ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
Question 1 of 5
A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Assign the child to a negative air pressure room. Varicella, commonly known as chickenpox, is highly contagious and spreads through respiratory droplets. Placing the child in a negative air pressure room helps prevent the spread of the virus to others by containing the infectious particles within the room. This isolation measure is crucial in protecting both the child and other patients.
Choice B is incorrect because aspirin should not be administered to children with varicella due to the risk of Reye's syndrome.
Choice C is incorrect as droplet precautions are not necessary for varicella, which primarily spreads through airborne respiratory droplets.
Choice D is incorrect as Koplik spots are associated with measles, not varicella.
Question 2 of 5
A nurse is providing teaching about the administration of gastrostomy tube feedings to the parents of a school-age child. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: The correct answer is A: Administer the feeding over 30 min. This instruction is important to prevent complications such as aspiration and dumping syndrome. Administering the feeding slowly over 30 minutes allows for proper digestion and absorption.
Choice B is incorrect because feeding bags and tubing should be changed every 24 hours to prevent bacterial growth.
Choice C is incorrect because the child should be placed in an upright position, not supine, after the feeding to reduce the risk of aspiration.
Choice D is incorrect because warming formula in the microwave can create hot spots and lead to burns.
Question 3 of 5
A nurse is caring for a school-age child who has sickle cell anemia and is in vaso-occlusive crisis. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Increase oral fluid intake. During a vaso-occlusive crisis in sickle cell anemia, there is a blockage of blood flow leading to tissue ischemia and pain. Increasing oral fluid intake helps to hydrate the child and improve blood flow, potentially reducing the severity of the crisis. Cold compresses (
A) can worsen vasoconstriction, platelet transfusion (
B) is not indicated for vaso-occlusive crisis, and active range of motion exercises (
C) can exacerbate pain and further compromise blood flow. Increasing fluid intake is the most appropriate intervention to help manage the crisis.
Question 4 of 5
A nurse is teaching a group of parents about childhood immunization. The nurse should identify that infants should receive the first dose of which of the following immunizations at 12 months of age?
Correct Answer: D
Rationale: The correct answer is D: Varicella. Infants should receive the first dose of varicella vaccine at 12 months of age to prevent chickenpox. Varicella is highly contagious and can lead to serious complications in children. The other choices are incorrect because:
A: Inactivated poliovirus - The first dose of polio vaccine is typically given at 2 months of age.
B: Human papillomavirus - HPV vaccine is usually recommended for adolescents, not infants.
C: Hepatitis B - Hepatitis B vaccine is usually given shortly after birth, not at 12 months of age.
In summary, varicella is the appropriate immunization for infants at 12 months to protect them from chickenpox, while the other options are administered at different ages or for different diseases.
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 5 of 5
The nurse is continuing to care for the child. The nurse should anticipate a prescription for pain medication.
Correct Answer: B,D
Rationale: The correct answers are B and D. A surgical consultation (
B) may be needed to address the underlying cause of the child's pain. Pain medication (
D) is essential to provide comfort and manage the child's pain. Skin traction (
A) and limb immobilization (E) are interventions for orthopedic issues, not for immediate pain relief. Antibiotics (
C) are not indicated unless there is an infection. Bed rest (F) is not a proactive measure for pain management.