ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
Question 1 of 5
A nurse on a pediatric unit is caring for four children. The nurse should use droplet precautions for which of the following children?
Correct Answer: A
Rationale: The correct answer is A: A toddler who has seasonal influenza. Droplet precautions are used for illnesses transmitted through respiratory secretions like influenza.
Toddlers are more susceptible to severe complications from influenza due to their immature immune systems.
Choice B is incorrect because viral conjunctivitis is transmitted through contact with infected eye secretions, requiring contact precautions.
Choice C is incorrect because hepatitis A is transmitted through the fecal-oral route, necessitating standard precautions.
Choice D is incorrect as pediculosis capitis (head lice) is transmitted through direct contact, warranting contact precautions.
Extract:
Medical History (0930): Three urinary tract infections over the past year treated with antibiotics. Diagnosed at 6 months old with vesicoureteral reflux; Vital Signs (0930): Heart rate: 128/min, Temperature: 38.4°C (101.1°F), Respiratory rate: 28/min; Nurse's Notes (0930): Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hours. Child febrile and lethargic. Notified provider of parent reports and child's fever. New prescriptions received. Urine sample obtained via sterile straight catheter; Diagnostic Results (1030): Urinalysis: Leukocyte esterase: positive (negative), Specific gravity: 1.035 (1.005 to 1.030), Appearance: cloudy and dark amber (clear), Nitrites: present (none), WBCs: 10 (0 to 4); Provider Prescriptions (0945): Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter; A nurse in a provider's office is caring for a 1-year-old toddler.
Question 2 of 5
The child is at risk for developing _______and__________ .
Correct Answer: A,C
Rationale: The correct answer is A and C. Pyelonephritis is a bacterial infection of the kidneys, common in children with underlying urinary tract abnormalities, putting them at risk. Renal scarring can result from untreated or recurrent pyelonephritis, leading to long-term kidney damage.
Choices B, D, and E are not directly related to the initial risk factors mentioned in the question.
Extract:
Nurses' 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 expiratory 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 86/46 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. Biplane radiographic study identifies object in esophagus. No foreign objects visualized in the chest or abdomen.
Question 3 of 5
Complete the following sentence by using the list of options. The nurse should first __ followed by __.
Correct Answer: A,B
Rationale: The correct answer is A,B. Firstly, keeping the child NPO (nothing by mouth) is essential before a flexible endoscopy to prevent aspiration. Secondly, preparing the child for the procedure ensures readiness and cooperation.
Choice C and E focus on prevention of choking hazards, not directly related to the procedure.
Choice D is important but typically done after the initial preparations. Waiting for return of gag reflex (F) is not necessary before a flexible endoscopy.
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 4 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 5 of 5
A nurse is reviewing the medical record of a toddler who is scheduled for surgery. Which of the following information should the nurse recognize as a potential risk for a latex allergy?
Correct Answer: C
Rationale: The correct answer is C: History of spina bifida. Spina bifida is a congenital condition associated with multiple surgeries and medical interventions, increasing exposure to latex products and thus the risk of developing a latex allergy. Suspected autism spectrum disorder (choice
A) is not directly linked to latex allergy. Diagnosis of hypospadias (choice
B) and previous cleft palate repair (choice
D) do involve surgeries but are not as strongly associated with latex exposure as spina bifida.