ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
Nurses' Notes: 0915: Received the child awake, alert, and crying. Parent states that child was playing with remote control toy and when the parent heard the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual and witnessed them gagging periodically. 0930: Child is lying on parent's chest with eyes open and requesting 'sippy cup.' Continues to have expiratory wheezing in bilateral upper lobes. Preparing child for diagnostic testing. Vital Signs: 0915: Blood pressure 88/45 mm Hg, Heart rate 90/min, Respiratory rate 30/min, Axillary temperature 36.9° C (98.4° F), Oxygen saturation 96%. 0930: Blood pressure 86/46 mm Hg, Heart rate 88/min, Respiratory rate 28/min, Axillary temperature 36.9° C (98.4° F), Oxygen saturation 95%. Assessment: 0915: Child awake and sobbing, asking parent for 'sippy cup' with excessive drooling and occasionally gagging. Breath sounds with small expiratory wheezing noted in bilateral upper lobes; respirations slightly elevated as child continues to cry and sob. Oxygen saturation 96% on room air. Penlight used to inspect throat with no visual signs of foreign object; no visual objects in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation. Abdomen soft and nontender with active bowel sounds in all four quadrants. Skin warm, pink, and smooth. Yellow urine noted in child's diaper. Provider notified of assessment findings. Laboratory Results: 0930: X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies object in esophagus. No foreign objects visualized in the chest or abdomen.
Question 1 of 5
Complete the following sentence by using the list of options. The nurse should first __ followed by __.
Correct Answer: A,B
Rationale: The correct answer is A,B. Firstly, keeping the child NPO (nothing by mouth) is essential before a flexible endoscopy to prevent aspiration. Secondly, preparing the child for the procedure ensures readiness and cooperation.
Choice C and E focus on prevention of choking hazards, not directly related to the procedure.
Choice D is important but typically done after the initial preparations. Waiting for return of gag reflex (F) is not necessary before a flexible endoscopy.
Extract:
Question 2 of 5
A nurse is planning postoperative care for an adolescent following scoliosis repair with spinal instrumentation. Which of the following actions should the nurse include in the plan of care?
Correct Answer: C
Rationale: The correct answer is C: Ensure two nurses logroll the adolescent every 2 hr. This action is crucial to prevent complications and maintain proper spinal alignment post-surgery. Logrolling involves turning the patient as a unit to prevent twisting or bending of the spine. It helps to avoid putting pressure on the surgical site and reduces the risk of injury. Maintaining the head of the bed at a 30° angle (
A) may be necessary for respiratory comfort but does not address the specific postoperative spinal care needed. Assisting the adolescent to ambulate 12 hr following surgery (
B) may be too soon and could risk injury. Offering sips of water 4 hr following surgery (
D) can be appropriate, but ensuring proper positioning and spinal care is more critical in the immediate postoperative period.
Extract:
A nurse is caring for a group of toddlers receiving digoxin therapy.
Question 3 of 5
For which of the following toddlers should the nurse revise the plan of care?
Correct Answer: D
Rationale: The correct answer is D: A toddler who has vomited 2 times in the last hour. Vomiting in a toddler can lead to dehydration and electrolyte imbalances, which can be potentially life-threatening. The nurse should revise the plan of care to address the vomiting and ensure hydration.
Choice A: A toddler with a digoxin level of 1.2 ng/mL falls within the therapeutic range, so the plan of care does not need revision based on this alone.
Choice B: An apical pulse of 100/min may be within the normal range for a toddler, so it does not necessarily warrant a revision of the plan of care.
Choice C: A potassium level of 4.0 mEq/L is within the normal range, so the plan of care does not need revision based on this parameter.
In summary, the nurse should revise the plan of care for the toddler who has vomited multiple times in the last hour to prevent dehydration and electrolyte imbalances
Extract:
Question 4 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: C
Rationale: The correct answer is C: Initiate airborne precautions. Varicella, commonly known as chickenpox, is highly contagious and spreads through airborne droplets. By initiating airborne precautions, the nurse helps prevent the transmission of the virus to others. Providing a warm blanket (
A) may be comforting but does not directly address the contagious nature of varicella. Assessing for Koplik spots (
B) is related to measles, not varicella. Administering aspirin for fever (
D) is contraindicated in children with varicella due to the risk of Reye's syndrome.
Question 5 of 5
A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
Correct Answer: C
Rationale: The correct answer is C. Vomiting can lead to decreased absorption of digoxin, potentially causing subtherapeutic levels and reducing the medication's effectiveness. A consistent therapeutic level of digoxin is vital for its intended therapeutic effects, such as improving cardiac output and reducing heart rate. Monitoring for signs of toxicity is crucial, but in this case, the nurse should prioritize addressing the vomiting episode to ensure proper drug absorption and efficacy.
Choices A, B, and D do not warrant a revision of the care plan as the apical pulse, potassium level, and digoxin level are within acceptable ranges.