not directly related to the child's risk in the given sentence.