ATI RN
ATI RN Pediatric Nursing 2023 I Questions
Extract:
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%. Laboratory Results: Chest x-ray: mild left ventricular hypertrophy is noted. Increased pulmonary vascular markings are noted in all lobes.
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 (Condition), A,B (Actions), B,C (Parameters)
Rationale: Condition: C. The condition that the infant is most likely experiencing is congestive heart failure, which can cause poor weight gain, tachypnea, decreased appetite, and periorbital edema. Actions: A. Digoxin can increase the contractility of the heart and decrease the heart rate. B. Elevating the head of the bed can help reduce the workload of the heart and improve breathing. Parameters: B. Intake and output can indicate fluid balance and renal function. C. Respiratory status can reflect cardiac function and oxygenation.
Extract:
Question 2 of 5
A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching?
Correct Answer: A
Rationale: A. Applying bactericidal ointment to lesions helps treat impetigo by killing the bacteria causing the infection. B. Acyclovir is for viral infections. C, D. These are not necessary for impetigo treatment.
Question 3 of 5
A nurse is caring for a preschool-age child who is postoperative following a tonsillectomy and is clearing her throat frequently. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: A. Observing the child's throat with a flashlight is necessary to detect any bleeding, which is a priority concern post-tonsillectomy. B, C, D. These actions follow assessment for bleeding.
Question 4 of 5
A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider?
Correct Answer: D
Rationale: D. Tachypnea (rapid breathing) in an infant with RSV is a concerning sign that may indicate respiratory distress and requires immediate reporting to the provider to prevent worsening respiratory failure. A. Rhinorrhea (runny nose) is a common symptom of RSV and not immediately alarming unless accompanied by other severe symptoms. B. Pharyngitis (sore throat) is less specific in infants with RSV and not typically a priority for reporting. C. Coughing is expected with RSV and does not warrant immediate reporting unless it severely impacts breathing.
Question 5 of 5
A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: A. Checking the pH of the gastric secretions is the priority action to confirm the correct placement of the NG tube in the stomach before administering the enteral feeding. B, C, D. These actions follow confirmation of tube placement.