ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a child who has cystic fibrosis and requires postural drainage. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Perform the procedure prior to meals. Postural drainage helps clear mucus from the lungs. Performing it before meals prevents aspiration since the child's stomach will be empty. This timing also maximizes the effectiveness of postural drainage by clearing the airways before meals, which can help improve breathing.
B: Holding hand flat for percussions is incorrect as cupped hands are used to provide effective percussions.
C: Administering a bronchodilator after the procedure does not relate to the timing of postural drainage.
D: Performing the procedure twice each day is not specific to the timing of postural drainage.
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 2 of 5
The nurse is continuing to care for the child. The nurse should anticipate a prescription for pain medication.
Correct Answer: B,D
Rationale: The correct answers are B and D. A surgical consultation (
B) may be needed to address the underlying cause of the child's pain. Pain medication (
D) is essential to provide comfort and manage the child's pain. Skin traction (
A) and limb immobilization (E) are interventions for orthopedic issues, not for immediate pain relief. Antibiotics (
C) are not indicated unless there is an infection. Bed rest (F) is not a proactive measure for pain management.
Extract:
Question 3 of 5
A nurse is assessing the fontanels of an infant. Which of the following findings should the nurse recognize as an expected finding?
Correct Answer: B
Rationale: The correct answer is B: The anterior fontanel is open. The anterior fontanel is typically open in infants to allow for brain growth and development. It is a normal finding during infancy and should close by around 18 months of age.
Choice A is incorrect because the posterior fontanel closes shortly after birth.
Choice C is incorrect because the fontanels are not expected to be the same size; the anterior fontanel is larger than the posterior fontanel.
Choice D is incorrect because the presence of molars in the fontanels would not be expected and could indicate a medical issue.
Question 4 of 5
A nurse is caring for a school-age child who has sickle cell anemia and is in vaso-occlusive crisis. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Increase oral fluid intake. During a vaso-occlusive crisis in sickle cell anemia, there is a blockage of blood flow leading to tissue ischemia and pain. Increasing oral fluid intake helps to hydrate the child and improve blood flow, potentially reducing the severity of the crisis. Cold compresses (
A) can worsen vasoconstriction, platelet transfusion (
B) is not indicated for vaso-occlusive crisis, and active range of motion exercises (
C) can exacerbate pain and further compromise blood flow. Increasing fluid intake is the most appropriate intervention to help manage the crisis.
Extract:
History and physical 0830: Pharyngitis 3 weeks ago. Prescribed 5-day course of azithromycin. Antibiotic discontinued on day 3 due to gastrointestinal upset. Current on all recommended immunizations.
Question 5 of 5
A nurse on the pediatric unit is admitting the child from the emergency department. For each of the assessment finding below, click to specify if the assessment finding is consistent with Kawasaki disease, scarlet fever, or rheumatic fever. Each finding may support more than 1 disease process of none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.
| Assessment finding | Kawasaki Disease | Scarlet fever | Pheumatic Fever |
|---|---|---|---|
| Recent diagnosis of pharyngitis. | |||
| Nodules | |||
| Cardiomegaly | |||
| Polyarthralgia |
Correct Answer: A,B,C,D
Rationale: The correct answer is .
A: Recent diagnosis of pharyngitis - Consistent with all three diseases as pharyngitis can be a symptom in Kawasaki disease, scarlet fever, and rheumatic fever.
B: Nodules - Can be seen in Kawasaki disease (cervical lymphadenopathy), scarlet fever (subcutaneous nodules), and rheumatic fever (subcutaneous nodules).
C: Cardiomegaly - Seen in Kawasaki disease (coronary artery aneurysms), scarlet fever (cardiomegaly due to myocarditis), and rheumatic fever (cardiomegaly due to carditis).
D: Polyarthralgia - Present in Kawasaki disease (arthritis), scarlet fever (arthritis), and rheumatic fever (migratory arthritis).
Therefore, all these assessment findings can be associated with Kawasaki disease, scarlet fever, and rheumatic fever.