ATI RN
ATI RN Pediatrics 2023 Questions
Extract:
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
Question 1 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
Rationale:
Correct Answer: B,D. -Water-soluble vitamins: Children with cystic fibrosis often have deficiencies in fat-soluble vitamins (A, D, E, and K) due to malabsorption related to pancreatic insufficiency. Supplementing with water-soluble vitamins is not typically indicated as they are not affected by pancreatic insufficiency. -Dornase alfa: Dornase alfa is a recombinant human deoxyribonuclease enzyme that helps to thin and break down the thick, tenacious mucus in the airways of patients with cystic fibrosis. It is commonly prescribed to improve respiratory symptoms such as wheezing, rhonchi, and dyspnea. -Acetaminophen: Acetaminophen may be prescribed for pain or fever relief, but it is not specific to cystic fibrosis management. However, it may be used to alleviate symptoms such as headache or discomfort associated with cystic fibrosis exacerbations. -Pancreatic Apase: Pancreatic enzymes (e.g., pancreatic lipase, protease, and amylase) are essential for digestion and absorption of nutrients in individuals with cystic fibrosis-associated pancreatic insufficiency. Pancreatic enzyme replacement therapy (PERT) with pancreatic Apase supplements is crucial for improving nutrient absorption and preventing malnutrition. -Meperidine is an opioid analgesic that is not typically used in the management of cystic fibrosis. While pain management may be necessary for some patients with cystic fibrosis, opioids are generally not recommended due to concerns about respiratory depression and addiction potential.
Extract:
Medication Administration Record - Diphenhydramine 10 mg PO 4 times per day - Pimecrolimus 1% cream apply to skin lesions daily
Question 2 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,C,D,F,G
Rationale:
Correct Answer: A,B,C,D,F,G. A. Correct. Using a mild detergent helps to minimize irritation and sensitivity, especially for children with skin conditions like eczema, which may benefit from pimecrolimus cream. B. Correct. Applying gloves can prevent scratching and further irritation to the skin, especially if the child has lesions or eczema on their hands. C. Correct. Keeping the child's fingernails short and filed can prevent accidental scratching and trauma to the skin, reducing the risk of exacerbating skin lesions. D. Correct. Emollients help to moisturize the skin and prevent dryness, which can be beneficial for children with skin conditions like eczema. Applying emollients after bathing helps to lock in moisture. E. Incorrect. Pimecrolimus cream should be applied in a thin layer to the affected skin areas, as directed by the healthcare provider. Using a thick layer may not improve efficacy and could increase the risk of side effects. F. Correct. It’s important for the guardian to understand that certain skin conditions, such as eczema, may not be contagious themselves but can become infected if lesions are present and scratched, leading to bacterial or viral infections. G. Correct. Skin conditions like eczema often have a chronic and relapsing course, with periods of exacerbation (flare-ups) and remission.
Extract:
Child recently admitted for suspected rheumatic fever
Question 3 of 5
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should identify that which of the following laboratory tests can contribute to confirming this diagnosis? Select all that apply.
Correct Answer: C,D,E
Rationale: C. CRP indicates inflammation, elevated in rheumatic fever. D. ASO titer shows prior streptococcal infection, key to diagnosis. E. ESR, another inflammation marker, supports diagnosis. A. BUN assesses kidney function, not specific. B. PTT evaluates clotting, unrelated.
Extract:
Child receiving peritoneal dialysis with minimal dialysate outflow
Question 4 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: Changing position may reposition the catheter, improving outflow. A. Fluid intake doesn't fix outflow. B. Longer dwell doesn't address obstruction. D. Bruit isn't relevant here.
Extract:
Question 5 of 5
A nurse is caring for a child who has had a lumbar puncture. The nurse should monitor the child for which of the following complications?
Correct Answer: D
Rationale:
Correct Answer: D. Headache is a common complication post-lumbar puncture due to CSF leak, worsening when upright. A. Double vision isn’t typical. B. Nuchal rigidity suggests meningitis, not a direct complication. C. Pain at the iliac crest isn’t related to the procedure site.