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. For each of the assessment finding below, click to specify if the assessment finding is consistent with Kawasaki disease, scarlet fever, or rheumatic fever. Each finding may support more than 1 disease process of none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.
| Assessment finding | Kawasaki Disease | Scarlet fever | Pheumatic Fever |
|---|---|---|---|
| Recent diagnosis of pharyngitis. | |||
| Nodules | |||
| Cardiomegaly | |||
| Polyarthralgia |
Correct Answer: A,B,C,D
Rationale: The correct answer is .
A: Recent diagnosis of pharyngitis - Consistent with all three diseases as pharyngitis can be a symptom in Kawasaki disease, scarlet fever, and rheumatic fever.
B: Nodules - Can be seen in Kawasaki disease (cervical lymphadenopathy), scarlet fever (subcutaneous nodules), and rheumatic fever (subcutaneous nodules).
C: Cardiomegaly - Seen in Kawasaki disease (coronary artery aneurysms), scarlet fever (cardiomegaly due to myocarditis), and rheumatic fever (cardiomegaly due to carditis).
D: Polyarthralgia - Present in Kawasaki disease (arthritis), scarlet fever (arthritis), and rheumatic fever (migratory arthritis).
Therefore, all these assessment findings can be associated with Kawasaki disease, scarlet fever, and rheumatic fever.
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 2 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:
Question 3 of 5
A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Assign the child to a negative air pressure room. Varicella, commonly known as chickenpox, is highly contagious and spreads through respiratory droplets. Placing the child in a negative air pressure room helps prevent the spread of the virus to others by containing the infectious particles within the room. This isolation measure is crucial in protecting both the child and other patients.
Choice B is incorrect because aspirin should not be administered to children with varicella due to the risk of Reye's syndrome.
Choice C is incorrect as droplet precautions are not necessary for varicella, which primarily spreads through airborne respiratory droplets.
Choice D is incorrect as Koplik spots are associated with measles, not varicella.
Question 4 of 5
A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?
Correct Answer: A
Rationale:
Correct Answer: A - Weak femoral pulses
Rationale: Coarctation of the aorta results in narrowing of the aorta, leading to decreased blood flow to the lower extremities. This causes weak or absent femoral pulses due to reduced blood supply. The other choices are incorrect as coarctation of the aorta typically does not directly cause increased intracranial pressure, upper extremity hypotension, or frequent nosebleeds. These symptoms are more commonly associated with other conditions such as head trauma, vascular issues, or nasal conditions.
Question 5 of 5
A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following clients should the nurse plan to hold the dose of digoxin?
Correct Answer: D
Rationale: The correct answer is D because vomiting can lead to decreased absorption of digoxin, potentially resulting in subtherapeutic levels. Holding the dose in this situation prevents giving an ineffective dose. Option A is incorrect because an apical pulse of 100 bpm is within the normal range for toddlers on digoxin. Option B is incorrect because a potassium level of 4.0 mEq/L is also within the normal range. Option C is incorrect because a digoxin level of 1.2 ng/mL falls within the therapeutic range.