ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
Nurses' Notes (0700 hrs): Received the child awake, alert, and crying. Parent states that the child was playing with a 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. Child is lying on the parent's chest with eyes open and requesting a ‘sippy cup'. Continues to have expiratory wheezing in bilateral upper lobes. Preparing the child for diagnostic testing; Vital Signs (0700 hrs): Heart rate: 90/min, Blood pressure: 88/45 mm Hg, Respiratory rate: 30/min, Oxygen saturation: 96%, Axillary temperature: 36.9° C (98.4° F); Diagnostic Results (0730 hrs): X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies an object in the esophagus. No foreign objects visualized in the chest or abdomen; Provider's Prescriptions (0745 hrs): Keep the child NPO, Prepare the child for flexible endoscopy, Obtain informed consent from the parents, Monitor the child closely for return of gag reflex; A nurse in the emergency department is caring for a toddler.
Question 1 of 5
Complete the following sentence by using the list of options. The nurse should first:
Correct Answer: D
Rationale: The correct answer is D: Obtain informed consent. This is the first step the nurse should take before any medical procedure to ensure the patient understands the procedure, risks, and gives permission. A: Preparing the child for endoscopy, B: Encouraging parents to inspect toys, and C: Monitoring for gag reflex are all important steps but not the first priority. A thorough explanation of the procedure and obtaining consent must precede any action to ensure patient autonomy and safety.
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 2 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.
Action to Take
Potential Condition
Parameter to Monitor
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:
Medical History (0930): Three urinary tract infections over the past year treated with antibiotics. Diagnosed at 6 months old with vesicoureteral reflux; Vital Signs (0930): Heart rate: 128/min, Temperature: 38.4°C (101.1°F), Respiratory rate: 28/min; Nurse's Notes (0930): Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hours. Child febrile and lethargic. Notified provider of parent reports and child's fever. New prescriptions received. Urine sample obtained via sterile straight catheter; Diagnostic Results (1030): Urinalysis: Leukocyte esterase: positive (negative), Specific gravity: 1.035 (1.005 to 1.030), Appearance: cloudy and dark amber (clear), Nitrites: present (none), WBCs: 10 (0 to 4); Provider Prescriptions (0945): Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter; A nurse in a provider's office is caring for a 1-year-old toddler.
Question 3 of 5
The child is at risk for developing _______and__________ .
Correct Answer: A,C
Rationale: The correct answer is A and C. Pyelonephritis is a bacterial infection of the kidneys, common in children with underlying urinary tract abnormalities, putting them at risk. Renal scarring can result from untreated or recurrent pyelonephritis, leading to long-term kidney damage.
Choices B, D, and E are not directly related to the initial risk factors mentioned in the question.
Extract:
A nurse is teaching the parent of a school-age child about bicycle safety.
Question 4 of 5
Which of the following instructions should the nurse include in the teaching?
Correct Answer: C
Rationale: The correct answer is C: Your child should walk the bicycle through intersections. This instruction is crucial for safety as walking the bicycle through intersections reduces the risk of accidents. By walking the bicycle, the child can better navigate the intersection and avoid collisions with vehicles or pedestrians.
Choice A is incorrect because the child's feet should be able to touch the ground easily for stability.
Choice B is incorrect as children should always ride their bicycles in the same direction as traffic flow to prevent accidents.
Choice D is incorrect because keeping the bicycle at least 3 feet from the curb is not necessary and may obstruct traffic flow.
Extract:
Which of the following best describes the purpose of obtaining consent?
Question 5 of 5
To ensure the patient understands the risks.
Correct Answer: A
Rationale: The correct answer is A because obtaining permission from the patient's family for treatment is crucial to ensure that the patient understands the risks involved. Involving the family helps in providing comprehensive information and support to the patient.
Choice B is incorrect because the primary focus should be on patient care rather than protecting the nurse legally.
Choice C is incorrect as proceeding with treatment without patient input goes against the principles of informed consent.