ATI RN
ATI RN Pediatrics 2023 Questions
Extract:
Group of clients on a pediatric unit
Question 1 of 5
A nurse is caring for a group of clients on a pediatric unit. Which of the following clients is most at risk for insufficient vascular perfusion?
Correct Answer: B
Rationale: The correct answer is B: A school-age child who is in a spica cast. A spica cast can cause constriction on blood vessels leading to compromised vascular perfusion. The weight and pressure from the cast can impede blood flow, increasing the risk of insufficient vascular perfusion. In contrast, choices A, C, and D do not directly impact vascular perfusion. A child receiving IV fluids (
A) is actually receiving hydration support, an adolescent with a urinary tract infection (
C) may have systemic issues but not directly related to vascular perfusion, and a preschooler with otitis media (
D) has an ear infection which does not affect vascular perfusion. This makes choice B the most at risk for insufficient vascular perfusion.
Extract:
10-year-old child receiving chemotherapy
Question 2 of 5
A nurse is caring for a 10-year-old child who is receiving chemotherapy. The child's guardian asks about managing adverse effects. Which of the following statements should the nurse make?
Correct Answer: A
Rationale: The correct answer is A: Use a soft-bristled toothbrush when platelet levels are low. This is important because chemotherapy can lower platelet levels, increasing the risk of bleeding. Using a soft-bristled toothbrush reduces the risk of gum bleeding or injury.
Choice B is incorrect because encouraging favorite foods may not always be suitable during chemotherapy, as some foods may exacerbate side effects or interact with medications.
Choice C is incorrect because chlorhexidine mouthwash can be too harsh for a child undergoing chemotherapy and may further irritate the mouth.
Choice D is incorrect because antiemetics should be administered as prescribed by the healthcare provider, not just for a specific time period after chemotherapy.
In summary, the correct answer focuses on a specific precaution related to the child's health condition, while the other choices may not be appropriate or relevant in this context.
Extract:
7-year-old client who weighs 18.1 kg (39.9 lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor. Vital Signs 0715: Temperature 38° C (100.4° F), Heart rate 80/min, Respiratory rate 22/min, Blood pressure 106/65 mm Hg. 0930: Temperature 38.4° C (101.1° F), Heart rate 90/min, Respiratory rate 23/min, Blood pressure 105/65 mm Hg. Provider Prescriptions: Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO, Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
Question 3 of 5
For each the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Advise child's guardian about the use of sunscreen. | ||
| Administer salicylic acid for pain and fever. | ||
| Administer sulfamethoxazole and trimethoprim. | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluid. |
Correct Answer: A: Anticipated, B: Contraindicated, C: Contraindicated, D: Anticipated, E: Contraindicated
Rationale: [1, 0, 0, 1, 0]
For choice A, educating the child about proper perineal hygiene is anticipated as it promotes health.
Choice B, advising about sunscreen, is contraindicated as it may not be relevant to the client's condition.
Choice C, administering salicylic acid, is contraindicated as it can be harmful due to potential side effects.
Choice D, administering sulfamethoxazole and trimethoprim, is anticipated for treating infections.
Choice E, limiting fluid intake, is contraindicated as it can lead to dehydration.
Extract:
Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted. 0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, non-productive cough present. Vital Signs 0730: Tympanic temperature 38.1° C (100.6° F), Heart rate 95/min, Respiratory rate 20/min, Oxygen saturation 98% on room air. 0800: Tympanic temperature 38.2° C (101° F), Heart rate 112/min, Respiratory rate 24/min, Oxygen saturation 96% on room air
Question 4 of 5
For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia.
| Findings | Acute laryngotracheobronchitis | pneumonia |
|---|---|---|
| Temperature | ||
| Stridor | ||
| Irritability | ||
| Cough findings at 0800 |
Correct Answer: A: Both, B: Acute laryngotracheobronchitis, C: Both, D: Acute laryngotracheobronchitis
Rationale:
To determine which findings are consistent with acute laryngotracheobronchitis or pneumonia, we need to consider the typical symptoms associated with each condition.
- A: Temperature is associated with both conditions, as fever is a common symptom in both acute laryngotracheobronchitis and pneumonia.
- B: Stridor is more commonly seen in acute laryngotracheobronchitis due to upper airway inflammation and narrowing.
- C: Irritability can be present in both conditions, as respiratory distress can cause irritability in children.
- D: Cough findings at 0800 typically indicate acute laryngotracheobronchitis, as cough is a defining symptom of this condition.
Therefore, the correct answer is A: Both, B: Acute laryngotracheobronchitis, C: Both, D: Acute laryngotracheobronchitis. Other choices are incorrect as they do not
Extract:
Guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, resulting in bleeding. History of allergic rhinitis. Assessment: Child alert, respiratory rate 24/min, no adventitious sounds, heart rate 108/min, generalized reddish scaly patches with lichenifications and depigmentation on bilateral extremities. Medication: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream daily
Question 5 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian? Select all that apply.
Correct Answer: A,B,C,D,E
Rationale:
To properly care for a child with a skin condition, the nurse should include the following instructions in the discharge plan:
A: Cutting and filing fingernails can prevent scratching and further skin irritation.
B: Emollients help maintain skin moisture and prevent dryness.
C: Gloves can protect the skin and prevent scratching, especially at night.
D: Using a mild detergent reduces the risk of skin irritation from harsh chemicals.
E: Informing about occasional flare-ups prepares the guardian for managing the condition's fluctuations.
Rationale for incorrect choices:
F: The condition is not contagious, so this statement is incorrect.
G: Pimecrolimus cream is not typically recommended as a first-line treatment for most skin conditions.