ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is assessing a preschool-age child who is in the immediate postoperative period following a tonsillectomy. Which of the following assessment findings is the priority?
Correct Answer: D
Rationale: The correct answer is D: The child swallows frequently. This is the priority assessment finding because it could indicate postoperative bleeding, a serious complication after a tonsillectomy. Frequent swallowing may suggest blood pooling in the throat. Prompt intervention is crucial to prevent further bleeding and ensure the child's safety.
Incorrect
Choices:
A: The child's throat pain increases - Important but not the priority as it is expected post-tonsillectomy.
B: The child refuses clear liquids - Not the priority unless it persists and leads to dehydration.
C: The child cries often - Common after surgery but not indicative of a serious complication like bleeding.
Question 2 of 5
A nurse is planning care for a preschooler who has neutropenia. Which of the following interventions should the nurse include in the plan?
Correct Answer: B
Rationale: The correct answer is B: Avoid raw fruits and vegetables in the child's diet. Neutropenia is a condition characterized by low neutrophil count, leading to increased susceptibility to infections. Raw fruits and vegetables may harbor bacteria that can cause infections in immunocompromised individuals.
Therefore, avoiding raw produce helps reduce the risk of infection. Administering vaccines prior to discharge (
Choice
A) may be important for other conditions, but in neutropenia, live vaccines are contraindicated. Bathing the child every other day (
Choice
C) and obtaining rectal temperature daily (
Choice
D) are not specific to managing neutropenia.
Question 3 of 5
A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
Correct Answer: A
Rationale: The correct answer is A because vomiting can affect the absorption and effectiveness of digoxin. Vomiting can lead to decreased drug levels in the bloodstream, potentially causing subtherapeutic effects. This can result in inadequate control of the toddler's condition and may lead to worsening symptoms.
Choices B, C, and D are within acceptable ranges and do not necessarily warrant a revision of the plan of care.
Choice B indicates a digoxin level within the therapeutic range, choice C indicates a slightly elevated pulse rate which can be expected with digoxin therapy, and choice D indicates a potassium level within the normal range.
Therefore, the nurse should focus on the toddler who has vomited to ensure proper absorption of the medication and adjust the plan of care accordingly.
Extract:
Nurse Notes: 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, non-productive 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 (100.6 F), Heart rate 95/min, Respiratory rate 20/min, Oxygen saturation 96% on room air. Provider Prescription: Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO, Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
Question 4 of 5
For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process.
| Finding | Acute laryngotracheobronchitis | pneumonia |
|---|---|---|
| Irritability | ||
| Cough findings at 0800 | ||
| Stridor | ||
| Temperature |
Correct Answer: A,B,C,D
Rationale: [
Rationale: ]
A - Irritability: Both acute laryngotracheobronchitis and pneumonia can cause irritability due to respiratory distress.
B - Cough findings at 0800: Both conditions manifest with cough, often worse in the morning.
C - Stridor: Stridor is a common sign of upper airway obstruction seen in acute laryngotracheobronchitis.
D - Temperature: Fever is a common symptom in both acute laryngotracheobronchitis and pneumonia.
Summary:
- Acute laryngotracheobronchitis and pneumonia can both present with irritability, cough, stridor, and fever.
Extract:
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 100/57mm 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 (5,000 to 10,000/mm3)
Question 5 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? Select all that apply.
Correct Answer: B,D,E
Rationale: The correct answers are B, D, and E. Dornase alfa is used for cystic fibrosis, water-soluble vitamins are essential for growth and development in children, and pancreatic lipase aids in digestion. Meperidine is not commonly prescribed for children due to its side effects. Acetaminophen is a common medication but should not be assumed without provider confirmation. The remaining choices are not typically prescribed or reconciled in a child's medication list.