ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Extract:
Question 1 of 5
A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: The correct answer is C: Apply pressure just above the insertion site. This is the first action the nurse should take as it helps to control the bleeding and prevent further blood loss. By applying pressure, the nurse can help stop the bleeding and stabilize the child's condition. Reinforcing the dressing (
Choice
A) may not address the immediate issue of active bleeding. Monitoring the pulse distal to the insertion site (
Choice
B) is important but should come after controlling the bleeding. Obtaining vital signs (
Choice
D) is also important but not the priority when dealing with active bleeding.
Extract:
A nurse is caring for a 3-year-old child. Nurse's Notes: 0730: Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted. 0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, nonproductive cough present. Vital Signs: 0730: Tympanic Temperature: 38.1°C (100.6° F). Heart Rate: 95/min. Respiratory Rate: 20/min. Oxygen Saturation: 98% on room air. 0800: Tympanic Temperature: 38.2°C (100.1°F). Heart Rate: 112/min. Respiratory Rate: 24/min. Oxygen Saturation: 96% on room air.
Question 2 of 5
The nurse is planning care for the client. For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia.
| Assessment finding | Acute Laryngotracheobronchitis | Pneumonia |
|---|---|---|
| Irritability | ||
| Cough (barking at times) | ||
| Stridor | ||
| Temperature |
Correct Answer: A,B,C
Rationale:
To determine if the finding is consistent with acute laryngotracheobronchitis or pneumonia, we need to consider the characteristic symptoms of each condition.
A: Irritability is a common symptom seen in both conditions due to respiratory distress.
B: Cough is specific to acute laryngotracheobronchitis, known as croup.
C: Stridor, a high-pitched sound on inspiration, is a hallmark of acute laryngotracheobronchitis.
D: Temperature is a non-specific symptom and can be present in both conditions.
Therefore, the correct answer is A, B, C as irritability, cough , and stridor are more indicative of acute laryngotracheobronchitis compared to pneumonia.
Extract:
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. History and Physical: 15-year-old adolescent admitted for a vaso-occlusive crisis. The parent reports low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and lower back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10. Vital Signs: Temperature: 37.8°C (100°F). Heart rate: 100/min. Blood pressure: 110/72 mmHg. Respiratory rate: 20/min. Oxygen saturation: 95% on room air. Assessment: Awake, alert, and oriented ×3. Yellow sclera of eyes noted bilaterally. Right upper quadrant tender to palpation. Hands painful to touch and swollen bilaterally. Right knee is swollen, warm to palpation, and the client reports pain as 8 on a scale of 0 to 10. Client is tearful and grimacing during the examination. Laboratory Results: Hct: 28% (32% to 44%). Hgb: 6 g/dL (10 to 15.5 g/dL). WBC count: 20,000/mm³ (6,200 to 17,000/mm³). ALT: 50 units/L (4 to 36 units/L). AST: 62 units/L (10 to 40 units/L). Total bilirubin: 3.0 mg/dL (0.3 to 1.0 mg/dL). Chest radiographic examination indicates cardiomegaly and left flow murmur.
Question 3 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include:
Correct Answer: A,B,C,G
Rationale:
Correct Answer: A, B, C, G
Rationale:
A: Instruct the parent to ensure the pneumococcal vaccine is current to prevent pneumococcal infections in the adolescent.
B: Monitor oxygen saturation continuously to assess respiratory status and detect any potential respiratory issues.
C: Administer folic acid as prescribed to support the adolescent's growth and development.
G: Give Oral Hydroxyurea to manage conditions like sickle cell anemia in adolescents.
Incorrect
Choices:
D: Applying cold compresses to the affected joints is not relevant to the care of an adolescent unless specifically indicated for a certain condition.
E: Placing the client on strict bed rest is not typically recommended for adolescents as it can lead to deconditioning and other complications.
F: Administering meperidine (Demerol) for pain is not a standard intervention for adolescents and may have adverse effects.
Extract:
A nurse is caring for a school-age child who has cystic fibrosis. History and Physical: School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K. Barrel-shaped chest. Clubbing of the fingers bilaterally. Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough. Vital Signs: Temperature: 38.4°C (101.1°F). Heart rate: 100/min. Respiratory rate: 40/min. Blood pressure: 100/57 mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa. Stool analysis positive for presence of fat and enzymes. Chest X-ray indicates obstructive emphysema. WBC count: 20,000/mm³ (normal range: 5,000 to 10,000/mm³).
Question 4 of 5
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list?
Correct Answer: B,D,E
Rationale: The correct answer is B, D, and E. Dornase alfa is a medication used for cystic fibrosis, often prescribed for children with this condition. Water-soluble vitamins are commonly given to children to meet their nutritional needs. Pancreatic lipase is used to aid digestion in children with pancreatic insufficiency. Meperidine is not typically prescribed for children due to its potential for toxicity and adverse effects. Acetaminophen is a common over-the-counter medication but may not necessarily be part of the child's prescription regimen.
Therefore, A and C are less likely to be prescribed or reconciled from the child's medication list compared to B, D, and E.
Extract:
Question 5 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 the acute stage of nephrotic syndrome, daily weight monitoring is crucial to assess fluid status and renal function. It helps in evaluating response to treatment and detecting complications like fluid overload or dehydration promptly. Limiting calorie intake (
B) is not appropriate as children with nephrotic syndrome often need increased calories due to protein loss. Increasing fluid intake (
C) to 2 L/day may exacerbate edema, a common symptom of nephrotic syndrome. Positioning the child supine at bedtime (
D) is not relevant to managing nephrotic syndrome.