ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a nonpharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
Correct Answer: C
Rationale: A. Visual analog scales may not be appropriate for toddlers who are cognitively impaired and unable to understand abstract concepts. B. FACES pain scale relies on the child's ability to express emotions through facial expressions, which may be limited in cognitively impaired toddlers. C. FLACC (Face, Legs, Activity, Cry, Consolability) pain scale is a validated tool for assessing pain in young children, including those who are cognitively impaired. D. CRIES pain scale is typically used for neonates and infants up to 6 months of age and may not be suitable for toddlers.
Question 2 of 5
A nurse is providing teaching to the guardian of a 2-year-old child about typical toddler behavior. Which of the following behaviors should the nurse include?
Correct Answer: B
Rationale: A.
Toddlers thrive on routines and consistency, which provide them with security and predictability. B.
Toddlers are in a stage of development where they assert their independence and autonomy by saying 'no' or 'mine' to almost everything. This is a normal and healthy behavior that reflects their growing sense of self and identity. The nurse should explain to the guardian that this behavior is not meant to be defiant or disrespectful, but rather a way of exploring their environment and expressing their preferences. C.
Toddlers are typically emotionally labile, meaning they can experience rapid changes in mood and emotions. D.
Toddlers may display increased independence rather than increased dependency as they strive to assert their autonomy.
Extract:
Nurse Notes: Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted. 0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, non-productive cough present. Vital Signs: 0730: Tympanic temperature 38.1 C (100.6 F), Heart rate 95/min, Respiratory rate 20/min, Oxygen saturation 98% on room air. 0800: Tympanic temperature 38.2 C (100.6 F), Heart rate 95/min, Respiratory rate 20/min, Oxygen saturation 96% on room air. Provider Prescription: Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO, Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
Question 3 of 5
For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process.
| Finding | Acute laryngotracheobronchitis | pneumonia |
|---|---|---|
| Irritability | ||
| Cough findings at 0800 | ||
| Stridor | ||
| Temperature |
Correct Answer: A,B,C,D
Rationale: A. Both acute laryngotracheobronchitis (croup) and pneumonia can cause irritability in a child due to discomfort from respiratory symptoms and fever. B. The presence of a barking, non-productive cough at 0800 is consistent with acute laryngotracheobronchitis (croup), as it is a characteristic symptom. Pneumonia can also present with cough, but it is typically productive and associated with other respiratory symptoms such as dyspnea and crackles. C. Stridor, an inspiratory wheezing sound, is a hallmark symptom of acute laryngotracheobronchitis (croup) due to inflammation and narrowing of the upper airway. It is not typically associated with pneumonia. D. Fever can occur in both acute laryngotracheobronchitis (croup) and pneumonia. In this case, the tympanic temperatures of 38.1°C and 38.2°C are consistent with both conditions. However, pneumonia may present with higher fevers compared to croup.
Extract:
Question 4 of 5
A nurse is planning care for a preschooler who has neutropenia. Which of the following interventions should the nurse include in the plan?
Correct Answer: B
Rationale: A. Administering vaccines prior to discharge may not be appropriate for a child with neutropenia as they have a compromised immune system, and live vaccines should be avoided. B. Avoiding raw fruits and vegetables in the child's diet is essential because raw produce may harbor bacteria that could potentially lead to infections in a child with neutropenia. Cooked fruits and vegetables are safer options. C. Bathing the child every other day may be appropriate to maintain cleanliness, but it is not specifically related to neutropenia management. D. Obtaining the child's rectal temperature once daily is important for monitoring for fever, which can be a sign of infection in a neutropenic child. However, dietary precautions to prevent bacterial exposure are more directly related to managing neutropenia.
Question 5 of 5
A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective?
Correct Answer: B
Rationale: A. Furosemide is a loop diuretic that typically causes potassium loss, so an increase in potassium levels would not be expected as an indication of effectiveness. B. Furosemide is prescribed to reduce fluid volume overload, which often manifests as peripheral edema in patients with heart failure. A decrease in peripheral edema indicates that the medication is effectively reducing fluid retention. C. Furosemide is not typically prescribed to decrease cardiac output but rather to reduce fluid volume overload, which may help improve cardiac function indirectly. D. Furosemide is not typically prescribed to increase venous pressure but rather to decrease fluid volume overload, which may help reduce venous pressure over time.