ATI RN
ATI RN Pediatrics Nursing 2023 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: B
Rationale: The correct answer is B: Monitor the newborn's temperature every 2 hr. This is crucial during phototherapy as it can cause hypothermia in newborns. Hyperbilirubinemia increases heat loss, making them susceptible to hypothermia. Checking the newborn's eyes (
A) is unnecessary as phototherapy does not affect the eyes. Placing mittens (
C) is not relevant to managing hyperbilirubinemia. Applying lotion (
D) can interfere with the phototherapy process.
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 100/57 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 (5,000 to 10,000/mm3).
Question 2 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 (Dornase alfa), D (Water-soluble vitamins), and E (Pancreatic lipase). Dornase alfa is used in cystic fibrosis, water-soluble vitamins are commonly prescribed for children for overall health, and pancreatic lipase is used in pancreatic insufficiency. Meperidine is not typically prescribed for children due to safety concerns. Acetaminophen is a common over-the-counter medication that may or may not be on the home medication list. The nurse should not expect the provider to prescribe or reconcile meperidine, acetaminophen, or other unspecified medications from the list.
Extract:
Question 3 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. Hypoglycemia in a child with diabetes can lead to shakiness due to low blood sugar levels affecting the brain's function. Shakiness is a common symptom of hypoglycemia as the body tries to increase blood sugar levels. Decreased appetite (
A) is more indicative of hyperglycemia. Increased capillary refill (
C) and thirst (
D) are not specific manifestations of hypoglycemia.
Extract:
Nurse's Notes (0700 hrs): The client reports a sudden onset of severe abdominal pain that started 4 hours ago. He describes the pain as sharp and constant, located in the upper right quadrant of the abdomen. The client has vomited twice in the past hour, with the vomitus being greenish in color. He denies any recent trauma or injury. The client appears anxious and is clutching his abdomen. He has a history of hypertension and is currently on medication for it. The client denies any known allergies; Physical Examination Results (0700 hrs): The client is alert and oriented but appears to be in significant distress. His skin is pale and diaphoretic. The abdomen is distended and tender to palpation, especially in the upper right quadrant. There is guarding and rebound tenderness noted. Bowel sounds are hypoactive. The client exhibits mild jaundice, with yellowing of the sclera. There are no visible signs of trauma or bruising on the abdomen; Vital Signs (0700 hrs): Temperature: 38.3°C (100.9°F), Pulse: 110 beats per minute, Respiratory Rate: 24 breaths per minute, Blood Pressure: 150/90 mm Hg, Oxygen Saturation: 95% on room air; A nurse is caring for a 45-year-old male client in the emergency department who presented with severe abdominal pain and vomiting.
Question 4 of 5
Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Notify the healthcare provider immediately. This is the priority action because it involves seeking guidance from the healthcare provider to address the situation effectively. By notifying the healthcare provider, the nurse can ensure timely and appropriate intervention based on the client's condition. Administering pain medication (
A) can wait until the healthcare provider is informed. Preparing for an abdominal ultrasound (
B) and inserting a nasogastric tube (
C) are important but not urgent in this scenario.
Therefore, they can be done after notifying the healthcare provider.
Extract:
Nurse's Notes: The infant presents with tachypnea, moderate retractions, and nasal flaring. Auscultation reveals crackles in all lung fields, with no nasal drainage. The infant has a dry cough that occurs periodically. The skin appears pale, the scalp is diaphoretic, and the lower extremities are cool to the touch. The infant is tachycardic with a regular rhythm, and no murmur is heard. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. Mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The diaper remains dry. The abdomen is soft, full, and round, with active bowel sounds; Medical History: The infant was born at 38 weeks gestation via vaginal delivery with no complications. The infant has had no previous hospitalizations or surgeries. The infant has been exclusively breastfed and has no known allergies. The mother reports that the infant has been feeding poorly for the past two days and has had decreased urine output. There is no family history of congenital heart disease or respiratory conditions; Diagnostic Results: Chest X-ray: Mild left ventricular hypertrophy noted. Increased pulmonary vascular markings in all lobes; Complete Blood Count (CBC): White Blood Cells (WBC): 12,000/mm³ (4,500-11,000/mm³), Hemoglobin (Hgb): 11 g/dL (11-14 g/dL), Hematocrit (Hct): 33% (33-39%), Platelets: 250,000/mm³ (150,000-450,000/mm³); Electrolytes: Sodium (Na): 138 mEq/L (135-145 mEq/L), Potassium (K): 4.2 mEq/L (3.5-5.0 mEq/L), Chloride (Cl): 102 mEq/L (98-106 mEq/L), Bicarbonate (HCO3): 22 mEq/L (22-28 mEq/L); Vital Signs: Temperature: 37.7°C (99.9°F), Heart rate: 174/min while sleeping, Respiratory rate: 72/min while sleeping, Blood pressure in right upper extremity: 60/39 mm Hg, Oxygen saturation: 90%; Physical Examination Results: The infant is alert but irritable. The skin is pale with a diaphoretic scalp and cool lower extremities. The infant exhibits tachypnea with moderate retractions and nasal flaring. Crackles are heard in all lung fields upon auscultation. The heart rate is tachycardic with a regular rhythm, and no murmur is detected. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. The mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The abdomen is soft, full, and round, with active bowel sounds; A nurse is caring for a 6-week-old infant in the pediatric unit.
Question 5 of 5
Complete the diagram by dragging from the choices below to specify: 1. What condition the client is most likely experiencing 2. Two actions the nurse should take to address that condition 3. Two parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: A,E
Rationale: Action to Take: A, E; Potential Condition: Congestive heart failure; Parameter to Monitor: Peripheral pulses, Respiratory status.
Rationale:
1. Congestive heart failure is a common condition characterized by fluid overload, leading to decreased perfusion and respiratory distress.
2. Actions to take include managing fluid intake, administering diuretics, and monitoring vital signs.
3. Parameters to monitor include peripheral pulses (indicative of perfusion) and respiratory status (to assess for signs of respiratory distress).