ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Weigh the child once per day. In nephrotic syndrome, monitoring weight daily is crucial to assess fluid status and response to treatment. Weight gain indicates fluid retention, a common complication. Positioning the child supine (
B) is not relevant. Calorie intake should be sufficient to meet increased metabolic demands, so limiting it to 45 cal/kg/day (
C) is incorrect. Increasing fluid intake to 2 L/day (
D) may worsen fluid overload.
Question 2 of 5
A nurse is assessing a school-age child who is receiving morphine. For which of the following adverse effects should the nurse monitor?
Correct Answer: D
Rationale: The correct answer is D: Bradypnea. Morphine is an opioid that can cause respiratory depression, leading to bradypnea (slow breathing). Monitoring the child's respiratory rate is crucial to detect any signs of respiratory distress. Stevens-Johnson syndrome (
A) is a severe skin reaction, not typically associated with morphine. Hypertension (
B) is not a common adverse effect of morphine; in fact, it can cause hypotension. Prolonged wound healing (
C) is not a known adverse effect of morphine. Monitoring for bradypnea will ensure timely intervention if the child experiences respiratory depression.
Extract:
History and Physical: Infant was full-term at birth. Birth weight was 3.5 kg (7.7 lb). Infant is not gaining weight as expected. One week ago at outpatient visit, weight was 3.6 kg (7.9 lb). Parent reports for past 2 days infant is breathing faster during feedings and does not finish feedings. Parent also reports decreased appetite and puffiness around the infant's eyes. Parent states that the last wet diaper was about 10 hr ago. Infant admitted for diagnostic evaluation, failure to thrive, and nutritional/fluid support. Vital Signs: Admission: Temperature 37.7° C (99.9° F), Heart rate 174/min while sleeping, Respiratory rate 72/min while sleeping. Assessment: Respirations: Tachypneic with moderate retractions and nasal flaring. Upon auscultation, crackles heard in all lung fields. No nasal drainage noted. Dry cough noted periodically. Skin: Pallor, scalp is diaphoretic, lower extremities are cool to touch. Cardiac: Tachycardic, regular rhythm, no murmur is heard. Peripheral pulses are full and bounding in the upper extremities and weak bilateral pedal pulses are noted. Fluids: Mucous membranes are slightly dry and pink. Skin turgor is slightly decreased. Capillary refill is 3 seconds. Noted periorbital edema and nonpitting edema of feet. Anterior fontanel is soft and slightly depressed. Diaper remains dry. Abdomen: Soft, full, round, bowel sounds are present and active. Blood pressure in right upper extremity 60/39 mm Hg, Oxygen saturation 90%
Question 3 of 5
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: C
Rationale: Action to Take: Provide chest physiotherapy and postural drainage; Potential Condition: Cystic fibrosis; Parameter to Monitor: Number of steatorrhea stools, Intake and output.
Rationale:
1. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system, leading to thick mucus production. Chest physiotherapy and postural drainage help clear mucus from the lungs.
2. Monitoring the number of steatorrhea stools is important as it indicates malabsorption in cystic fibrosis. Intake and output monitoring helps assess hydration status and nutritional intake.
3. Pyloric stenosis, congestive heart failure, and respiratory syncytial virus bronchiolitis are not conditions typically associated with chest physiotherapy and postural drainage.
4. Anticipating a prescription for digoxin and implementing contact precautions are not relevant actions for addressing cystic fibrosis.
5. Monitoring for periorbital edema is
Extract:
Question 4 of 5
A nurse is obtaining informed consent for an adolescent who is scheduled for a cardiac catheterization. The adolescent's guardian states, 'I don't understand why they need to do this procedure.' Which of the following actions should the nurse take?
Correct Answer: D
Rationale:
Correct Answer: D - Notify the provider who is scheduled to perform the procedure.
Rationale:
1. The provider performing the procedure is best suited to explain the necessity and details of the cardiac catheterization to address the guardian's concerns.
2. The provider can offer additional information, clarify any doubts, and ensure that the guardian makes an informed decision.
3. Involving the provider maintains a patient-centered approach and ensures comprehensive understanding before proceeding with the procedure.
Summary of Other
Choices:
A: Requesting assistance from the anesthesiologist may not directly address the guardian's concerns about the procedure.
B: Explaining the procedure is essential, but the provider performing the procedure is the most appropriate person to provide detailed information.
C: Witnessing the adolescent's signature is important but does not address the guardian's lack of understanding.
Extract:
Nurses Notes: 0915: Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more and witnessed them gagging periodically. 0930: Child is lying on parent's chest with eyes open and requesting ‘sippy cup.' Continues to have expiratory wheezing in bilateral upper lobes. Preparing child for diagnostic testing. Vital Signs: Blood pressure 88/45 mm Hg, Heart rate 90/min, Respiratory rate 30/min, Axillary temperature 36.9°C (98.4 F), Oxygen saturation 96%. 0930: Blood pressure 86/46 mmHg, Heart rate 88/min, Respiratory rate 28/min, Axillary temperature 36.9 C(98.4 F), Oxygen saturation 95%. Assessment: 0915: Child awake and sobbing, asking for ‘sippy cup' with excessive drooling and occasionally gagging. Breath sounds with small expiratory wheezing noted in bilateral upper lobes, respirations slightly elevated as child continues to cry and sob. Oxygen saturation 96% on room air. Penlight used to inspect the throat with no visual signs of foreign object in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation. Abdomen soft and non-tender with active bowel sounds in all four quadrants. Skin warm, pink, and smooth. Yellow urine noted in child's diaper. Provider notified of assessment findings. Laboratory Results: 0930: x-ray of the neck, chest, and abdomen completed plane radiographic study identifies object in esophagus, No foreign objects visualized in the chest or abdomen
Question 5 of 5
Complete the following sentence by using the list of options. The nurse should first ___ followed by ___.
Correct Answer: A, E
Rationale: First, the nurse should keep the child NPO (nothing by mouth) to prevent aspiration during the endoscopy (E). This is crucial for safety. Next, preparing the child for flexible endoscopy (E) is important to ensure the procedure is conducted smoothly.
Choices B, C, D, F are incorrect as they are not directly related to the immediate safety and preparation required for the endoscopy.