ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
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 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,E
Rationale: A. Meperidine is a narcotic analgesic used for pain relief and is not typically indicated for the management of cystic fibrosis. B. Dornase alfa is a medication commonly used in the management of cystic fibrosis to help improve respiratory function by reducing the viscosity of mucus in the airways. C. While acetaminophen may be used for managing fever or pain in children with cystic fibrosis, it is not specifically indicated as a standard medication for cystic fibrosis management. D. Children with cystic fibrosis often have deficiencies in fat-soluble vitamins (A, D, E, and K) due to malabsorption. Fat-soluble forms of these vitamins are typically prescribed to address these deficiencies. E. Pancreatic enzyme replacement therapy, such as pancreatic lipase, is necessary for children with cystic fibrosis who have pancreatic insufficiency. This medication helps improve digestion and absorption of nutrients by replacing the deficient pancreatic enzymes.
Extract:
Question 2 of 5
A nurse is teaching a group of parents about childhood immunizations. The nurse should identify that infants should receive the first dose of which of the following immunizations at 12 months of age?
Correct Answer: B
Rationale: A. The first dose of inactivated poliovirus vaccine is typically administered at 2 months of age, not at 12 months. B. The first dose of varicella (chickenpox) vaccine is recommended at 12 months of age. C. Human papillomavirus vaccine is typically administered starting at age 9-11 years, not at 12 months. D. The first dose of hepatitis B vaccine is typically administered at birth, not at 12 months.
Question 3 of 5
A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include?
Correct Answer: D
Rationale: A. Providing a warm blanket can help alleviate discomfort associated with fever and chills, which are common symptoms of varicella, but it is not the priority intervention. B. Koplik spots are seen in measles, not varicella. C. Aspirin administration is contraindicated in varicella due to the risk of Reye's syndrome. Acetaminophen or ibuprofen may be used for fever. D. Varicella is spread through respiratory droplets and direct contact, so airborne precautions are necessary to prevent transmission.
Question 4 of 5
A nurse is providing instructions about a 24-hr urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Correct Answer: A
Rationale: A. Discarding the first voided specimen is necessary to ensure accuracy in a 24-hour urine collection. This helps eliminate any urine that has been in the bladder prior to the start of the collection period. B. Voiding every hour is not necessary for a 24-hour urine collection. The goal is to collect all urine produced over a 24-hour period, not voiding at set intervals. C. Cleansing the perineum with a povidone-iodine solution prior to voiding is not typically necessary for a 24-hour urine collection unless specifically instructed by the healthcare provider. D. Saving the final specimen in a separate container is not necessary for a 24-hour urine collection. All urine produced during the specified collection period should be saved in the same container.
Question 5 of 5
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a nonpharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
Correct Answer: C
Rationale: A. Visual analog scales may not be appropriate for toddlers who are cognitively impaired and unable to understand abstract concepts. B. FACES pain scale relies on the child's ability to express emotions through facial expressions, which may be limited in cognitively impaired toddlers. C. FLACC (Face, Legs, Activity, Cry, Consolability) pain scale is a validated tool for assessing pain in young children, including those who are cognitively impaired. D. CRIES pain scale is typically used for neonates and infants up to 6 months of age and may not be suitable for toddlers.