ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is preparing to perform a venipuncture on a 4-year-old child. Which of the following actions should the nurse take to ensure atraumatic care?
Correct Answer: C
Rationale: The correct answer is C: Apply a topical anesthetic cream 1 hr prior to the procedure. This action is essential for atraumatic care as it helps to numb the area where the venipuncture will be performed, reducing the child's discomfort and anxiety during the procedure. Applying the cream an hour before the procedure allows adequate time for the anesthetic effect to take place.
Other choices are incorrect because:
A: Asking the child's parent to leave the room may increase the child's anxiety and make the procedure more traumatic.
B: Performing the procedure in the playroom may not provide a sterile environment necessary for venipuncture.
D: Explaining the procedure in detail to the child 3 hours prior may cause unnecessary anxiety and fear, as children may not fully understand the details or remember them after such a long period.
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 2 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 3 of 5
A nurse is preparing to administer an IM injection to a 3-year-old child. Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct answer is D: "You can choose which leg you get your medicine in." This statement empowers the child by giving them a sense of control over the situation, which can help alleviate anxiety and fear associated with the injection. By allowing the child to choose the leg, it helps build trust and cooperation.
A: Offering a prize for not crying may encourage the child to suppress their emotions rather than addressing them.
B: This statement provides false reassurance and does not prepare the child for the sensation of the injection.
C: While minimizing the sensation is important, this statement does not address the child's autonomy or control.
In summary, choice D is correct as it promotes autonomy and reduces anxiety, while the other choices do not address the child's emotional needs or provide a sense of control.
Question 4 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: The correct answer is C: a toddler who has seasonal influenza. Droplet precautions are used for illnesses transmitted through respiratory secretions, such as influenza. Seasonal influenza is a contagious respiratory illness spread through droplets when an infected person coughs or sneezes. This precaution includes wearing a mask within close proximity to the child to prevent the spread of the virus.
Incorrect choices:
A: Pediculosis capitis (head lice) is spread through direct head-to-head contact, not respiratory secretions.
B: Viral conjunctivitis is an eye infection spread through direct contact with discharge from the eye, not respiratory droplets.
D: Hepatitis A is primarily spread through the fecal-oral route, not respiratory secretions.
Question 5 of 5
A nurse is caring for a 1-week-old newborn who has hyperbilirubinemia and is being treated with phototherapy. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Monitor the newborn's temperature every 2 hr. Hyperbilirubinemia can lead to increased risk of hypothermia during phototherapy. Monitoring temperature every 2 hours is crucial to detect any signs of hypothermia early and prevent complications. Checking the newborn's eyes every 8 hours (
A) is not directly related to managing hyperbilirubinemia or phototherapy. Placing mittens on the newborn's hands (
B) is not necessary for this situation. Applying lotion to the newborn's skin (
D) is not indicated and can interfere with phototherapy.