ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 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: D
Rationale: The correct answer is D: Ensure two nurses logroll the adolescent every 2 hr. This is essential postoperative care for a patient with spinal instrumentation to prevent injury to the surgical site and reduce the risk of complications such as pressure ulcers and venous thromboembolism. Logrolling helps maintain spinal alignment and stability.
A: Offering sips of water 4 hr following surgery is not recommended as the patient may still be recovering from anesthesia and at risk of aspiration.
B: Assisting the adolescent to ambulate 12 hr following surgery may be too soon, as the patient may still be weak and in pain.
C: Maintaining the head of the bed at a 30° angle is a general guideline for postoperative patients but is not specific to spinal surgery.
Therefore, the correct choice is D as it directly addresses the specific needs of a patient following scoliosis repair with spinal instrumentation.
Question 2 of 5
A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Initiate contact isolation precautions. Impetigo contagiosa is a highly contagious skin infection caused by bacteria. Contact isolation precautions are necessary to prevent the spread of the infection to others. Administering amphotericin B IV (choice
A) is used for fungal infections, not bacterial infections like impetigo. Applying lidocaine ointment topically (choice
B) is for pain relief and does not treat the underlying infection. Reporting the disease to the state health department (choice
D) is important for tracking outbreaks but does not directly address immediate patient care.
Question 3 of 5
A nurse is teaching a group of parents about childhood immunizations. The nurse should identify that infants should receive the first dose of which of the following immunizations at 12 months of age?
Correct Answer: B
Rationale: The correct answer is B: Varicella. Varicella vaccine is recommended to be given at 12 months of age to protect against chickenpox. This timing allows for early protection before potential exposure. Inactivated polio virus, human papillomavirus, and hepatitis B vaccines are typically given at different ages based on the recommended immunization schedules. Varicella vaccine at 12 months is crucial to prevent severe complications from chickenpox in infants.
Extract:
History and Physical: 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. Vital Signs: Temperature 38.4 C (101.1 F), Heart rate 100/min, Respiratory rate 40/min, Blood pressure 100/57mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa, Stool analysis positive for presence of fat and enzymes, Chest X-ray indicates obstructive emphysema, WBC count 20,000/mm3 (5,000 to 10,000/mm3)
Question 4 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,E
Rationale: The correct answers are B, D, and E. Dornase alfa is used for cystic fibrosis, water-soluble vitamins are essential for growth and development in children, and pancreatic lipase aids in digestion. Meperidine is not commonly prescribed for children due to its side effects. Acetaminophen is a common medication but should not be assumed without provider confirmation. The remaining choices are not typically prescribed or reconciled in a child's medication list.
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 5 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: [
Rationale: ]
A - Irritability: Both acute laryngotracheobronchitis and pneumonia can cause irritability due to respiratory distress.
B - Cough findings at 0800: Both conditions manifest with cough, often worse in the morning.
C - Stridor: Stridor is a common sign of upper airway obstruction seen in acute laryngotracheobronchitis.
D - Temperature: Fever is a common symptom in both acute laryngotracheobronchitis and pneumonia.
Summary:
- Acute laryngotracheobronchitis and pneumonia can both present with irritability, cough, stridor, and fever.