ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 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: The correct answer is A: Discard the first voided specimen. For a 24-hr urine collection, it is important to start the collection with an empty bladder to ensure accuracy. By discarding the first voided specimen, the nurse can begin the collection period accurately. Voiding every hour (
B) is not necessary for a 24-hr collection and could lead to inaccuracies. Cleansing the perineum with povidone-iodine solution (
C) is not required and may introduce contaminants. Saving the final specimen in a separate container (
D) is unnecessary and can complicate the collection process.
Question 2 of 5
A nurse is assessing a 4-month-old infant during a well-baby visit. For which of the following findings should the nurse notify the provider?
Correct Answer: B
Rationale: The correct answer is B: Doll's eye reflex intact. This reflex, also known as oculocephalic reflex, should not be present in infants beyond 3 months old. It involves the eyes moving in the opposite direction of head movement, which is abnormal in older infants. This finding could indicate a neurological issue and should be reported to the provider for further evaluation.
Choice A is normal as lack of head lag at 4 months indicates appropriate muscle tone.
Choice C is normal as infants should start producing tears when crying around this age.
Choice D is normal in infants under 2 years old as the Babinski reflex is present until this age.
Question 3 of 5
A nurse is assessing a school-age child who is receiving prednisolone. For which of the following adverse effects should the nurse monitor?
Correct Answer: B
Rationale: The correct answer is B: Prolonged wound healing. Prednisolone is a corticosteroid that can suppress the immune system, leading to delayed wound healing. The nurse should monitor for this adverse effect by observing for slow or ineffective healing of any wounds the child may have. Stevens-Johnson syndrome (
A) is a severe skin reaction but is not a common side effect of prednisolone. Hypotension (
C) is not typically associated with prednisolone use. Renal failure (
D) is a potential adverse effect of long-term corticosteroid use but is less common compared to prolonged wound healing.
Extract:
Nurses' Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream apply to skin lesions daily. Assessment: Child is alert and responsive, Respiratory rate even and nonlabored at rate of 24/min. No adventitious sounds auscultated. Heart rate 108/min, Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities.
Question 4 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian? Select all that apply.
Correct Answer: A,B,D,F,G
Rationale:
Correct Answer: A, B, D, F, G
Rationale:
A: Cutting and filing fingernails frequently is important to prevent scratching and worsening of lesions.
B: Using a mild detergent helps prevent skin irritation and flare-ups in children with skin conditions.
D: Informing about occasional flare-ups prepares the guardian for potential worsening of the condition.
F: Applying gloves to the child's hands can prevent scratching and spreading of the lesions.
G: Applying emollients after bathing helps maintain skin hydration and reduce dryness, which is beneficial for the child's skin condition.
Summary:
C: Pimecrolimus cream should not be applied thickly without specific instructions from the healthcare provider.
E: The statement about the condition being contagious is not accurate for most skin conditions and can lead to unnecessary fear and stigma.
Extract:
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.