ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 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.
Question 2 of 5
A nurse is preparing to administer immunizations to a 5-year-old child who is up-to-date with the current immunization schedule. Which of the following immunizations should the nurse plan to administer?
Correct Answer: B
Rationale: The correct answer is B: Varicella. Varicella vaccine is typically given to children around 12-15 months of age, and a second dose is recommended at around 4-6 years. Since the child is 5 years old and up-to-date with the immunization schedule, the nurse should plan to administer the second dose of the varicella vaccine to ensure continued protection against chickenpox.
Choice A (Rotavirus) is usually given in infancy, so it is not needed at this age.
Choice C (Haemophilus influenzae type b) is typically administered in infancy and early childhood.
Choice D (Hepatitis
B) is usually given shortly after birth and during early childhood. The other choices are not relevant in this scenario.
Question 3 of 5
A nurse is planning care for a preschooler who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan?
Correct Answer: B
Rationale: The correct answer is B: Establish a reward system. For children with autism spectrum disorder, establishing a reward system can help reinforce desired behaviors and encourage positive interactions. This intervention is effective in promoting learning and improving behavior. Maintaining extended eye contact (
A) may be overwhelming for a child with autism. Engaging in cooperative play (
C) might be challenging due to difficulties in social interactions. Holding the child during assessments (
D) may cause distress as individuals with autism may have sensory sensitivities.
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 planning care for a child who has a prescription to transfuse 2 units of packed RBCs. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Infuse each unit of blood within 4 hr. This is important because packed RBCs should be infused in a timely manner to prevent bacterial growth and ensure the effectiveness of the transfusion. Infusing each unit within 4 hours helps maintain the integrity of the blood product and reduces the risk of complications such as bacterial contamination.
Choice B is incorrect because infusing dextrose 5% in water during the transfusion of packed RBCs is unnecessary and may dilute the blood product, affecting its efficacy.
Choice C is incorrect as storing the second unit of blood at room temperature for up to 2 hours is not recommended. Blood products should be stored according to specific guidelines to maintain their integrity and prevent contamination.
Choice D is incorrect as administering RBCs using non-filtered IV tubing can increase the risk of particulate contamination and adverse reactions in the recipient.
Therefore, the correct intervention is to infuse each unit of blood within