ATI RN
ATI RN Pediatrics Nursing 2023 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 100/57 mm 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 (Dornase alfa), D (Water-soluble vitamins), and E (Pancreatic lipase). Dornase alfa is used in cystic fibrosis, water-soluble vitamins are commonly prescribed for children for overall health, and pancreatic lipase is used in pancreatic insufficiency. Meperidine is not typically prescribed for children due to safety concerns. Acetaminophen is a common over-the-counter medication that may or may not be on the home medication list. The nurse should not expect the provider to prescribe or reconcile meperidine, acetaminophen, or other unspecified medications from the list.
Extract:
Question 2 of 5
A nurse is assessing a school-age child who is receiving prednisolone. For which of the following adverse effects should the nurse monitor?
Correct Answer: A
Rationale: The correct answer is A: Prolonged wound healing. Prednisolone is a corticosteroid that can suppress the immune system, leading to delayed wound healing. The nurse should monitor for this adverse effect by observing the child's wound healing progress.
Choice B, hypotension, is not a common adverse effect of prednisolone.
Choice C, Stevens-Johnson syndrome, is a severe skin reaction typically caused by medications like sulfonamides, not corticosteroids.
Choice D, renal failure, is also not a common adverse effect of prednisolone. Monitoring for prolonged wound healing is crucial to prevent complications and ensure the child's well-being.
Question 3 of 5
A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Initiate contact isolation precautions. Impetigo contagiosa is a highly contagious bacterial skin infection. By initiating contact isolation precautions, the nurse can prevent the spread of the infection to other patients and healthcare workers. This includes wearing gloves, gowns, and masks when in contact with the infected child. Reporting the disease to the state health department (choice
B) is important for surveillance purposes but does not directly address preventing transmission in the hospital setting. Administering amphotericin B IV (choice
C) is inappropriate as it is an antifungal medication and not indicated for impetigo. Applying lidocaine ointment topically (choice
D) is also incorrect as it is a local anesthetic and does not treat the underlying bacterial infection.
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 the client reports pain as 8 on a scale of 0 to 10. Client is tearful and grimacing during the examination. Laboratory Results: Hct 28% (32% to 44%), Hgb 6 g/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).
Question 4 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:
Correct Answer: A,C,D,E,G
Rationale:
A: Monitoring oxygen saturation is crucial in assessing respiratory status, especially in adolescents with potential respiratory issues.
C: Oral hydroxyurea is commonly used in treating certain hematologic conditions in adolescents.
D: Administering meperidine IV for pain management is appropriate for adolescents experiencing severe pain.
E: Ensuring the pneumococcal vaccine is current helps prevent serious infections in adolescents.
G: Administering folic acid as prescribed is essential for adolescents with certain medical conditions.
Summary:
B: Restricting oral intake may not be appropriate unless specified by a healthcare provider.
F: Strict bed rest is not typically recommended for adolescents unless medically necessary.
Extract:
Question 5 of 5
A nurse is caring for a child who is receiving conditioning therapy for enuresis. Which of the following statements by the child's parent indicates the treatment is effective?
Correct Answer: D
Rationale: The correct answer is D because holding urine for about 15 minutes before going to the bathroom is an indication of improved bladder control, which is the goal of conditioning therapy for enuresis. This demonstrates that the child is developing the ability to delay urination, a key aspect of the treatment.
Choice A is incorrect because going to the bathroom immediately when the alarm goes off does not show improved bladder control.
Choice B is incorrect as drinking less may not necessarily indicate treatment effectiveness.
Choice C is incorrect as Kegel exercises are not typically part of conditioning therapy for enuresis.