ATI RN
ATI RN Pediatric Nursing 2023 II Questions
Extract:
Question 1 of 5
A nurse is assessing a 7-year-old child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
Correct Answer: B
Rationale: The correct answer is B: Shakiness. In hypoglycemia, the body's blood sugar level drops too low, leading to symptoms like shakiness due to the release of stress hormones like adrenaline. Increased capillary refill (
A) is not associated with hypoglycemia. Thirst (
C) is more commonly seen in hyperglycemia. Decreased appetite (
D) is not a typical manifestation of hypoglycemia in a child with diabetes mellitus.
Question 2 of 5
A nurse is assessing a 4-month-old infant during a well-baby visit. For which of the following findings should the nurse notify the provider?
Correct Answer: B
Rationale: The correct answer is B: Doll's eye reflex intact. This reflex is abnormal in infants over 3 months old and suggests a neurological issue. A: No head lag is normal at 4 months. C: Tears when crying is a normal response. D: Positive Babinski reflex is normal in infants under 2 years old. The Doll's eye reflex should disappear by 3 months, so its presence at 4 months is concerning.
Question 3 of 5
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Weigh the child once per day. In nephrotic syndrome, monitoring weight is crucial to assess fluid retention. Daily weight can indicate fluid status changes, allowing for timely interventions. Positioning the child supine (
B) does not address the fluid balance issue. Limiting calorie intake (
C) may be necessary for some cases but is not a priority in the acute stage. Increasing fluid intake (
D) can worsen fluid retention.
Question 4 of 5
A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective?
Correct Answer: B
Rationale: The correct answer is B: A decrease in peripheral edema. Furosemide is a loop diuretic that works by increasing urine output, reducing fluid retention, and decreasing edema in patients with heart failure.
Therefore, if the medication is effective, the nurse should expect to see a reduction in peripheral edema as a result of the decreased fluid volume in the body.
Choices A, C, and D are incorrect because an increase in potassium levels, a decrease in cardiac output, and an increase in venous pressure are not expected outcomes of furosemide therapy and would actually indicate an ineffective treatment or potential complications.
Question 5 of 5
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: A
Rationale: The correct answer is A: Tachypnea. Respiratory syncytial virus (RSV) can cause respiratory distress in infants. Tachypnea, or rapid breathing, is a concerning sign that indicates the infant is having difficulty breathing and may need immediate medical intervention. Reporting tachypnea promptly to the provider allows for timely assessment and appropriate treatment to prevent respiratory compromise.
Incorrect choices:
B: Coughing - While coughing is common in RSV, it is not as urgent as tachypnea in indicating respiratory distress.
C: Rhinorrhea - Runny nose is a common symptom of RSV but does not require immediate reporting as it is not a critical sign of distress.
D: Pharyngitis - Throat inflammation may occur with RSV but is not as urgent as tachypnea in indicating respiratory distress.