ATI RN
ATI RN Pediatric Nursing 2023 I Questions
Extract:
Question 1 of 5
A nurse is caring for a school-age child who has diabetes mellitus. Which of the following findings should the nurse recognize as being consistent with hyperglycemia?
Correct Answer: D
Rationale: D. Thirst (polydipsia) is a classic symptom of hyperglycemia in diabetes mellitus, as the body tries to dilute the excess sugar in the bloodstream by increasing fluid intake. A, B, C. These are more associated with hypoglycemia.
Extract:
A nurse on a pediatric intensive care unit is caring for a toddler who weighs 12 kg (26.5 lb) and is postoperative following open heart surgery.
Question 2 of 5
Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: B. This is a concerning finding indicating possible inadequate renal perfusion, especially considering the postoperative status of the toddler. A. Chest tube drainage of 22 mL/hour is expected. C. Skin temperature of 36°C is slightly low but not critical. D. Pulses of 2+ are adequate.
Extract:
School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K. Barrel-shaped chest, Clubbing of the fingers bilaterally, Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough. Vital Signs: Temperature 38.4° C (101.1° F), Heart rate 100/min, Respiratory rate 40/min, Blood pressure 100/57 mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa, Stool analysis positive for presence of fat and enzymes, Chest x-ray indicates obstructive emphysema, WBC count 20,000/mm3 (5,000 to 10,000/mm3).
Question 3 of 5
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.
Correct Answer: A,C,E
Rationale: A. Deficient levels of vitamins A, D, E, and K indicate malabsorption, necessitating supplementation with water-soluble vitamins to address nutritional deficiencies. B. Acetaminophen is an analgesic and antipyretic that has no effect on the underlying cause of cystic fibrosis. C. Dornase alfa (Pulmozyme) is a recombinant human deoxyribonuclease enzyme used in the management of cystic fibrosis to improve pulmonary function by reducing the viscosity of mucus in the airways. D. Meperidine is an opioid analgesic that can cause respiratory depression and increase the risk of pulmonary complications. E. Children with cystic fibrosis often have pancreatic insufficiency, leading to malabsorption of fats and fat-soluble vitamins. Pancreatic lipase supplements are necessary to aid in the digestion of fats.
Extract:
A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low 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 mm Hg, Respiratory rate 20/min, Oxygen saturation 95% on room air. Assessment: Awake, alert, and oriented x 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.
Question 4 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: A,B,C,F
Rationale: A. Clients with sickle cell disease are at increased risk for infections, including those caused by pneumococcus. Ensuring vaccination status helps prevent future complications. B. Folic acid supplementation may be part of the overall management of sickle cell disease, but it is not a priority intervention during a vaso-occlusive crisis. C. Vaso-occlusive crises can lead to tissue hypoxia due to impaired blood flow. Continuous monitoring of oxygen saturation helps in assessing tissue perfusion and detecting hypoxemia early. D. Placing the client on strict bed rest can increase the risk of thrombosis and impair circulation. E. Cold can cause vasoconstriction, worsening the pain and sickling process. Warm compresses are more appropriate for promoting comfort and improving circulation. F. Meperidine (Demerol) is a potent opioid analgesic that can help alleviate severe pain associated with vaso-occlusive crises. G. The nurse should not restrict oral intake, as hydration is important to prevent dehydration and further sickling. H. Hydroxyurea is used to prevent vaso-occlusive crises in patients with sickle cell disease but is not typically administered during an acute crisis. This is a medication that reduces the frequency and severity of vaso-occlusive crises by increasing the production of fetal hemoglobin, which prevents sickling.
Extract:
Question 5 of 5
A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care?
Correct Answer: B
Rationale: B. Providing a pacifier coated with an oral sucrose solution has been shown to reduce pain and stress during immunizations in infants, promoting atraumatic care. A. EMLA cream requires time to work. C. Deltoid muscle is not used in infants. D. A 20-gauge needle is too large.