ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
History and physical 0830: Pharyngitis 3 weeks ago. Prescribed 5-day course of azithromycin. Antibiotic discontinued on day 3 due to gastrointestinal upset. Current on all recommended immunizations.
Question 1 of 5
A nurse on the pediatric unit is admitting the child from the emergency department. Complete the following sentence by using the lists of options. The nurse suspects the child is experiencing rheumatic fever. The nurse should recognize the child is at greatest risk of developing--- due to---
Correct Answer: C,D
Rationale: The correct answers are C: Rheumatic heart disease and D: Streptococcal pharyngitis. Rheumatic fever is caused by untreated streptococcal infection. If not treated promptly, it can lead to rheumatic heart disease, a serious complication. Streptococcal pharyngitis is a common precursor to rheumatic fever. Glomerulonephritis (
A) is a potential complication of streptococcal infection but not directly related to rheumatic fever. Pericarditis (
B) is an inflammation of the pericardium and not directly associated with rheumatic fever. Recent immunizations (E) and viral infections (F) are not linked to the development of rheumatic fever.
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 2 of 5
The nurse is continuing to care for the child. After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the discharge teaching?
| Parent Statement | Reflects Understanding | Needs Reinforcement |
|---|---|---|
| We should notify the provider if the cast becomes loose over time. | ||
| It is important that our child avoids placing anything inside the cast. | ||
| We should prop the casted arm on pillows for the next 24 hours. | ||
| We should expect the swelling to get better. | ||
| We need to be very careful about how we handle the cast for the first 2 days while it dries. |
Correct Answer: A,B,C,D,E
Rationale: [1,1,1,1,1]
Parent Statement: We should notify the provider if the cast becomes loose over time.
Reflects Understanding: This statement shows awareness of the need for prompt action in case of an issue with the cast, ensuring proper care.
Needs Reinforcement: None. This statement is crucial for the child's well-being.
Parent Statement: It is important that our child avoids placing anything inside the cast.
Reflects Understanding: This statement highlights the importance of maintaining the integrity of the cast to prevent complications.
Needs Reinforcement: None. Preventing foreign objects from entering the cast is essential.
Parent Statement: We should prop the casted arm on pillows for the next 24 hours.
Reflects Understanding: Proper elevation helps reduce swelling and promotes healing.
Needs Reinforcement: None. Elevation is a standard practice in cast care.
Parent Statement: We should expect the swelling to get better.
Reflects Understanding: Knowing that swelling should improve indicates awareness of the expected healing process
Extract:
Question 3 of 5
A nurse is assessing a 5-year-old child who has diabetes insipidus and is receiving desmopressin. Which of the following findings should the nurse identify as an indication that the medication is effective?
Correct Answer: D
Rationale: The correct answer is D: Cessation of nocturnal enuresis. Desmopressin is a medication used to treat diabetes insipidus by decreasing urine output. Nocturnal enuresis is a common symptom of diabetes insipidus due to excessive urine production at night.
Therefore, the cessation of nocturnal enuresis indicates that the medication is effectively reducing urine output in the child.
Choices A, B, and C are unrelated to the effectiveness of desmopressin in treating diabetes insipidus.
Choice A, heart rate of 140/min, is not a specific indicator of desmopressin effectiveness.
Choice B, capillary refill of 3 seconds, is a measure of peripheral perfusion and not directly related to diabetes insipidus.
Choice C, absence of hypoglycemic episodes, is more relevant to diabetes mellitus and not diabetes insipidus.
Extract:
A nurse is caring for a recently admitted 18-year-old client:
Nurses' Notes
1000:
Client admitted to behavioral health unit for prolonged weight loss and refusal to eat. Client collapsed at school. The client's parents were called. They contacted the primary care provider, who arranged for a direct admission.
Weight 37.2 kg (82 lb)
Height 157.5 cm (62 inches)
BMI 15
1200:
Client observed during noon meal. Client pushed food around the plate. Intake 10% of meal. Offered nutritional supplement. Client declined. Reports feeling anxious due to admission and mealtime. Client states, "I cannot eat this with you watching me."
1500:
Snack provided. Client observed throwing snack into the trash can. When realized they had been observed, they admitted to their action and asked for a second snack. Client ate 10% of their snack.
Question 4 of 5
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.
Correct Answer: A[2,4],B[2],C[0,4]
Rationale: Action to Take: Provide the client with foods that have a variety of textures, Encourage the client to limit fasting; Potential Condition: Anorexia nervosa; Parameter to Monitor: Weight on a daily basis, Behavior 15 minutes after meals.
Rationale: In anorexia nervosa, the client typically has a fear of gaining weight, leading to restrictive eating habits. Providing foods with different textures can help normalize eating habits and improve nutrition. Encouraging the client to limit fasting can help address the underlying issue of restricted food intake. Weight monitoring is crucial in assessing nutritional status, while monitoring behavior post-meals can provide insights into the client's relationship with food. Bulimia nervosa and binge eating disorder are not the most likely conditions based on the client's symptoms. Monitoring cardiac function with ECG and calcium level are not the primary parameters for assessing progress in anorexia nervosa.
Extract:
Nurses' Notes
4 weeks ago:
21-year-old client reports increased stress and worry for the last 3 months. Client is worried about academic performance due to Inability to focus on studies. School performance is suffering. Denies illicit drug use and drinks in moderation socially on the weekends.
Discussed lifestyle modifications to reduce stress. Instructed client to return in 1 month to reevaluate symptoms.
Today:
Client reports a slight improvement in stress but is now having loss of appetite and difficulty sleeping.
Instructed client to begin trazodone per provider's prescription.
Question 5 of 5
A nurse is caring for a client in the outpatient health clinic. For each potential nursing Intervention, click to specify if the intervention is indicated or not indicated.
| Nursing intervention | Indicated | Not indicated |
|---|---|---|
| Encourage naps during the day when client is tired. | ||
| Encourage a regular sleep-wake schedule. | ||
| Encourage high-calorie finger foods. | ||
| Advise client to notify provider if pregnant. | ||
| Instruct client to avoid foods that have been fermented or aged. | ||
| Advise client to rise slowly from sitting position. | ||
| Encourage client to sleep until later in the morning. |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Encouraging naps during the day when the client is tired is indicated for managing fatigue.
- Encouraging a regular sleep-wake schedule helps promote better sleep hygiene.
- Advising the client to notify the provider if pregnant is crucial for appropriate prenatal care.
- Other options are not indicated: high-calorie finger foods may not be suitable for all clients, avoiding fermented or aged foods is specific dietary advice, rising slowly is for orthostatic hypotension, and sleeping until later in the morning may disrupt the sleep-wake cycle.