ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is caring for an infant who has necrotizing enterocolitis. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: A. While vomiting can be a symptom in some gastrointestinal disorders, it is not specific to necrotizing enterocolitis. B. Hypertension is not typically associated with necrotizing enterocolitis. Instead, infants may present with hypotension due to septic shock or poor perfusion. C. A rounded abdomen is a common finding in infants with necrotizing enterocolitis due to abdominal distension from gas and fluid accumulation. D. Tachypnea may occur in response to systemic infection or respiratory distress but is not a defining characteristic of necrotizing enterocolitis.
Question 2 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: A. Nutritional management is crucial in cystic fibrosis due to malabsorption issues. A dietitian can provide guidance on appropriate dietary intake and may recommend enzyme replacement therapy. B. Occupational therapists may assist with activities of daily living, but their primary role may not be as critical initially as nutritional management. C. Speech-language pathologists primarily focus on speech and swallowing disorders, which may not be the primary concern at the time of admission. D. Physical therapists may assist with physical activity and mobility, but their primary role may not be as critical initially as nutritional management.
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. 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 client reports pain as 8 on a scale of 0-10, Client is tearful and grimacing during the examination. Laboratory Results: Hct 28% (32% to 44%), Hgb 6g/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 systolic murmur
Question 3 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: A,C,D,E,G
Rationale: A. Continuous monitoring of oxygen saturation is crucial in a vaso-occlusive crisis to detect any signs of hypoxia early, which could exacerbate the crisis and lead to more severe complications. This is important for assessing respiratory status, especially in patients with sickle cell disease who may be at risk for acute chest syndrome. B. Oral intake should not be restricted during a vaso-occlusive crisis as hydration is important for maintaining adequate blood flow and preventing dehydration. C. Hydroxyurea is used to reduce the frequency of painful crises in patients with sickle cell disease. It works by increasing the production of fetal hemoglobin, which can help prevent sickle cell crises. D. Meperidine (Demerol) is an opioid analgesic commonly used to manage severe pain associated with sickle cell crises. E. Vaccination is important in preventing infections, which can trigger or worsen a vaso-occlusive crisis in individuals with sickle cell disease. Ensuring the pneumococcal vaccine is current helps protect the adolescent from potential infections. F. Placing the client on strict bed rest can increase the risk of thrombosis and impair circulation. G. Folic acid supplementation is often recommended for patients with sickle cell disease to support red blood cell production and prevent folate deficiency, which can worsen anemia.
Extract:
Question 4 of 5
A nurse is preparing to perform a venipuncture on a 4-year-old child. Which of the following actions should the nurse take to ensure atraumatic care?
Correct Answer: C
Rationale: A. Asking the child's parent to leave the room may increase the child's anxiety and make the procedure more traumatic. B. Performing the procedure in the playroom may not necessarily ensure atraumatic care as the environment may still be unfamiliar and anxiety-provoking for the child. C. Applying a topical anesthetic cream helps numb the area, reducing the pain and discomfort associated with venipuncture, thus promoting atraumatic care. D. Explaining the procedure in detail to the child 3 hours prior to the procedure may not be effective in reducing the child's anxiety at the time of the procedure and may increase anticipation-related stress.
Question 5 of 5
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should identify that which of the following laboratory tests can contribute to confirming this diagnosis? Select all that apply.
Correct Answer: B,C,D
Rationale: A. Partial thromboplastin time (PTT) is not typically used to diagnose rheumatic fever. It is used to evaluate coagulation disorders. B. Elevated C-reactive protein (CRP) levels indicate inflammation, which can be associated with rheumatic fever. C. Elevated erythrocyte sedimentation rate (ESR) is a marker of inflammation and can be elevated in rheumatic fever. D. Elevated Antistreptolysin O (ASO) titer indicates recent streptococcal infection, which is a predisposing factor for rheumatic fever. E. Blood urea nitrogen (BUN) is not typically used to diagnose rheumatic fever. It is used to assess kidney function.