ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is caring for a 1-week-old newborn who has hyperbilirubinemia and is being treated with phototherapy. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: A. Checking the newborn's eyes every 8 hours is not directly related to the management of hyperbilirubinemia or phototherapy; eye shields are typically used during phototherapy to protect the eyes. B. Placing mittens on the newborn's hands is not necessary for the management of hyperbilirubinemia or phototherapy. C. Monitoring the newborn's temperature every 2 hours is important during phototherapy to prevent complications such as hypothermia or hyperthermia. D. Applying lotion to the newborn's skin is not recommended during phototherapy as it can interfere with the effectiveness of the treatment.
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: A. Administering vaccines prior to discharge may not be appropriate for a child with neutropenia as they have a compromised immune system, and live vaccines should be avoided. B. Avoiding raw fruits and vegetables in the child's diet is essential because raw produce may harbor bacteria that could potentially lead to infections in a child with neutropenia. Cooked fruits and vegetables are safer options. C. Bathing the child every other day may be appropriate to maintain cleanliness, but it is not specifically related to neutropenia management. D. Obtaining the child's rectal temperature once daily is important for monitoring for fever, which can be a sign of infection in a neutropenic child. However, dietary precautions to prevent bacterial exposure are more directly related to managing neutropenia.
Question 3 of 5
A nurse is caring for a newly admitted child who has cystic fibrosis. For which of the following members of the interprofessional team should the nurse initiate a referral?
Correct Answer: A
Rationale: A. Nutritional management is crucial in cystic fibrosis due to malabsorption issues. A dietitian can provide guidance on appropriate dietary intake and may recommend enzyme replacement therapy. B. Occupational therapists may assist with activities of daily living, but their primary role may not be as critical initially as nutritional management. C. Speech-language pathologists primarily focus on speech and swallowing disorders, which may not be the primary concern at the time of admission. D. Physical therapists may assist with physical activity and mobility, but their primary role may not be as critical initially as nutritional management.
Question 4 of 5
A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include?
Correct Answer: D
Rationale: A. Providing a warm blanket can help alleviate discomfort associated with fever and chills, which are common symptoms of varicella, but it is not the priority intervention. B. Koplik spots are seen in measles, not varicella. C. Aspirin administration is contraindicated in varicella due to the risk of Reye's syndrome. Acetaminophen or ibuprofen may be used for fever. D. Varicella is spread through respiratory droplets and direct contact, so airborne precautions are necessary to prevent transmission.
Extract:
History and Physical: 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%
Question 5 of 5
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.
Correct Answer: C
Rationale: Condition: C. Congestive heart failure - The infant's symptoms of poor weight gain, tachypnea, decreased appetite, and periorbital edema are indicative of congestive heart failure. Actions: A. Anticipate a prescription for digoxin - Digoxin is commonly prescribed to manage congestive heart failure in infants by improving cardiac contractility and reducing heart rate. B. Elevate the head of the bed to a 45° angle - This helps reduce venous return to the heart, decreasing preload and relieving symptoms of congestion. Parameters: B. Intake and output - Monitoring fluid balance is crucial in congestive heart failure to assess for volume overload. D. Presence of periorbital edema - Persistent edema indicates ongoing fluid retention, a key sign to monitor treatment effectiveness.