ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
History and Physical: Infant was full-term at birth. Birth weight was 3.5 kg (7.7 lb). Infant is not gaining weight as expected. One week ago at outpatient visit, weight was 3.6 kg (7.9 lb). Parent reports for past 2 days infant is breathing faster during feedings and does not finish feedings. Parent also reports decreased appetite and puffiness around the infant's eyes. Parent states that the last wet diaper was about 10 hr ago. Infant admitted for diagnostic evaluation, failure to thrive, and nutritional/fluid support. Vital Signs: Admission: Temperature 37.7° C (99.9° F), Heart rate 174/min while sleeping, Respiratory rate 72/min while sleeping. Assessment: Respirations: Tachypneic with moderate retractions and nasal flaring. Upon auscultation, crackles heard in all lung fields. No nasal drainage noted. Dry cough noted periodically. Skin: Pallor, scalp is diaphoretic, lower extremities are cool to touch. Cardiac: Tachycardic, regular rhythm, no murmur is heard. Peripheral pulses are full and bounding in the upper extremities and weak bilateral pedal pulses are noted. Fluids: Mucous membranes are slightly dry and pink. Skin turgor is slightly decreased. Capillary refill is 3 seconds. Noted periorbital edema and nonpitting edema of feet. Anterior fontanel is soft and slightly depressed. Diaper remains dry. Abdomen: Soft, full, round, bowel sounds are present and active. Blood pressure in right upper extremity 60/39 mm Hg, Oxygen saturation 90%
Question 1 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: C
Rationale: Action to Take: Provide chest physiotherapy and postural drainage; Potential Condition: Cystic fibrosis; Parameter to Monitor: Number of steatorrhea stools, Intake and output.
Rationale:
1. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system, leading to thick mucus production. Chest physiotherapy and postural drainage help clear mucus from the lungs.
2. Monitoring the number of steatorrhea stools is important as it indicates malabsorption in cystic fibrosis. Intake and output monitoring helps assess hydration status and nutritional intake.
3. Pyloric stenosis, congestive heart failure, and respiratory syncytial virus bronchiolitis are not conditions typically associated with chest physiotherapy and postural drainage.
4. Anticipating a prescription for digoxin and implementing contact precautions are not relevant actions for addressing cystic fibrosis.
5. Monitoring for periorbital edema is
Extract:
Question 2 of 5
A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take?
Correct Answer: D
Rationale: The correct answer is D, using a tumbling E chart for the assessment. This type of chart is commonly used for young children due to its simplicity - the child is asked to identify the direction the "E" is facing. This helps assess visual acuity accurately in children who may not yet know letters. Assessing both eyes together first (choice
A) may lead to inaccuracies. Positioning the child 4.6 meters away (choice
B) is too far for a child's assessment. Testing without glasses first (choice
C) may not provide an accurate baseline. Overall, using a tumbling E chart is the most appropriate method for assessing visual acuity in a 4-year-old child.
Question 3 of 5
A nurse is caring for a 1-year-old child who has been hospitalized. Which of the following items in the child's room is a common source of health care-associated infection?
Correct Answer: B
Rationale: The correct answer is B: Bedside computer keyboard. The keyboard is a common source of healthcare-associated infections due to frequent use and potential contamination from various sources. Keyboards are often touched by multiple healthcare providers without proper cleaning, leading to the spread of pathogens. Unopened bottles of formula (
A) are typically sterile until opened. Disposable diapers (
C) are not a common source of infection if disposed of properly. Protective plastic gowns (
D) are used to prevent contamination rather than being a source of infection.
Question 4 of 5
A nurse is assessing a school-age child who is receiving morphine. For which of the following adverse effects should the nurse monitor?
Correct Answer: D
Rationale: The correct answer is D: Bradypnea. Morphine is an opioid that can cause respiratory depression, leading to bradypnea (slow breathing). Monitoring the child's respiratory rate is crucial to detect any signs of respiratory distress. Stevens-Johnson syndrome (
A) is a severe skin reaction, not typically associated with morphine. Hypertension (
B) is not a common adverse effect of morphine; in fact, it can cause hypotension. Prolonged wound healing (
C) is not a known adverse effect of morphine. Monitoring for bradypnea will ensure timely intervention if the child experiences respiratory depression.
Extract:
Nurses' Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream apply to skin lesions daily. Assessment: Child is alert and responsive, Respiratory rate even and nonlabored at rate of 24/min. No adventitious sounds auscultated. Heart rate 108/min, Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities.
Question 5 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian? Select all that apply.
Correct Answer: A,B,D,F,G
Rationale:
Correct Answer: A, B, D, F, G
Rationale:
A: Cutting and filing fingernails frequently is important to prevent scratching and worsening of lesions.
B: Using a mild detergent helps prevent skin irritation and flare-ups in children with skin conditions.
D: Informing about occasional flare-ups prepares the guardian for potential worsening of the condition.
F: Applying gloves to the child's hands can prevent scratching and spreading of the lesions.
G: Applying emollients after bathing helps maintain skin hydration and reduce dryness, which is beneficial for the child's skin condition.
Summary:
C: Pimecrolimus cream should not be applied thickly without specific instructions from the healthcare provider.
E: The statement about the condition being contagious is not accurate for most skin conditions and can lead to unnecessary fear and stigma.