ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
Nurse's Notes: The infant presents with tachypnea, moderate retractions, and nasal flaring. Auscultation reveals crackles in all lung fields, with no nasal drainage. The infant has a dry cough that occurs periodically. The skin appears pale, the scalp is diaphoretic, and the lower extremities are cool to the touch. The infant is tachycardic with a regular rhythm, and no murmur is heard. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. Mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The diaper remains dry. The abdomen is soft, full, and round, with active bowel sounds; Medical History: The infant was born at 38 weeks gestation via vaginal delivery with no complications. The infant has had no previous hospitalizations or surgeries. The infant has been exclusively breastfed and has no known allergies. The mother reports that the infant has been feeding poorly for the past two days and has had decreased urine output. There is no family history of congenital heart disease or respiratory conditions; Diagnostic Results: Chest X-ray: Mild left ventricular hypertrophy noted. Increased pulmonary vascular markings in all lobes; Complete Blood Count (CBC): White Blood Cells (WBC): 12,000/mm³ (4,500-11,000/mm³), Hemoglobin (Hgb): 11 g/dL (11-14 g/dL), Hematocrit (Hct): 33% (33-39%), Platelets: 250,000/mm³ (150,000-450,000/mm³); Electrolytes: Sodium (Na): 138 mEq/L (135-145 mEq/L), Potassium (K): 4.2 mEq/L (3.5-5.0 mEq/L), Chloride (Cl): 102 mEq/L (98-106 mEq/L), Bicarbonate (HCO3): 22 mEq/L (22-28 mEq/L); Vital Signs: Temperature: 37.7°C (99.9°F), Heart rate: 174/min while sleeping, Respiratory rate: 72/min while sleeping, Blood pressure in right upper extremity: 60/39 mm Hg, Oxygen saturation: 90%; Physical Examination Results: The infant is alert but irritable. The skin is pale with a diaphoretic scalp and cool lower extremities. The infant exhibits tachypnea with moderate retractions and nasal flaring. Crackles are heard in all lung fields upon auscultation. The heart rate is tachycardic with a regular rhythm, and no murmur is detected. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. The mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The abdomen is soft, full, and round, with active bowel sounds; A nurse is caring for a 6-week-old infant in the pediatric unit.
Question 1 of 5
Complete the diagram by dragging from the choices below to specify: 1. What condition the client is most likely experiencing 2. Two actions the nurse should take to address that condition 3. Two parameters the nurse should monitor to assess the client's progress.
Correct Answer: A,E
Rationale: Action to Take: A, E; Potential Condition: Congestive heart failure; Parameter to Monitor: Peripheral pulses, Respiratory status.
Rationale:
1. Congestive heart failure is a common condition characterized by fluid overload, leading to decreased perfusion and respiratory distress.
2. Actions to take include managing fluid intake, administering diuretics, and monitoring vital signs.
3. Parameters to monitor include peripheral pulses (indicative of perfusion) and respiratory status (to assess for signs of respiratory distress).
Extract:
A nurse is preparing a child for a lumbar puncture.
Question 2 of 5
In which of the following positions should the child be placed for the procedure?
Correct Answer: B
Rationale: The correct answer is B: Lateral. Placing the child in a lateral position is ideal for the procedure as it allows for easy access to the targeted area while providing stability and comfort. Lateral positioning also minimizes the risk of injury and maximizes the effectiveness of the procedure.
A: Semi-Fowler's position is not suitable as it may not provide adequate access or stability.
C: Supine position is not ideal for certain procedures that require a lateral approach.
D: Prone position is not appropriate as it does not allow for proper access or visibility of the target area.
Extract:
A nurse is planning care for a child who has a prescription to transfuse 2 units of packed RBCs.
Question 3 of 5
Which of the following interventions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Infuse each unit of blood within 4 hr. This is crucial to prevent bacterial contamination and ensure blood product integrity. Storing blood at room temperature for too long (
A) can promote bacterial growth. Administering RBCs with non-filtered IV tubing (
C) can lead to potential infusion reactions due to the presence of microaggregates. Infusing dextrose 5% in water during packed RBC infusion (
D) can cause hemolysis due to the low osmolarity of the solution.
Extract:
Question 4 of 5
A nurse is admitting a child who has erythema infectiosum. Which of the following transmission-based precautions should the nurse initiate?
Correct Answer: A
Rationale: The correct answer is A: Droplet precautions. Erythema infectiosum, also known as Fifth disease, is primarily transmitted through respiratory secretions. Droplet precautions are necessary to prevent the spread of the virus through droplets when the child coughs or sneezes. This precaution includes wearing a mask and ensuring proper hand hygiene.
Other choices are incorrect because:
B: Airborne precautions are for diseases transmitted through small droplet nuclei that remain suspended in the air for long periods, such as tuberculosis.
C: Contact precautions are for diseases spread by direct contact with an infected person or surfaces, like MRSA.
D: Protective environment precautions are used for immunocompromised patients to protect them from environmental pathogens.
Question 5 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: A
Rationale:
Correct Answer: A (Bradypnea)
Rationale:
1. Morphine is an opioid analgesic that can cause respiratory depression.
2. Bradypnea (slow breathing) is a common adverse effect of opioids.
3. Monitoring for bradypnea is crucial to prevent respiratory compromise and overdose.
4. Stevens-Johnson syndrome, prolonged wound healing, and hypertension are not typical adverse effects of morphine.
5. Bradypnea is the priority adverse effect to monitor due to its life-threatening nature.