ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
Question 1 of 5
A nurse is providing teaching about home safety to the adult child of an older adult client who is postoperative following knee replacement surgery. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: The correct answer is D: Ensure that area rugs have rubber backs. This instruction is important to prevent slips and falls, as rubber-backed rugs provide better traction on smooth surfaces, reducing the risk of accidents. Placing throw rugs over electrical cords (
B) can cause tripping hazards. Marking the edges of the doorway with tape (
C) may not be effective and can be unsightly. Encouraging the client to avoid wearing shoes at home (
A) may not directly impact safety. Overall, ensuring area rugs have rubber backs (
D) is the most practical and effective approach to enhancing home safety for a postoperative older adult.
Question 2 of 5
A nurse in a clinic is planning care for a child who has ADHD and is taking atomoxetine. Which of the following laboratory values should the nurse monitor?
Correct Answer: A
Rationale: The correct answer is A: Liver function tests. Atomoxetine, used for ADHD, can potentially cause liver toxicity. Monitoring liver function tests helps detect any signs of liver damage early on.
Choice B, kidney function tests, is not as relevant as atomoxetine primarily affects the liver.
Choice C, hemoglobin and hematocrit, is not directly impacted by atomoxetine.
Choice D, serum sodium and potassium, is not typically affected by atomoxetine use.
Extract:
History and Physical
6-year-old child
Vomited 3 times in the past 24 hr
Irritable behavior for the past 24 hr
Respiratory infection started 3 days ago
Brudzinski's and Kernig's signs positive
Question 3 of 5
A nurse is planning care for a child during admission to the facility. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Initiate seizure precautions. This should be the first action as it prioritizes the safety of the child. Seizure precautions involve ensuring a safe environment, such as removing any potential hazards and providing padding to prevent injury during a seizure. Collecting blood cultures (
B) and obtaining a prescription for pain medication (
A) can be important but are not as urgent as ensuring the child's safety in case of a seizure. Transporting the child for a CT scan (
C) is not an immediate priority unless there is a critical need.
Extract:
Question 4 of 5
A nurse is planning care for a school-age child who is 4 hr postoperative following appendicitis. Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Administer analgesics on a scheduled basis for the first 24 hr. This is essential postoperatively to manage pain effectively and improve the child's comfort level. Pain management is crucial in the early stages following surgery to prevent complications and aid in the child's recovery. Applying a warm compress (choice
A) may not be appropriate for the surgical site and could potentially cause harm. Giving cromolyn nebulized solution (choice
C) is not indicated for pain management postoperatively. Offering clear liquids (choice
D) too soon after surgery could increase the risk of complications such as nausea, vomiting, or aspiration.
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 5 of 5
The nurse is continuing to care for the child. Complete the following sentence by using the list of options. The child is at highest risk of developing------ as evidenced bt the child's------
Correct Answer: C,F
Rationale: The correct answer is C, Compartment syndrome, and F, Paresthesia. Compartment syndrome results from increased pressure within a closed anatomical space, leading to compromised blood flow and nerve function. Paresthesia, abnormal sensations like tingling or numbness, is an early sign of nerve compression in compartment syndrome. The combination of these symptoms indicates a critical condition requiring immediate intervention to prevent tissue damage.
Choices A, B, D, and E do not align with the clinical presentation of compartment syndrome, whereas choice G, weak pulses, may be seen in severe cases but are not specific enough to be the highest risk factor in this scenario.