ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Question 1 of 5
A nurse is providing teaching to a parent of a child who has HIV. Which of the following statements by the parent indicates an understanding of the teaching?
Correct Answer: A
Rationale:
Correct Answer: A. "I will ensure that my child is tested for tuberculosis every year."
Rationale: This statement shows understanding as children with HIV are at increased risk for tuberculosis. Regular testing is essential for early detection and treatment, preventing complications.
Summary of other choices:
B. Incorrect. Risk of transmission doesn't decrease after 2 weeks; consistent adherence to medication is crucial.
C. Incorrect. Doubling medications without healthcare provider's guidance can be harmful.
D. Incorrect. Immunizations are vital for children with HIV and should not be repeated in remission.
Question 2 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 3 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:
History and Physical: School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K. Barrel-shaped chest, Clubbing of the fingers bilaterally, Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough. Vital Signs: Temperature 38.4 C (101.1 F), Heart rate 100/min, Respiratory rate 40/min, Blood pressure 100/57mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa, Stool analysis positive for presence of fat and enzymes, Chest X-ray indicates obstructive emphysema, WBC count 20,000/mm3 (5,000 to 10,000/mm3)
Question 4 of 5
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.
Correct Answer: B,D,E
Rationale: The correct answers are B, D, and E. Dornase alfa is used for cystic fibrosis, water-soluble vitamins are essential for growth and development in children, and pancreatic lipase aids in digestion. Meperidine is not commonly prescribed for children due to its side effects. Acetaminophen is a common medication but should not be assumed without provider confirmation. The remaining choices are not typically prescribed or reconciled in a child's medication list.
Extract:
Question 5 of 5
A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Apply pressure just above the insertion site. This action is crucial to control the bleeding and prevent further complications. Applying pressure directly over the site helps to stop the bleeding and stabilize the child's condition. Monitoring the pulse distal to the insertion site (
B) is important but secondary to stopping the bleeding. Obtaining vital signs (
C) can wait until the bleeding is controlled. Reinforcing the dressing (
D) is not the priority as the dressing is already saturated with blood.