ATI RN
ATI RN Pediatric Nursing 2023 II Questions
Extract:
Question 1 of 5
A nurse is assessing a school-age child who is receiving prednisolone. For which of the following adverse effects should the nurse monitor?
Correct Answer: B
Rationale: Stevens-Johnson syndrome is a severe allergic reaction that can occur with various medications, but it is not a common adverse effect of prednisolone. Prolonged wound healing is a potential adverse effect of corticosteroids like prednisolone due to their immunosuppressive effects. Hypotension is not a common adverse effect of prednisolone; rather, it can cause fluid retention and hypertension. Renal failure is a rare adverse effect of prednisolone and is not typically monitored for in school-age children unless there are preexisting renal issues.
Extract:
History and Physical: A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low 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.
Question 2 of 5
Select the 5 interventions the nurse should include.
Correct Answer: B,C,D
Rationale: A. The nurse should not restrict oral intake, as hydration is important to prevent dehydration and further sickling. B. Hydroxyurea is used to prevent vaso-occlusive crises in patients with sickle cell disease but is not typically administered during an acute crisis; however, it may be reconciled from the home medication list. C. Meperidine (Demerol) is a potent opioid analgesic that can help alleviate severe pain associated with vaso-occlusive crises. D. Instructing the parent to ensure the pneumococcal vaccine is current is not an immediate priority but is important for long-term care.
Extract:
Exhibit 2 Nurses' 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.
Question 3 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 | ||
| Temperature | ||
| Cough findings at 0800 | ||
| Stridor |
Correct Answer: A,B,C,D
Rationale: A. This finding is consistent with both acute laryngotracheobronchitis and pneumonia, as both conditions can cause discomfort and distress in children. B. Fever can be present in both acute laryngotracheobronchitis and pneumonia as they are both infections of the respiratory tract. C. This finding is more consistent with acute laryngotracheobronchitis than pneumonia, as acute laryngotracheobronchitis is characterized by a barking, non-productive cough that worsens at night or with agitation. D. This finding is more consistent with acute laryngotracheobronchitis than pneumonia, as acute laryngotracheobronchitis causes inflammation and narrowing of the upper airway, leading to a high-pitched sound during inhalation.
Extract:
Question 4 of 5
A nurse is reviewing the complete blood count results for a 4-year-old child who is receiving treatment for acute lymphoblastic leukemia. Which of the following findings should indicate to the nurse that the treatment is having a therapeutic effect?
Correct Answer: C
Rationale: A low hemoglobin level indicates anemia, which is common in leukemia but does not necessarily indicate treatment effectiveness. A low platelet count is a sign of bone marrow suppression, which is a common side effect of chemotherapy for leukemia. A normal RBC count indicates that the child's bone marrow is producing enough red blood cells to carry oxygen throughout the body. Elevated WBC count is typical in leukemia and does not necessarily indicate treatment effectiveness.
Question 5 of 5
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a nonpharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
Correct Answer: C
Rationale: Visual analog scales rely on the child's ability to comprehend and interpret visual cues, which may be challenging for a cognitively impaired toddler. FACES scales require the child to identify their pain level based on facial expressions, which may also be challenging for a cognitively impaired toddler. FLACC (Face, Legs, Activity, Cry, Consolability) scales are specifically designed for non-verbal or cognitively impaired individuals, assessing pain based on observable behaviors such as facial expression, leg movement, activity level, cry, and ability to be consoled. CRIES scales are primarily used for assessing pain in newborns and infants and may not be as applicable for a cognitively impaired toddler.