ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 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 the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more 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: 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 mmHg, 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 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 the throat with no visual signs of foreign object in child's nose or ears upon inspection. Pupils equal, round, and reactive to light and accommodation. Abdomen soft and non-tender 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 plane 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, E
Rationale: A. Keeping the child NPO is crucial to prevent further ingestion or aspiration of the battery, which could lead to serious complications. This is the first priority to ensure safety. B. Teaching the child's parents the importance of inspecting the child's play area is important for future prevention but is not the immediate priority in this acute situation. C. Obtaining an informed consent is not the priority in this scenario. It should be done after keeping the child NPO. D. Encouraging parents to inspect toys for easily removable parts is important for prevention but is not the immediate priority when dealing with a child who has already ingested a foreign object. E. Preparing the child for flexible endoscopy is the second action to visualize and safely remove the battery from the esophagus, following the initial step of keeping the child NPO.
Extract:
Question 2 of 5
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: A. Daily weight monitoring is essential in managing nephrotic syndrome to assess for fluid retention and response to treatment. B. Positioning the child supine at bedtime is not specific to the management of nephrotic syndrome. C. Calorie intake may need to be increased rather than limited in nephrotic syndrome to compensate for protein loss and meet increased energy needs. D. Fluid intake may need to be restricted rather than increased, depending on the child's fluid status and response to treatment.
Question 3 of 5
A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective?
Correct Answer: B
Rationale: A. Furosemide is a loop diuretic that typically causes potassium loss, so an increase in potassium levels would not be expected as an indication of effectiveness. B. Furosemide is prescribed to reduce fluid volume overload, which often manifests as peripheral edema in patients with heart failure. A decrease in peripheral edema indicates that the medication is effectively reducing fluid retention. C. Furosemide is not typically prescribed to decrease cardiac output but rather to reduce fluid volume overload, which may help improve cardiac function indirectly. D. Furosemide is not typically prescribed to increase venous pressure but rather to decrease fluid volume overload, which may help reduce venous pressure over time.
Question 4 of 5
A nurse is preparing a child for a lumbar puncture. In which of the following positions should the child be placed for the procedure?
Correct Answer: B
Rationale: A. Placing the child prone (face-down) is not appropriate for a lumbar puncture as it would make access to the lumbar spine difficult. B. Placing the child in a lateral position (lying on their side with knees drawn up towards the chest) allows for proper positioning of the spine for the lumbar puncture procedure. C. Placing the child supine (lying on their back) is not appropriate for a lumbar puncture as it does not provide the necessary spinal alignment for the procedure. D. Placing the child in a semi-Fowler's position (with the head of the bed elevated at a 45-degree angle) is not appropriate for a lumbar puncture as it does not facilitate access to the lumbar spine.
Question 5 of 5
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should identify that which of the following laboratory tests can contribute to confirming this diagnosis? Select all that apply.
Correct Answer: B,C,D
Rationale: A. Partial thromboplastin time (PTT) is not typically used to diagnose rheumatic fever. It is used to evaluate coagulation disorders. B. Elevated C-reactive protein (CRP) levels indicate inflammation, which can be associated with rheumatic fever. C. Elevated erythrocyte sedimentation rate (ESR) is a marker of inflammation and can be elevated in rheumatic fever. D. Elevated Antistreptolysin O (ASO) titer indicates recent streptococcal infection, which is a predisposing factor for rheumatic fever. E. Blood urea nitrogen (BUN) is not typically used to diagnose rheumatic fever. It is used to assess kidney function.