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: Condition: C. Congestive heart failure - The infant's symptoms of poor weight gain, tachypnea, decreased appetite, and periorbital edema are indicative of congestive heart failure. Actions: A. Anticipate a prescription for digoxin - Digoxin is commonly prescribed to manage congestive heart failure in infants by improving cardiac contractility and reducing heart rate. B. Elevate the head of the bed to a 45° angle - This helps reduce venous return to the heart, decreasing preload and relieving symptoms of congestion. Parameters: B. Intake and output - Monitoring fluid balance is crucial in congestive heart failure to assess for volume overload. D. Presence of periorbital edema - Persistent edema indicates ongoing fluid retention, a key sign to monitor treatment effectiveness.
Extract:
Question 2 of 5
A nurse is caring for an infant who has necrotizing enterocolitis. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: A. While vomiting can be a symptom in some gastrointestinal disorders, it is not specific to necrotizing enterocolitis. B. Hypertension is not typically associated with necrotizing enterocolitis. Instead, infants may present with hypotension due to septic shock or poor perfusion. C. A rounded abdomen is a common finding in infants with necrotizing enterocolitis due to abdominal distension from gas and fluid accumulation. D. Tachypnea may occur in response to systemic infection or respiratory distress but is not a defining characteristic of necrotizing enterocolitis.
Question 3 of 5
A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include?
Correct Answer: D
Rationale: A. Providing a warm blanket can help alleviate discomfort associated with fever and chills, which are common symptoms of varicella, but it is not the priority intervention. B. Koplik spots are seen in measles, not varicella. C. Aspirin administration is contraindicated in varicella due to the risk of Reye's syndrome. Acetaminophen or ibuprofen may be used for fever. D. Varicella is spread through respiratory droplets and direct contact, so airborne precautions are necessary to prevent transmission.
Question 4 of 5
A nurse is providing teaching to the parent of a 10-month-old infant who is having difficulty eating. The parent is feeding their infant goat milk. Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: A. Warming goat's milk before feeding does not address the issue of nutritional adequacy or suitability for the infant's age. B. Soy milk may not be appropriate for a 10-month-old infant and may not adequately address nutritional needs. C. Commercially prepared formula is recommended for infants who are not breastfeeding and provides essential nutrients necessary for growth and development. D. Reinitiating breastfeeding may not be feasible or appropriate in this situation if the parent has chosen to feed the infant goat milk.
Question 5 of 5
A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: A. Amphotericin B is an antifungal medication and is not indicated for impetigo, which is a bacterial skin infection. B. Lidocaine ointment is a local anesthetic and is not indicated for the treatment of impetigo. C. Impetigo is highly contagious, and contact isolation precautions should be initiated to prevent its spread within the hospital setting. D. Reporting the disease to the state health department may be necessary for surveillance purposes, but the immediate priority is to implement infection control measures.