ATI RN Pediatrics Nursing 2023 I | Nurselytic

Questions 66

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ATI RN Pediatrics Nursing 2023 I Questions

Extract:

Provider Prescriptions: Pancrelipase 8,000 units PO with each meal and snack, Chest physiotherapy three times daily; Diagnostic Results: HbA1c 8.5% (4% to 5.9%), Hgb 13.5 mg/dL (10 to 15.5 g/dL), Hct 39% (32% to 44%), WBC count 9,600/mm3 (5,000 to 10,000/mm3)


Question 1 of 5

A nurse is reviewing the medical record of a school-age child who has cystic fibrosis. Which of the following findings should the nurse report to the provider?

Correct Answer: B

Rationale: The correct answer is B: HbA1c. In cystic fibrosis, monitoring blood glucose levels is crucial due to the potential for developing cystic fibrosis-related diabetes. HbA1c reflects average blood sugar levels over 2-3 months, providing insight into long-term glucose control. Reporting abnormal HbA1c levels can help the provider adjust treatment plans to prevent complications.
Choice A (heart rate) is not directly related to cystic fibrosis.
Choice C (WBC count) is more indicative of infection, which is not the primary concern in cystic fibrosis.
Choice D (oxygen saturation) is important but usually monitored continuously in patients with cystic fibrosis and does not require immediate reporting unless significantly low.

Extract:

History and Physical: 16 year-old female presents with abdominal and pelvic pain lasting 2 days. Past medical history includes right arm fracture at age 7. Reproductive history includes sexual activity with 4 partners over the last 2 months. Oral contraceptives used for the past 12 months. Last menstrual period 7 days ago. Current on all vaccinations; human papillomavirus vaccine deferred. Vaginal examination: Noted cervical mucopurulent discharge; Vital Signs: Temperature 38° C (100.4° F), Heart rate 96/min, Respiratory rate 16/min, Blood pressure 104/68 mm Hg, Oxygen saturation 98% on room air


Question 2 of 5

A nurse is caring for an adolescent. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Action to Take

Condition: Urinary tract infection
Actions: Bedrest in semi-Fowler's
Acetaminophen
Parameters: Vaginal bleeding
Temperature

Potential Condition

Condition: Ectopic pregnancy
Actions: Bedrest in semi-Fowler's
Enema
Parameters: Cullen sign
Temperature

Parameter to Monitor

Condition: Acute Appendicitis
Actions: Sitz baths
Acetaminophen
Parameters: Phrenic nerve irritation
Rebound tenderness

Correct Answer: D

Rationale: Action to Take: Bedrest in semi-Fowler's, Acetaminophen; Potential Condition: Pelvic Inflammatory Disease; Parameter to Monitor: Temperature >38.3°C, Rebound tenderness. The correct answer is D because Pelvic Inflammatory Disease is common in adolescents and requires rest and pain management with Acetaminophen. Monitoring temperature and rebound tenderness are key indicators of the effectiveness of treatment.

Choices A and B are incorrect as they suggest actions and parameters not typically associated with Pelvic Inflammatory Disease.
Choice C is incorrect as it suggests a different condition and unrelated parameters.

Extract:

Vital Signs 1405: Temperature 38° C (100.4° F), Heart rate 96/min, Respiratory rate 18/min, Blood pressure 104/72 mm Hg, Oxygen saturation 98% on room air; Laboratory Results 1430: C-reactive protein 3.2 mg/dL (<1.0 mg/dL), Albumin 3.4 g/dL (3.5 to 5.0 g/dL), Hemoglobin 11 g/dL (10 to 15.5 g/dL), Hematocrit 33% (32% to 44%), RBC count 4.0 x 10°/μL (4.0 to 5.5 x 10/μL), WBC count 13,000/mm3 (5,000 to 10,000/mm3), Platelets 275,000/mm3 (150,000 to 400,000/mm3), Potassium 3.5 mEq/L (3.4 to 4.7 mEq/L), Magnesium 1.4 mEq/L (1.4 to 1.7 mEq/L), Total calcium 9.0 mg/dL (8.8 to 10.8 mg/dL); Stool: Positive for occult blood (negative), Positive for leukocytes 4/high-power field (<2/high-power field), Negative for helicobacter pylori (negative)


Question 3 of 5

A nurse is caring for an adolescent in the emergency department (ED). Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Action to Take

Condition: Celiac disease
Actions: Gluten-free diet
Record intake
Parameters: Abrupt pain decrease
Albumin

Potential Condition

Condition: Appendicitis
Actions: Prepare for surgery
Enema
Parameters: Pain decrease
Rigidity

Parameter to Monitor

Condition: Peptic ulcer disease
Actions: Gluten-free diet
Surgery
Parameters: Pain decrease
Hemoglobin

Correct Answer: D

Rationale: Action to Take: Gluten-free diet, Record intake; Potential Condition: Crohn's disease; Parameter to Monitor: Albumin, Hemoglobin. Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract, requiring a gluten-free diet and careful monitoring of nutrient intake to manage symptoms and prevent malnutrition. Monitoring albumin and hemoglobin levels helps assess the client's nutritional status and response to treatment. The other choices are incorrect because they do not align with the characteristic features of Crohn's disease, such as gluten sensitivity and the need for meticulous dietary management. The actions and parameters in the correct answer are specific to Crohn's disease, making it the most appropriate choice for the scenario presented.

Extract:

A nurse is caring for a toddler who received radiation therapy 2 years ago for a brain tumor.


Question 4 of 5

Which of the following should the nurse identify as a late adverse effect of the radiation therapy?

Correct Answer: D

Rationale: The correct answer is D: Short stature. Late adverse effects of radiation therapy typically manifest months to years after treatment. Radiation can affect bones and inhibit growth, leading to short stature. Mucosal ulceration (
A) and desquamation (
C) are early side effects, while nausea (
B) is a common acute side effect.
Therefore, they are not considered late adverse effects.
Choice E, F, and G are not provided.

Extract:

A nurse is assessing a school-age child prior to administering digoxin.


Question 5 of 5

For which of the following findings should the nurse withhold the medication?

Correct Answer: C

Rationale: The correct answer is C: Heart rate 64/min. A heart rate of 64/min is below the normal range (60-100/min) for adults, indicating bradycardia, which can be a sign of decreased cardiac output. The nurse should withhold medication that can further lower the heart rate and worsen the condition.
A: Urine output 25 mL/hr is low but not necessarily a reason to withhold medication.
B: Oxygen saturation 88% is below the normal range (95-100%) but is not a direct contraindication to withhold medication.
D: Respiratory rate 18/min is within the normal range (12-20/min) and not a reason to withhold medication.

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