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: Condition Most Likely Experiencing: Congestive heart failure. The infant's symptoms, including tachypnea, retractions, nasal flaring, crackles, tachycardia, weak pedal pulses, periorbital edema, and non-pitting edema, along with chest X-ray findings of left ventricular hypertrophy and increased pulmonary vascular markings, are consistent with congestive heart failure. Actions to Take: 1. Anticipate a prescription for digoxin to improve cardiac output. 2. Elevate the head of the bed to a 45° angle to reduce breathing effort and pulmonary congestion. Parameters to Monitor: Peripheral pulses to assess circulation improvement and respiratory status to track reduction in congestion.
Extract:
A nurse is assessing a school-age child who has heart failure and is taking furosemide.
Question 2 of 5
Which of the following findings should the nurse identify as an indication that the medication is effective?
Correct Answer: B
Rationale: Furosemide causes potassium loss, not increase. Reduced edema shows effective fluid reduction. Cardiac output should improve, not decrease. Venous pressure should decrease, not increase.
Extract:
A nurse is providing peritoneal dialysis to a child and observes there is minimal dialysate outflow at the end of the outflow time.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Longer dwell time doesn't aid outflow. Position changes use gravity to improve drainage. Fluid intake doesn't affect outflow. Bruits are for vascular access, not peritoneal catheters.
Extract:
A nurse is working in a nursing home.
Question 4 of 5
What is the first priority for the nurse in this situation?
Correct Answer: A
Rationale: Moving patients from harm ensures immediate safety, the top priority in a fire. Removing flammables or extinguishing fires is secondary. Reporting to the fire area risks safety. Full evacuation may follow after initial safety measures.
Extract:
Nurses' Notes (0800 hrs): The client's guardian reports that the child has been unable to sleep recently and has been very irritable. The guardian expresses concern about the child's skin condition worsening and the child scratching excessively, which results in the areas bleeding. The guardian states the child has a history of allergic rhinitis. The child appears alert and responsive but frequently scratches at the affected areas. The guardian mentions that the child has been using a new laundry detergent recently. The child has been given diphenhydramine 10 mg PO for itching. The guardian is worried about the potential for infection due to the open sores; Vital Signs (0800 hrs): Temperature: 37.2°C (99°F), Heart rate: 110/min, Respiratory rate: 22/min, Blood pressure: 100/60 mmHg; Physical Examination Results (0800 hrs): Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities. The affected areas are dry and rough to the touch. Some areas show signs of excoriation and minor bleeding. No signs of systemic infection observed. The child appears to be in mild distress due to itching; Medication Administration Record: Diphenhydramine 10 mg PO, 4 times per day, Pimecrolimus 1% cream, apply to skin lesions daily; A nurse is caring for a 3-year-old male client in the emergency department. The client presents with a history of irritability, scratching, and bleeding from skin lesions. The nurse is preparing to discharge the client.
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,C,E,G
Rationale:
Choice A: Mild detergent reduces skin irritation.
Choice B: Emollients hydrate skin, preventing dryness.
Choice C: Gloves prevent scratching damage.
Choice D: Thick pimecrolimus layers risk side effects; thin layers are correct.
Choice E: Short nails minimize excoriation.
Choice F: Eczema isn't contagious.
Choice G: Flare-ups are expected in chronic skin conditions like eczema.