ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Extract:
A nurse is caring for a school-age child who has cystic fibrosis. 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 (normal range: 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?
Correct Answer: B,D,E
Rationale: The correct answer is B, D, and E. Dornase alfa is a medication used for cystic fibrosis, often prescribed for children with this condition. Water-soluble vitamins are commonly given to children to meet their nutritional needs. Pancreatic lipase is used to aid digestion in children with pancreatic insufficiency. Meperidine is not typically prescribed for children due to its potential for toxicity and adverse effects. Acetaminophen is a common over-the-counter medication but may not necessarily be part of the child's prescription regimen.
Therefore, A and C are less likely to be prescribed or reconciled from the child's medication list compared to B, D, and E.
Extract:
Question 2 of 5
A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: The correct answer is C: Apply pressure just above the insertion site. This is the first action the nurse should take as it helps to control the bleeding and prevent further blood loss. By applying pressure, the nurse can help stop the bleeding and stabilize the child's condition. Reinforcing the dressing (
Choice
A) may not address the immediate issue of active bleeding. Monitoring the pulse distal to the insertion site (
Choice
B) is important but should come after controlling the bleeding. Obtaining vital signs (
Choice
D) is also important but not the priority when dealing with active bleeding.
Extract:
A nurse in the emergency department is caring for a toddler. Nurse's Notes: 0915: Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent heard the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual and witnessed them gagging periodically. 0930: Child is lying on parent's chest with eyes open and requesting €˜sippy cup.' Continues to have wheezing in bilateral upper lobes. Preparing child for diagnostic testing. Vital Signs: 0915: Blood Pressure: 88/45 mm Hg. Heart Rate: 90/min. Respiratory Rate: 30/min. Axillary Temperature: 36.9°C (98.4°F). Oxygen Saturation: 96%. 0930: Blood Pressure: 85/46 mm Hg. Heart Rate: 88/min. Respiratory Rate: 28/min. Axillary Temperature: 36.9°C (98.4°F). Oxygen Saturation: 95%. Assessment: 0915: Child awake and sobbing, asking parent for €˜sippy cup' with excessive drooling and occasionally gagging. Breath sounds with small expiratory wheezing noted in bilateral upper lobes. Respirations slightly elevated as child continues to cry and sob. Oxygen saturation 96% on room air. Penlight used to inspect throat with no visual signs of foreign object. No visual objects in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation. Abdomen soft and nontender with active bowel sounds in all four quadrants. Skin warm, pink, and smooth. Yellow urine noted in child's diaper. Provider notified of assessment findings. Laboratory Results: 0930: X-ray of the neck, chest, and abdomen completed. Barium radiography study identifies object in the esophagus. No foreign objects visualized in the chest or abdomen.
Question 3 of 5
Complete the following sentence using the list of options: 'The nurse should first select _____, followed by _____.'
Correct Answer: C,E
Rationale: The correct answer is C and E. First, keeping the child NPO is important to prevent complications during the flexible endoscopy procedure (E). This ensures the child's stomach is empty and reduces the risk of aspiration. Second, preparing the child for the procedure (E) is essential for their comfort and cooperation. Obtaining informed consent (
A) may be necessary but is not the first step in this scenario. Teaching parents about inspecting play areas (
B) and toys for safety, and monitoring the child's gag reflex (F) are important, but not the immediate priorities before a flexible endoscopy.
Extract:
A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI). Nurses' Notes: 0700: 7-year old client who weighs 18.1kg (39.9lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor. Vital Signs: 0715: Temperature: 38 °C (100.4° F). Heart rate: 80/min. Respiratory rate: 22/min. Blood pressure: 106/65 mm Hg. 0930: Temperature: 38.4°C (101.1° F). Heart rate: 90/min. Respiratory rate: 23/min. Blood pressure: 105/65 mm Hg. Provider Prescriptions: sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO. salicylic acid 20mg/kg/dose every 4hr as needed for pain and fever.
Question 4 of 5
The nurse is planning care for the client. For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Potential Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Administer sulfamethoxazole and trimethoprim | ||
| Administer salicylic acid for pain and fever | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluids. | ||
| Advise the child's guardian about the use of cotton underwear. |
Correct Answer: A,B,E
Rationale: [1, 0, 1]
The correct answer is A, B, and E.
- A: Educating the child about proper perineal hygiene is anticipated to prevent infections.
- B: Administering sulfamethoxazole and trimethoprim is anticipated for treating infections.
- E: Advising the child's guardian about the use of cotton underwear can help maintain proper hygiene.
C: Administering salicylic acid for pain and fever is contraindicated as it is not suitable for treating infections.
D: Ensuring the child receives a maximum of 1,200 mL/day of fluids is not relevant to preventing infections.
Extract:
Question 5 of 5
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Weigh the child once per day. In the acute stage of nephrotic syndrome, daily weight monitoring is crucial to assess fluid status and renal function. It helps in evaluating response to treatment and detecting complications like fluid overload or dehydration promptly. Limiting calorie intake (
B) is not appropriate as children with nephrotic syndrome often need increased calories due to protein loss. Increasing fluid intake (
C) to 2 L/day may exacerbate edema, a common symptom of nephrotic syndrome. Positioning the child supine at bedtime (
D) is not relevant to managing nephrotic syndrome.