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: A. This statement demonstrates an understanding of the increased risk of tuberculosis in individuals with HIV and the importance of regular screening. Tuberculosis is a common opportunistic infection in individuals with HIV, and regular testing is essential for early detection and treatment. B. While starting antiretroviral therapy such as zidovudine is important for managing HIV, it does not immediately decrease the risk of transmission. It takes time for viral load suppression to occur and for the risk of transmission to decrease significantly. C. Doubling medications without healthcare provider guidance could lead to incorrect dosing and potential harm. HIV medications should be taken exactly as prescribed by the healthcare provider. D. Childhood immunizations are essential for preventing other infectious diseases but may need to be adjusted based on the child's immune status and specific recommendations from the healthcare provider. The statement does not address the immediate concern of managing HIV.
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.
Correct Answer: C
Rationale: Condition: C. Congestive heart failure - The infant's symptoms of poor weight gain, tachypnea, decreased appetite, and periorbital edema are indicative of congestive heart failure. Actions: A. Anticipate a prescription for digoxin - Digoxin is commonly prescribed to manage congestive heart failure in infants by improving cardiac contractility and reducing heart rate. B. Elevate the head of the bed to a 45° angle - This helps reduce venous return to the heart, decreasing preload and relieving symptoms of congestion. Parameters: B. Intake and output - Monitoring fluid balance is crucial in congestive heart failure to assess for volume overload. D. Presence of periorbital edema - Persistent edema indicates ongoing fluid retention, a key sign to monitor treatment effectiveness.
Extract:
Question 3 of 5
A nurse is providing teaching to the guardian of a 2-year-old child about typical toddler behavior. Which of the following behaviors should the nurse include?
Correct Answer: B
Rationale: A.
Toddlers thrive on routines and consistency, which provide them with security and predictability. B.
Toddlers are in a stage of development where they assert their independence and autonomy by saying 'no' or 'mine' to almost everything. This is a normal and healthy behavior that reflects their growing sense of self and identity. The nurse should explain to the guardian that this behavior is not meant to be defiant or disrespectful, but rather a way of exploring their environment and expressing their preferences. C.
Toddlers are typically emotionally labile, meaning they can experience rapid changes in mood and emotions. D.
Toddlers may display increased independence rather than increased dependency as they strive to assert their autonomy.
Question 4 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: A. No head lag when pulled to a sitting position is a normal finding at 4 months of age and does not require notification of the provider. B. The Doll's eye reflex (also known as oculocephalic reflex) should be absent by 4 months of age. Its persistence could indicate neurological abnormalities and warrants further evaluation by the provider. C. Presence of tears when crying is a normal physiological response and does not require notification of the provider. D. Positive Babinski reflex is normal in infants under 2 years old and typically disappears by 12 to 24 months of age. It does not require immediate notification of the provider.
Question 5 of 5
A nurse is assessing a preschool-age child who is in the immediate postoperative period following a tonsillectomy. Which of the following assessment findings is the priority?
Correct Answer: D
Rationale: A. Increasing throat pain is expected post-tonsillectomy and can be managed with pain medication. While important to address, it is not the priority in this situation. B. Refusing clear liquids might indicate discomfort or difficulty swallowing, but it is not as immediately concerning as other symptoms. C. Crying often may be due to discomfort or fear but is not as indicative of potential complications as frequent swallowing. D. Frequent swallowing could indicate bleeding, a potential complication post-tonsillectomy, and requires immediate attention to prevent further complications.