ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Extract:
Question 1 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. For a child with cystic fibrosis, proper nutrition is crucial due to malabsorption issues. A dietitian can help create a personalized nutrition plan to ensure the child receives sufficient nutrients. Referring to a dietitian is essential to optimize the child's growth and overall health. Physical therapists (
B), speech-language pathologists (
C), and occupational therapists (
D) are important members of the team but are not the first priority for a child with cystic fibrosis. They may be needed later depending on the child's specific needs.
Extract:
A nurse in the emergency department is preparing to discharge a 3-year-old child. Nurse's Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. The guardian expresses concern about the child's atopic dermatitis worsening, and the child scratching excessively, which results in bleeding areas. The guardian states the child has a history of allergies and rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO, 4 times per day. Pimecrolimus 1% cream, apply to skin lesions daily. Assessment: Child is alert and responsive. Respiratory rate is even and monitored at 24/min. No adventitious sounds auscultated. Heart rate: 108/min. Generalized small clusters of reddish, scaly patches with lichenification and depigmentation on the child's bilateral upper and lower extremities.
Question 2 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian?
Correct Answer: A,B,C,E,F
Rationale: The correct answers are A, B, C, E, and F.
A: Applying emollients after bathing helps moisturize the skin, which is beneficial for the child's condition.
B: Cutting and filing fingernails frequently can prevent scratching and potential skin damage.
C: Informing the guardian about occasional flare-ups helps manage expectations and preparedness.
E: Applying gloves can protect the child's hands from irritants or scratching, aiding in the healing process.
F: Applying a thin layer of prescription cream to lesions as instructed by a healthcare provider helps manage the condition effectively.
These choices promote skin care, prevention of skin damage, awareness of condition management, protection of skin, and proper medication application.
Extract:
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. History and Physical: 15-year-old adolescent admitted for a vaso-occlusive crisis. The parent reports low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and lower back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10. Vital Signs: Temperature: 37.8°C (100°F). Heart rate: 100/min. Blood pressure: 110/72 mmHg. Respiratory rate: 20/min. Oxygen saturation: 95% on room air. Assessment: Awake, alert, and oriented ×3. Yellow sclera of eyes noted bilaterally. Right upper quadrant tender to palpation. Hands painful to touch and swollen bilaterally. Right knee is swollen, warm to palpation, and the client reports pain as 8 on a scale of 0 to 10. Client is tearful and grimacing during the examination. Laboratory Results: Hct: 28% (32% to 44%). Hgb: 6 g/dL (10 to 15.5 g/dL). WBC count: 20,000/mm³ (6,200 to 17,000/mm³). ALT: 50 units/L (4 to 36 units/L). AST: 62 units/L (10 to 40 units/L). Total bilirubin: 3.0 mg/dL (0.3 to 1.0 mg/dL). Chest radiographic examination indicates cardiomegaly and left flow murmur.
Question 3 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include:
Correct Answer: A,B,C,G
Rationale:
Correct Answer: A, B, C, G
Rationale:
A: Instruct the parent to ensure the pneumococcal vaccine is current to prevent pneumococcal infections in the adolescent.
B: Monitor oxygen saturation continuously to assess respiratory status and detect any potential respiratory issues.
C: Administer folic acid as prescribed to support the adolescent's growth and development.
G: Give Oral Hydroxyurea to manage conditions like sickle cell anemia in adolescents.
Incorrect
Choices:
D: Applying cold compresses to the affected joints is not relevant to the care of an adolescent unless specifically indicated for a certain condition.
E: Placing the client on strict bed rest is not typically recommended for adolescents as it can lead to deconditioning and other complications.
F: Administering meperidine (Demerol) for pain is not a standard intervention for adolescents and may have adverse effects.
Extract:
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?
Question 4 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: The correct answer is B: Reposition the client using a turning sheet. Repositioning the client using a turning sheet helps prevent skin breakdown and pressure ulcers, which are common risks associated with prolonged immobilization in a halo vest. Turning the client also promotes circulation and respiratory function.
Choice A is incorrect because tightening the screws on the halo device should be done by a healthcare provider as per specific instructions, not by the nurse.
Choice C is incorrect as encouraging flexion and extension of the neck can destabilize the cervical spine and interfere with the healing process.
Choice D is incorrect because assessing the pin sites for infection should be done daily, not every other day, to promptly detect and treat any signs of infection.
Extract:
A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI). Nurses' Notes: 0700: 7-year old client who weighs 18.1kg (39.9lb) 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 20mg/kg/dose every 4hr as needed for pain and fever.
Question 5 of 5
The nurse is planning care for the client. For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Potential Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Administer sulfamethoxazole and trimethoprim | ||
| Administer salicylic acid for pain and fever | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluids. | ||
| Advise the child's guardian about the use of cotton underwear. |
Correct Answer: A,B,E
Rationale: [1, 0, 1]
The correct answer is A, B, and E.
- A: Educating the child about proper perineal hygiene is anticipated to prevent infections.
- B: Administering sulfamethoxazole and trimethoprim is anticipated for treating infections.
- E: Advising the child's guardian about the use of cotton underwear can help maintain proper hygiene.
C: Administering salicylic acid for pain and fever is contraindicated as it is not suitable for treating infections.
D: Ensuring the child receives a maximum of 1,200 mL/day of fluids is not relevant to preventing infections.