ATI RN
ATI RN Pediatrics 2023 Questions
Extract:
Adolescent with major depressive disorder
Question 1 of 5
A nurse is caring for an adolescent who has major depressive disorder. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale:
Correct Answer: D. Assessing suicide risk is the priority in depression due to safety concerns. A. Medication is secondary. B. Therapy is beneficial but not first. C. ADLs can wait after safety is ensured.
Extract:
History and Physical 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.
Question 2 of 5
Select the 5 interventions the nurse should include.
Correct Answer: A,B,E,H
Rationale:
Correct Answer: A,B,E,H. A. Folic acid is important for patients with sickle cell disease because it helps produce new red blood cells. B. Continuous monitoring of oxygen saturation is crucial because hypoxia can exacerbate sickling of red blood cells. E. Patients with sickle cell disease are at increased risk for infections, including pneumococcal infections, due to functional asplenia. H. Hydroxyurea increases fetal hemoglobin production, reducing the frequency of vaso-occlusive crises. Interventions to avoid: C. Cold can cause vasoconstriction, worsening pain. D. Hydration is crucial; restricting intake could worsen the crisis. F. Strict bed rest increases the risk of complications like thrombosis. G. Meperidine is not recommended due to side effects like respiratory depression.
Extract:
Group of clients on a pediatric unit
Question 3 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: A spica cast restricts movement, risking circulation impairment. A. IV fluids don't typically affect perfusion. C. UTI affects urinary, not vascular, system. D. Otitis media is unrelated.
Extract:
Adolescent following scoliosis repair with spinal instrumentation
Question 4 of 5
A nurse is planning postoperative care for an adolescent following scoliosis repair with spinal instrumentation. Which of the following actions should the nurse include in the plan of care?
Correct Answer: A
Rationale: Logrolling maintains spinal alignment, critical post-surgery. B. 30° is too high; lower angles are safer. C. Ambulation at 12 hours is too soon. D. Liquids depend on bowel sounds, not a fixed time.
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
Question 5 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: B,D
Rationale:
Correct Answer: B,D. -Water-soluble vitamins: Children with cystic fibrosis often have deficiencies in fat-soluble vitamins (A, D, E, and K) due to malabsorption related to pancreatic insufficiency. Supplementing with water-soluble vitamins is not typically indicated as they are not affected by pancreatic insufficiency. -Dornase alfa: Dornase alfa is a recombinant human deoxyribonuclease enzyme that helps to thin and break down the thick, tenacious mucus in the airways of patients with cystic fibrosis. It is commonly prescribed to improve respiratory symptoms such as wheezing, rhonchi, and dyspnea. -Acetaminophen: Acetaminophen may be prescribed for pain or fever relief, but it is not specific to cystic fibrosis management. However, it may be used to alleviate symptoms such as headache or discomfort associated with cystic fibrosis exacerbations. -Pancreatic Apase: Pancreatic enzymes (e.g., pancreatic lipase, protease, and amylase) are essential for digestion and absorption of nutrients in individuals with cystic fibrosis-associated pancreatic insufficiency. Pancreatic enzyme replacement therapy (PERT) with pancreatic Apase supplements is crucial for improving nutrient absorption and preventing malnutrition. -Meperidine is an opioid analgesic that is not typically used in the management of cystic fibrosis. While pain management may be necessary for some patients with cystic fibrosis, opioids are generally not recommended due to concerns about respiratory depression and addiction potential.