ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 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. This finding is the priority because it could indicate a neurological issue or seizure activity, which can be life-threatening in a child with sickle cell anemia. Kyphosis (
A) is a spinal deformity that may require monitoring but is not as urgent as facial twitching. Constipation (
B) and enuresis (
C) are common issues in children and can be managed with interventions such as dietary changes or bladder training. Facial twitching (
D) requires immediate attention as it may be a sign of a more serious complication.
Question 2 of 5
A nurse is caring for a child who has epiglottitis due to an infection with Haemophilus influenzae type B. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: C,D,E
Rationale: The correct actions are to monitor oxygen saturation (
C) due to potential airway compromise, begin droplet precautions (
D) to prevent spread of infection, and initiate IV access (E) for potential emergency treatment. Inspecting the epiglottis (
A) could trigger a spasm and worsen the airway obstruction. Obtaining a throat culture (
B) may not be necessary in the immediate management of epiglottitis.
Question 3 of 5
A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
Correct Answer: A
Rationale: The correct answer is A because vomiting can affect the absorption and effectiveness of digoxin. Vomiting can lead to decreased drug levels in the bloodstream, potentially causing subtherapeutic effects. This can result in inadequate control of the toddler's condition and may lead to worsening symptoms.
Choices B, C, and D are within acceptable ranges and do not necessarily warrant a revision of the plan of care.
Choice B indicates a digoxin level within the therapeutic range, choice C indicates a slightly elevated pulse rate which can be expected with digoxin therapy, and choice D indicates a potassium level within the normal range.
Therefore, the nurse should focus on the toddler who has vomited to ensure proper absorption of the medication and adjust the plan of care accordingly.
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 4 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.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: C
Rationale: Action to Take: Provide chest physiotherapy and postural drainage; Potential Condition: Cystic fibrosis; Parameter to Monitor: Number of steatorrhea stools, Intake and output.
Rationale:
1. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system, leading to thick mucus production. Chest physiotherapy and postural drainage help clear mucus from the lungs.
2. Monitoring the number of steatorrhea stools is important as it indicates malabsorption in cystic fibrosis. Intake and output monitoring helps assess hydration status and nutritional intake.
3. Pyloric stenosis, congestive heart failure, and respiratory syncytial virus bronchiolitis are not conditions typically associated with chest physiotherapy and postural drainage.
4. Anticipating a prescription for digoxin and implementing contact precautions are not relevant actions for addressing cystic fibrosis.
5. Monitoring for periorbital edema is
Extract:
Question 5 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: The correct answer is A: Dietitian. In cystic fibrosis, nutrition is crucial due to malabsorption issues. A dietitian can assess the child's nutritional needs, provide dietary recommendations, and help optimize nutrient intake. Referring to an occupational therapist (
B) would address activities of daily living, not specific to cystic fibrosis. Speech-language pathologists (
C) focus on speech and swallowing disorders, not directly related to cystic fibrosis. Physical therapists (
D) primarily address mobility and physical function, which may not be the priority in cystic fibrosis.