ATI RN
ATI RN Pediatric Nursing 2023 II Questions
Extract:
Question 1 of 5
A nurse is caring for a child who has sickle cell anemia. Which of the following findings is the priority for the nurse to report to the provider?
Correct Answer: D
Rationale: The correct answer is D: Facial twitching. Facial twitching may indicate a neurological complication like a stroke in a child with sickle cell anemia, which requires immediate medical attention to prevent further complications. Kyphosis (
A) is a spinal curvature that is common in sickle cell anemia but does not require immediate attention. Constipation (
B) and enuresis (
C) are common issues in children with sickle cell anemia but do not pose immediate risks.
Therefore, they can be addressed by the nurse without the need for urgent reporting to the provider.
Question 2 of 5
A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct action is to apply pressure just above the insertion site. This is because the priority is to control the bleeding. Applying pressure helps to stop the bleeding and prevent further blood loss. Monitoring the pulse distal to the insertion site (choice
B) can be done after controlling the bleeding. Obtaining vital signs (choice
C) is important but not the first priority in this situation. Reinforcing the dressing (choice
D) can be done after the bleeding is under control. It is crucial to address the immediate issue of bleeding first before moving on to other assessments or interventions.
Question 3 of 5
A nurse is assessing a 4-month-old infant during a well-baby visit. For which of the following findings should the nurse notify the provider?
Correct Answer: B
Rationale: The correct answer is B: Doll's eye reflex intact. This reflex is abnormal in infants over 3 months old and suggests a neurological issue. A: No head lag is normal at 4 months. C: Tears when crying is a normal response. D: Positive Babinski reflex is normal in infants under 2 years old. The Doll's eye reflex should disappear by 3 months, so its presence at 4 months is concerning.
Question 4 of 5
A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take?
Correct Answer: D
Rationale: The correct answer is D: Use a tumbling E chart for the assessment. This is because a tumbling E chart is commonly used for testing visual acuity in young children as they may not yet know their letters. The chart consists of the letter 'E' facing in different directions, and the child is asked to point in the direction the 'E' is facing. This method helps assess visual acuity without the child needing to know letters.
A: Assessing both eyes together first, then separately may not be as effective in determining each eye's individual visual acuity.
B: Positioning the child 4.6 meters from the chart is the standard distance for adults, not for testing children's visual acuity.
C: Testing the child without glasses before testing with glasses may not provide an accurate assessment of the child's visual acuity with correction.
Question 5 of 5
A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider?
Correct Answer: A
Rationale: The correct answer is A: Tachypnea. Respiratory syncytial virus (RSV) can cause respiratory distress in infants. Tachypnea, or rapid breathing, is a concerning sign that indicates the infant is having difficulty breathing and may need immediate medical intervention. Reporting tachypnea promptly to the provider allows for timely assessment and appropriate treatment to prevent respiratory compromise.
Incorrect choices:
B: Coughing - While coughing is common in RSV, it is not as urgent as tachypnea in indicating respiratory distress.
C: Rhinorrhea - Runny nose is a common symptom of RSV but does not require immediate reporting as it is not a critical sign of distress.
D: Pharyngitis - Throat inflammation may occur with RSV but is not as urgent as tachypnea in indicating respiratory distress.