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: 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:
History and Physical: A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10. Vital signs: Temperature 37.8 C (100 F), Heart rate 100/min, Blood pressure 110/72 mm Hg, Respiratory rate 20/min, Oxygen saturation 95% on room air. Assessment: Awake, alert, and oriented X 3, Yellow sclera of eyes noted bilaterally, Right upper quadrant tender to palpation, Hands painful to touch and swollen bilaterally, Right knee is swollen, warm to palpation, and client reports pain as 8 on a scale of 0-10, Client is tearful and grimacing during the examination. Laboratory Results: Hct 28% (32% to 44%), Hgb 6g/dL (10 to 15.5 g/dL), WBC count 20,000/mm3 (6,200 to 17,000/mm3), ALT 50 units/L (4 to 36 units/L), AST 62 units/L (10 to 40 units/L), Total bilirubin 3.0 mg/dL (0.3 to 1.0 mg/dL), Chest radiographic examination indicates cardiomegaly and systolic murmur
Question 2 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: A,C,D,E,G
Rationale: The correct interventions are A, C, D, E, and G. A: Monitoring oxygen saturation is crucial for assessing respiratory status. C: Giving oral hydroxyurea is essential for managing sickle cell disease. D: Administering meperidine IV for pain control is appropriate. E: Ensuring the pneumococcal vaccine is current helps prevent infections. G: Administering folic acid is part of managing sickle cell disease. Summary: B is incorrect as restricting oral intake may worsen dehydration. F is incorrect as strict bed rest is not recommended for adolescents.
Extract:
Question 3 of 5
A nurse is assessing a school-age child who is receiving morphine. For which of the following adverse effects should the nurse monitor?
Correct Answer: D
Rationale: The correct answer is D: Bradypnea. Morphine is an opioid that can cause respiratory depression, leading to bradypnea (slow breathing). Monitoring the child's respiratory rate is crucial to detect any signs of respiratory distress. Stevens-Johnson syndrome (
A) is a severe skin reaction, not typically associated with morphine. Hypertension (
B) is not a common adverse effect of morphine; in fact, it can cause hypotension. Prolonged wound healing (
C) is not a known adverse effect of morphine. Monitoring for bradypnea will ensure timely intervention if the child experiences respiratory depression.
Question 4 of 5
A nurse is planning care for a child who has a prescription to transfuse 2 units of packed RBCs. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Infuse each unit of blood within 4 hr. This is important because packed RBCs should be infused in a timely manner to prevent bacterial growth and ensure the effectiveness of the transfusion. Infusing each unit within 4 hours helps maintain the integrity of the blood product and reduces the risk of complications such as bacterial contamination.
Choice B is incorrect because infusing dextrose 5% in water during the transfusion of packed RBCs is unnecessary and may dilute the blood product, affecting its efficacy.
Choice C is incorrect as storing the second unit of blood at room temperature for up to 2 hours is not recommended. Blood products should be stored according to specific guidelines to maintain their integrity and prevent contamination.
Choice D is incorrect as administering RBCs using non-filtered IV tubing can increase the risk of particulate contamination and adverse reactions in the recipient.
Therefore, the correct intervention is to infuse each unit of blood within
Question 5 of 5
A nurse is planning care for a preschooler who has neutropenia. Which of the following interventions should the nurse include in the plan?
Correct Answer: B
Rationale: The correct answer is B: Avoid raw fruits and vegetables in the child's diet. Neutropenia is a condition characterized by low neutrophil count, leading to increased susceptibility to infections. Raw fruits and vegetables may harbor bacteria that can cause infections in immunocompromised individuals.
Therefore, avoiding raw produce helps reduce the risk of infection. Administering vaccines prior to discharge (
Choice
A) may be important for other conditions, but in neutropenia, live vaccines are contraindicated. Bathing the child every other day (
Choice
C) and obtaining rectal temperature daily (
Choice
D) are not specific to managing neutropenia.