ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: A. Encouraging flexion and extension of the neck is contraindicated in a client with a halo vest to prevent further injury to the cervical spine. B. Repositioning the client using a turning sheet helps to maintain proper alignment and prevent complications such as pressure ulcers. C. Assessing the pin sites for infection should be done daily, not once every other day, to monitor for signs of infection. D. Tightening the screws on the halo device should be done as prescribed by the healthcare provider and typically does not occur every 48 hours.
Question 2 of 5
A nurse is caring for a 1-year-old child who has been hospitalized. Which of the following items in the child's room is a common source of health care-associated infection?
Correct Answer: B
Rationale: A. Unopened bottles of formula are not typically a source of healthcare-associated infection. B. Bedside computer keyboards can harbor various pathogens and are commonly touched by multiple individuals without thorough cleaning, making them a common source of healthcare-associated infections. C. Disposable diapers, if properly disposed of and not reused, are not typically a source of healthcare-associated infection. D. Protective plastic gowns, if used appropriately, are not typically a source of healthcare-associated infection.
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 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: A. No head lag when pulled to a sitting position is a normal finding at 4 months of age and does not require notification of the provider. B. The Doll's eye reflex (also known as oculocephalic reflex) should be absent by 4 months of age. Its persistence could indicate neurological abnormalities and warrants further evaluation by the provider. C. Presence of tears when crying is a normal physiological response and does not require notification of the provider. D. Positive Babinski reflex is normal in infants under 2 years old and typically disappears by 12 to 24 months of age. It does not require immediate notification of the provider.
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.