ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 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: The correct answer is D, using a tumbling E chart for the assessment. This type of chart is commonly used for young children due to its simplicity - the child is asked to identify the direction the "E" is facing. This helps assess visual acuity accurately in children who may not yet know letters. Assessing both eyes together first (choice
A) may lead to inaccuracies. Positioning the child 4.6 meters away (choice
B) is too far for a child's assessment. Testing without glasses first (choice
C) may not provide an accurate baseline. Overall, using a tumbling E chart is the most appropriate method for assessing visual acuity in a 4-year-old child.
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 2 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.
Extract:
Question 3 of 5
A nurse is providing teaching to the guardian of an 11-month-old infant who has acute diarrhea. Which of the following food items should the nurse instruct the parent to provide to the infant?
Correct Answer: A
Rationale: The correct answer is A: Oral electrolyte solution. This is because infants with acute diarrhea are at risk of dehydration due to fluid loss. Oral electrolyte solution helps replace lost fluids and electrolytes, preventing dehydration. Applesauce, white grape juice, and chicken soup are not recommended for infants with acute diarrhea as they can worsen diarrhea symptoms or lack the necessary electrolytes to rehydrate the infant. It is crucial to prioritize rehydration with oral electrolyte solution in managing acute diarrhea in infants.
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.
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: 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.