ATI RN
ATI RN Pediatrics Nursing 2023 I Questions
Extract:
Vital Signs 1405: Temperature 38° C (100.4° F), Heart rate 96/min, Respiratory rate 18/min, Blood pressure 104/72 mm Hg, Oxygen saturation 98% on room air; Laboratory Results 1430: C-reactive protein 3.2 mg/dL (<1.0 mg/dL), Albumin 3.4 g/dL (3.5 to 5.0 g/dL), Hemoglobin 11 g/dL (10 to 15.5 g/dL), Hematocrit 33% (32% to 44%), RBC count 4.0 x 10°/μL (4.0 to 5.5 x 10/μL), WBC count 13,000/mm3 (5,000 to 10,000/mm3), Platelets 275,000/mm3 (150,000 to 400,000/mm3), Potassium 3.5 mEq/L (3.4 to 4.7 mEq/L), Magnesium 1.4 mEq/L (1.4 to 1.7 mEq/L), Total calcium 9.0 mg/dL (8.8 to 10.8 mg/dL); Stool: Positive for occult blood (negative), Positive for leukocytes 4/high-power field (<2/high-power field), Negative for helicobacter pylori (negative)
Question 1 of 5
A nurse is caring for an adolescent in the emergency department (ED). 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: D
Rationale: Action to Take: Gluten-free diet, Record intake; Potential Condition: Crohn's disease; Parameter to Monitor: Albumin, Hemoglobin. Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract, requiring a gluten-free diet and careful monitoring of nutrient intake to manage symptoms and prevent malnutrition. Monitoring albumin and hemoglobin levels helps assess the client's nutritional status and response to treatment. The other choices are incorrect because they do not align with the characteristic features of Crohn's disease, such as gluten sensitivity and the need for meticulous dietary management. The actions and parameters in the correct answer are specific to Crohn's disease, making it the most appropriate choice for the scenario presented.
Extract:
A nurse is caring for a toddler who received radiation therapy 2 years ago for a brain tumor.
Question 2 of 5
Which of the following should the nurse identify as a late adverse effect of the radiation therapy?
Correct Answer: D
Rationale: The correct answer is D: Short stature. Late adverse effects of radiation therapy typically manifest months to years after treatment. Radiation can affect bones and inhibit growth, leading to short stature. Mucosal ulceration (
A) and desquamation (
C) are early side effects, while nausea (
B) is a common acute side effect.
Therefore, they are not considered late adverse effects.
Choice E, F, and G are not provided.
Extract:
A nurse is assessing a school-age child prior to administering digoxin.
Question 3 of 5
For which of the following findings should the nurse withhold the medication?
Correct Answer: C
Rationale: The correct answer is C: Heart rate 64/min. A heart rate of 64/min is below the normal range (60-100/min) for adults, indicating bradycardia, which can be a sign of decreased cardiac output. The nurse should withhold medication that can further lower the heart rate and worsen the condition.
A: Urine output 25 mL/hr is low but not necessarily a reason to withhold medication.
B: Oxygen saturation 88% is below the normal range (95-100%) but is not a direct contraindication to withhold medication.
D: Respiratory rate 18/min is within the normal range (12-20/min) and not a reason to withhold medication.
Extract:
Nurses' Notes 1200: Caregiver reports toddler has had diarrhea and decreased appetite for 3 days. Toddler alert, uncooperative but can be consoled by caregiver. Weight 12.7 kg (28 lb). Oral mucosa pink, slightly moist. Heart rate regular without murmur. Respirations unlabored with clear breath sounds. Abdomen soft, no masses, hyperactive bowel sounds. Liquid stool in diaper. Diaper area reddened. Capillary refill 2 seconds. IV started and infusing at 45 mL/hr. 1400: Caregiver reports toddler cried themselves to sleep. Reports no tears. 1600: Toddler continues to sleep. IV site intact and patent. Awakens briefly with vital signs, vomits x1, and is lethargic. Capillary refill 4 seconds. Extremities cool; Vital Signs 1200: Temperature 37.1° C (98.8° F), Heart rate 108/min, Respiratory rate 28/min; 1600: Temperature 37.1° C (98.8° F), Heart rate 112/min, Respiratory rate 26/min, Blood pressure 100/60 mm Hg; I&O 1600: IV intake 180 mL, Oral intake none (refuses), Urine output unable to determine - 3 liquid stools in diapers, Stool output 100 mL
Question 4 of 5
A nurse is caring for a toddler admitted to the hospital. Click to highlight the findings that require immediate follow-up.
Correct Answer: A,C,D
Rationale: The correct choices (A,C,
D) require immediate follow-up due to potential signs of serious health issues. A: Capillary refill of 4 seconds indicates poor circulation. C: Lack of tears can be a sign of dehydration. D: Lethargy can indicate a decline in health status. The other choices (B,E,F,G) do not present immediate threats to the toddler's health.
Extract:
Vital Signs 0900: Temperature 37° C (98.6° F), Heart rate 90/min, Respiratory rate 22/min, Blood pressure 110/70 mm Hg, Oxygen saturation 96% on room air; 1000: Temperature 37.3°C (99.7° F), Heart rate 98/min, Respiratory rate 25/min, Blood pressure 120/74 mm Hg, Oxygen saturation 96% on room air; Laboratory Results 1000: WBC count 9,500/mm3 (5,000 to 10,000/mm3), Hgb 9 g/dL (10 to 15.5 g/dL), Hct 18% (32% to 44%), Platelets 450,000/mm3 (150,000 to 400,000/mm3); Nurses' Notes 0900: Child admitted to unit in vaso-occlusive crisis. Child reports pain in the right knee as 7 on a scale of 0 to 10. Right knee is swollen and warm to the touch. Pulses are +2 and capillary refill 2 seconds in all extremities. 1000: Notified provider regarding laboratory results. Child reports pain in the right knee is now 10 on a scale of 0 to 10.
Question 5 of 5
A nurse is caring for a 12-year-old client who has sickle cell disease. Complete the following sentence by using the lists of options: The nurse should anticipate a provider prescription for ___ due to the child's ___.
Correct Answer: A
Rationale: The correct answer is A: IV hydromorphone due to pain. In sickle cell disease, vaso-occlusive pain crises are common due to the blockage of blood flow by sickled red blood cells. IV hydromorphone is a potent opioid analgesic used to manage severe pain in such crises. IV fluids (option
B) may be necessary to prevent dehydration, but it is not the primary intervention for pain management in sickle cell disease. Acetaminophen (option
C) is used for fever, which is not the main concern in this case. Oxygen (option
D) may be needed in cases of acute chest syndrome but is not the first-line treatment for pain in sickle cell crisis.