ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
History and Physical
6-year-old child
Vomited 3 times in the past 24 hr
Irritable behavior for the past 24 hr
Respiratory infection started 3 days ago
Brudzinski's and Kernig's signs positive
Question 1 of 5
A nurse is planning care for a child during admission to the facility. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Initiate seizure precautions. This should be the first action as it prioritizes the safety of the child. Seizure precautions involve ensuring a safe environment, such as removing any potential hazards and providing padding to prevent injury during a seizure. Collecting blood cultures (
B) and obtaining a prescription for pain medication (
A) can be important but are not as urgent as ensuring the child's safety in case of a seizure. Transporting the child for a CT scan (
C) is not an immediate priority unless there is a critical need.
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 2 of 5
The nurse is continuing to care for the child. After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the discharge teaching?
| Parent Statement | Reflects Understanding | Needs Reinforcement |
|---|---|---|
| We should notify the provider if the cast becomes loose over time. | ||
| It is important that our child avoids placing anything inside the cast. | ||
| We should prop the casted arm on pillows for the next 24 hours. | ||
| We should expect the swelling to get better. | ||
| We need to be very careful about how we handle the cast for the first 2 days while it dries. |
Correct Answer: A,B,C,D,E
Rationale: [1,1,1,1,1]
Parent Statement: We should notify the provider if the cast becomes loose over time.
Reflects Understanding: This statement shows awareness of the need for prompt action in case of an issue with the cast, ensuring proper care.
Needs Reinforcement: None. This statement is crucial for the child's well-being.
Parent Statement: It is important that our child avoids placing anything inside the cast.
Reflects Understanding: This statement highlights the importance of maintaining the integrity of the cast to prevent complications.
Needs Reinforcement: None. Preventing foreign objects from entering the cast is essential.
Parent Statement: We should prop the casted arm on pillows for the next 24 hours.
Reflects Understanding: Proper elevation helps reduce swelling and promotes healing.
Needs Reinforcement: None. Elevation is a standard practice in cast care.
Parent Statement: We should expect the swelling to get better.
Reflects Understanding: Knowing that swelling should improve indicates awareness of the expected healing process
Extract:
Question 3 of 5
A nurse is assessing a child who has bacterial pneumonia. Which of the following manifestations should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Fever. Bacterial pneumonia commonly presents with fever due to the body's immune response to the infection. This is a classic sign of inflammation caused by the bacterial infection in the lungs. Steatorrhea (
B), tinnitus (
C), and dysphagia (
D) are not typical manifestations of bacterial pneumonia. Steatorrhea is associated with malabsorption disorders, tinnitus is often related to ear issues, and dysphagia is difficulty swallowing, which is not a common symptom of pneumonia.
Therefore, the nurse should expect fever as a key manifestation of bacterial pneumonia in the child.
Question 4 of 5
A nurse is assessing a 5-year-old child who has diabetes insipidus and is receiving desmopressin. Which of the following findings should the nurse identify as an indication that the medication is effective?
Correct Answer: D
Rationale: The correct answer is D: Cessation of nocturnal enuresis. Desmopressin is a medication used to treat diabetes insipidus by decreasing urine output. Nocturnal enuresis is a common symptom of diabetes insipidus due to excessive urine production at night.
Therefore, the cessation of nocturnal enuresis indicates that the medication is effectively reducing urine output in the child.
Choices A, B, and C are unrelated to the effectiveness of desmopressin in treating diabetes insipidus.
Choice A, heart rate of 140/min, is not a specific indicator of desmopressin effectiveness.
Choice B, capillary refill of 3 seconds, is a measure of peripheral perfusion and not directly related to diabetes insipidus.
Choice C, absence of hypoglycemic episodes, is more relevant to diabetes mellitus and not diabetes insipidus.
Question 5 of 5
A nurse is caring for a child who has cystic fibrosis and requires postural drainage. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A. Performing postural drainage prior to meals helps prevent aspiration of food or stomach contents during the procedure. Postural drainage is typically done 1-2 hours after meals to minimize the risk of aspiration. Holding the hand flat (
B) is incorrect as cupped hands are used for percussion to avoid injury. Administering a bronchodilator after (
C) can lead to increased mucous production. Performing the procedure twice daily (
D) is generally recommended, but the timing in relation to meals is crucial.