ATI RN
ATI Pediatrics Exam 2 Questions
Extract:
A preschooler with acute lymphoblastic leukemia (ALL), receiving chemotherapy and steroids, no bowel movement for 5 days, crying and clinging to guardian, temperature of 38.8°C (101.9°F) tympanic, erythematous central line catheter insertion site with purulent drainage.
Question 1 of 5
A nurse on a pediatric unit is preparing to admit a preschooler after receiving a transfer report from a nurse in the emergency department. Which of the following findings should the nurse report to the provider immediately?
Correct Answer: D
Rationale: The correct answer is D. The insertion site of the central line catheter being erythematous with purulent drainage indicates a potential infection, which can lead to sepsis in a pediatric patient. Immediate reporting to the provider is crucial for prompt intervention to prevent further complications. Reporting the other findings is important but they do not pose an immediate threat to the child's health.
Choice A could indicate constipation, which is significant but not an immediate concern.
Choice B suggests emotional distress,
Choice C indicates fever, which may require monitoring but not immediate intervention.
Therefore, choice D is the most critical finding that requires immediate action.
Extract:
A 7-year-old child with fever, tachycardia, low oxygen saturation, WBC count 15,000/mm^3, Hgb 8 g/dL, Hct 32%.
Question 2 of 5
A nurse is caring for a 7-year-old child who has a fever, tachycardia, and low oxygen saturation. The nurse reviews the child's laboratory results and notes the following: - WBC count 15,000/mm^3 (normal range: 5,000 to 10,000/mm^3) - Hgb 8 g/dL (normal range: 10 to 15.5 g/dL) - Hct 32% (normal range: 32% to 44%) The nurse should suspect that the child has which of the following conditions?
Correct Answer: B
Rationale: The correct answer is B: Sickle cell anemia. The child's low hemoglobin (Hgb) and hematocrit (Hct) levels indicate anemia. Sickle cell anemia is a type of hemolytic anemia characterized by low red blood cell count and hemolysis, leading to low Hgb and Hct levels. In sickle cell anemia, the red blood cells can become sickle-shaped, leading to vaso-occlusive crises, which can cause tissue hypoxia and result in tachycardia and low oxygen saturation. Leukemia (
A) is a cancer of the blood and bone marrow, typically presenting with abnormal white blood cell count. Hemophilia (
C) is a bleeding disorder due to deficiency in clotting factors, not related to the presented symptoms. Iron deficiency anemia (
D) would typically present with low Hgb and Hct levels, but the characteristic sickle-shaped cells seen in sickle cell anemia are
Extract:
Administering vaccines at a county health immunization clinic.
Question 3 of 5
A nurse is administering vaccines at a county health immunization clinic. Which of the following clients should the nurse plan to administer the meningococcal conjugate (MCV4) vaccine?
Correct Answer: C
Rationale: The correct answer is C - An 11-year-old school-age child. The MCV4 vaccine is typically recommended for children at age 11-12 years old, as this is the age when they are at increased risk of contracting meningococcal disease. This vaccine helps protect against meningococcal bacteria, which can cause serious infections like meningitis. Administering the vaccine at this age ensures optimal protection during adolescence when the risk of exposure is higher due to social interactions.
Choices A, B, and D are incorrect because the MCV4 vaccine is not typically administered at these ages based on the recommended schedule.
Extract:
An adolescent in the ED with high fever, headache, neck stiffness, CSF analysis: WBC count 300 cells/microliter, protein 45 mg/dL, glucose 40 mg/dL, turbid color.
Question 4 of 5
A nurse is caring for an adolescent who was brought to the emergency department (ED) with a high fever, headache, and neck stiffness. The nurse reviews the adolescent's cerebrospinal fluid (CSF) analysis results and notes the following: - WBC count 300 cells/microliter (normal range: 0 to 10 cells/microliter) - Protein 45 mg/dL (normal range: 15 to 45 mg/dL) - Glucose 40 mg/dL (normal range: 50 to 75 mg/dL) - Color Turbid (normal: clear and colorless) The nurse should suspect that the adolescent has which of the following conditions?
Correct Answer: A
Rationale: The correct answer is A: Bacterial meningitis. The CSF analysis shows elevated WBC count, decreased glucose levels, and turbid appearance, which are indicative of bacterial meningitis. Bacterial meningitis is characterized by an increased WBC count due to the body's immune response to the infection, low glucose levels as bacteria consume glucose, and turbid appearance due to the presence of bacteria and pus. Viral meningitis typically has normal glucose levels and a slightly elevated WBC count but is usually less severe. Encephalitis would present with different CSF findings and symptoms such as altered mental status. Brain abscess would have different CSF findings and often presents with focal neurological deficits.
Extract:
An adolescent in the ED with fever, headache, and neck stiffness.
Question 5 of 5
A nurse is caring for an adolescent who was brought to the emergency department (ED) with a fever, headache, and neck stiffness. The nurse should determine the assessment findings are consistent with which of the following disease processes?
Correct Answer: A
Rationale: The correct answer is A: Bacterial meningitis. The assessment findings of fever, headache, and neck stiffness are classic symptoms of bacterial meningitis. Fever is a common sign of infection, while headache and neck stiffness are indicative of meningeal irritation and inflammation. With bacterial meningitis, the inflammation of the meninges (protective membranes covering the brain and spinal cord) is caused by bacterial infection. Prompt recognition and treatment are essential due to the potential for rapid deterioration and serious complications. Encephalitis (choice
B) is inflammation of the brain, which may present with similar symptoms but typically lacks the prominent neck stiffness seen in meningitis. Gastroenteritis (choice
C) involves gastrointestinal symptoms like nausea, vomiting, and diarrhea, not the neurological symptoms described. Migraine (choice
D) is a type of headache disorder characterized by recurrent moderate to severe headaches with associated symptoms, but it does not typically present with fever or neck stiffness.