ATI RN
ATI RN Pediatrics 2023 Questions
Extract:
Child receiving peritoneal dialysis with minimal dialysate outflow
Question 1 of 5
A nurse is providing peritoneal dialysis to a child and observes there is minimal dialysate outflow at the end of the outflow time. Which of the following actions should the nurse take?
Correct Answer: C
Rationale:
Correct
Answer: C. Instruct the child to change position.
Rationale: Changing the child's position can help redistribute the dialysate within the peritoneal cavity, promoting better outflow. This can help overcome any potential blockages or obstructions that may be impeding the flow of dialysate. Additionally, changing position can help prevent the dialysate from becoming stagnant in one area, improving the effectiveness of peritoneal dialysis.
Incorrect
Choices:
A: Increasing oral fluid intake may help with hydration but will not directly address the issue of minimal dialysate outflow.
B: Increasing the dwell time during the next dialysis infusion may lead to increased absorption of waste products but will not address the current issue of minimal outflow.
D: Assessing for a bruit at the site of the peritoneal catheter is important for monitoring catheter function but will not directly address the current issue of minimal outflow.
Extract:
4-month-old infant
Question 2 of 5
A nurse is preparing to collect a capillary blood specimen from the heel of a 4-month-old infant. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Puncture the outer aspect of the heel. This is the correct action because the outer aspect of the heel has better blood flow and is less painful for the infant. Puncturing the inner aspect can lead to injury of the medial and lateral plantar arteries and nerves. Wiping the site with alcohol after the puncture (choice
A) can introduce contaminants, increasing the risk of infection. Applying a cool pack (choice
C) can vasoconstrict blood vessels, making it harder to collect the specimen. Using a surgical blade (choice
D) is unnecessary and increases the risk of injury.
Extract:
Group of clients on a pediatric unit
Question 3 of 5
A nurse is caring for a group of clients on a pediatric unit. Which of the following clients is most at risk for insufficient vascular perfusion?
Correct Answer: B
Rationale: The correct answer is B: A school-age child who is in a spica cast. A spica cast can cause constriction on blood vessels leading to compromised vascular perfusion. The weight and pressure from the cast can impede blood flow, increasing the risk of insufficient vascular perfusion. In contrast, choices A, C, and D do not directly impact vascular perfusion. A child receiving IV fluids (
A) is actually receiving hydration support, an adolescent with a urinary tract infection (
C) may have systemic issues but not directly related to vascular perfusion, and a preschooler with otitis media (
D) has an ear infection which does not affect vascular perfusion. This makes choice B the most at risk for insufficient vascular perfusion.
Extract:
10-year-old child receiving chemotherapy
Question 4 of 5
A nurse is caring for a 10-year-old child who is receiving chemotherapy. The child's guardian asks about managing adverse effects. Which of the following statements should the nurse make?
Correct Answer: A
Rationale: The correct answer is A: Use a soft-bristled toothbrush when platelet levels are low. This is important because chemotherapy can lower platelet levels, increasing the risk of bleeding. Using a soft-bristled toothbrush reduces the risk of gum bleeding or injury.
Choice B is incorrect because encouraging favorite foods may not always be suitable during chemotherapy, as some foods may exacerbate side effects or interact with medications.
Choice C is incorrect because chlorhexidine mouthwash can be too harsh for a child undergoing chemotherapy and may further irritate the mouth.
Choice D is incorrect because antiemetics should be administered as prescribed by the healthcare provider, not just for a specific time period after chemotherapy.
In summary, the correct answer focuses on a specific precaution related to the child's health condition, while the other choices may not be appropriate or relevant in this context.
Extract:
7-year-old client who weighs 18.1 kg (39.9 lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor. Vital Signs 0715: Temperature 38° C (100.4° F), Heart rate 80/min, Respiratory rate 22/min, Blood pressure 106/65 mm Hg. 0930: Temperature 38.4° C (101.1° F), Heart rate 90/min, Respiratory rate 23/min, Blood pressure 105/65 mm Hg. Provider Prescriptions: Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO, Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
Question 5 of 5
For each the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Advise child's guardian about the use of sunscreen. | ||
| Administer salicylic acid for pain and fever. | ||
| Administer sulfamethoxazole and trimethoprim. | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluid. |
Correct Answer: A: Anticipated, B: Contraindicated, C: Contraindicated, D: Anticipated, E: Contraindicated
Rationale: [1, 0, 0, 1, 0]
For choice A, educating the child about proper perineal hygiene is anticipated as it promotes health.
Choice B, advising about sunscreen, is contraindicated as it may not be relevant to the client's condition.
Choice C, administering salicylic acid, is contraindicated as it can be harmful due to potential side effects.
Choice D, administering sulfamethoxazole and trimethoprim, is anticipated for treating infections.
Choice E, limiting fluid intake, is contraindicated as it can lead to dehydration.