ATI RN
ATI RN Pediatric Nursing 2023 II Questions
Extract:
Question 1 of 5
A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take?
Correct Answer: D
Rationale: Visual acuity should be assessed for each eye separately first, then both eyes together to detect any differences between the eyes. The nurse should position the child 3 meters (10 feet) from the chart. If the child wears glasses, they should be tested with and without their glasses to assess visual acuity accurately. A tumbling E chart, where the child identifies the direction of the E (up, down, left, or right), is commonly used for assessing visual acuity in young children who may not yet know letters.
Question 2 of 5
A nurse on a pediatric unit is caring for four children. The nurse should use droplet precautions for which of the following children?
Correct Answer: C
Rationale: Pediculosis capitis (head lice) does not require droplet precautions. Viral conjunctivitis (pink eye) is typically spread through direct contact or contact with contaminated surfaces, not droplets. Seasonal influenza is a respiratory illness that can spread through droplets when the infected person coughs or sneezes, necessitating droplet precautions. Hepatitis A is primarily spread through the fecal-oral route and does not require droplet precautions.
Question 3 of 5
A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first?
Correct Answer: C
Rationale: While osteomyelitis is a serious condition requiring treatment, receiving an IV bolus of nafcillin is not an urgent procedure compared to a neurological symptom like slurred speech. Pain management is important, but a pain level of 7, while significant, does not indicate an immediate life-threatening situation. Slurred speech in an adolescent with sickle cell anemia could indicate a neurological complication or a stroke, which requires immediate assessment and intervention. Although the toddler with a partial-thickness burn needs care, it is not as urgent as assessing a potential neurological issue.
Question 4 of 5
A nurse is providing instructions about a 24-hr urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Correct Answer: A
Rationale: Discarding the first voided specimen is necessary for a 24-hour urine collection to ensure the collection reflects a full 24-hour period. Voiding every hour is not a specific instruction for a 24-hour urine collection and may not be practical or feasible. Cleansing the perineum with a povidone-iodine solution is not necessary unless specifically instructed by the healthcare provider. Saving the final specimen in a separate container is not required.
Question 5 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: Offering sips of water 4 hours following surgery may be too early and could increase the risk of postoperative complications such as nausea and vomiting. Assisting the adolescent to ambulate 12 hours following surgery may be too early depending on the surgical procedure and the adolescent's condition. Maintaining the head of the bed at a 30° angle is incorrect because this position increases pressure on the spinal cord and can cause complications. Logrolling the adolescent every 2 hours prevents spinal injury and promotes healing by keeping the spine in alignment.