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: First, the nurse should keep the child NPO (nothing by mouth) to prevent aspiration during the endoscopy (E). This is crucial for safety. Next, preparing the child for flexible endoscopy (E) is important to ensure the procedure is conducted smoothly.
Choices B, C, D, F are incorrect as they are not directly related to the immediate safety and preparation required for the endoscopy.
Extract:
Nurses' Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream apply to skin lesions daily. Assessment: Child is alert and responsive, Respiratory rate even and nonlabored at rate of 24/min. No adventitious sounds auscultated. Heart rate 108/min, Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities.
Question 2 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,D,F,G
Rationale:
Correct
Answer: A, B, D, F, G
Rationale:
A: Cutting and filing fingernails frequently is important to prevent scratching and worsening of lesions.
B: Using a mild detergent helps prevent skin irritation and flare-ups in children with skin conditions.
D: Informing about occasional flare-ups prepares the guardian for potential worsening of the condition.
F: Applying gloves to the child's hands can prevent scratching and spreading of the lesions.
G: Applying emollients after bathing helps maintain skin hydration and reduce dryness, which is beneficial for the child's skin condition.
Summary:
C: Pimecrolimus cream should not be applied thickly without specific instructions from the healthcare provider.
E: The statement about the condition being contagious is not accurate for most skin conditions and can lead to unnecessary fear and stigma.
Extract:
Question 3 of 5
A nurse is teaching the parent of a school-age child about bicycle safety. 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 important for bicycle safety as walking the bicycle through intersections allows the child to be more visible to drivers and reduces the risk of accidents. Riding against traffic (choice
A) is dangerous as it goes against traffic laws and increases the likelihood of collisions. Keeping the bicycle 3 feet from the curb (choice
B) is incorrect as it can put the child in the path of vehicles. Ensuring the child's feet are 3 to 6 inches off the ground (choice
D) is not a safety instruction related to bicycle riding.
Question 4 of 5
A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?
Correct Answer: B
Rationale:
Correct
Answer: B - Reposition the client using a turning sheet.
Rationale: Repositioning using a turning sheet helps prevent complications such as pressure ulcers and nerve damage. The halo vest immobilizes the cervical spine, making it crucial to use proper techniques to move the client safely.
Incorrect
Choices:
A: Encouraging flexion and extension of the neck is contraindicated as it can disrupt spinal alignment and lead to further injury.
C: Assessing the pin sites for infection every other day is important, but not the immediate action needed for client safety and comfort.
D: Tightening the screws on the halo device without proper instruction can lead to complications, and it is not the nurse's role to adjust the device without specific orders from the healthcare provider.
Question 5 of 5
A nurse is evaluating the pain level of a toddler who is cognitively impaired to a nonpharmacologic intervention. Which of the following pain scales should the nurse use to evaluate the toddler's pain level?
Correct Answer: C
Rationale: The correct answer is C: FLACC. FLACC stands for Face, Legs, Activity, Cry, and Consolability and is a pain assessment tool specifically designed for nonverbal or cognitively impaired individuals like toddlers. The tool assesses the toddler's facial expressions, leg movements, activity level, crying, and ability to be consoled. This comprehensive evaluation helps the nurse accurately determine the toddler's pain level. Visual analog scale (
A) and FACES scale (
B) require the ability to communicate and understand abstract concepts, making them unsuitable for cognitively impaired toddlers. CRIES scale (
D) is primarily used for infants and may not be as effective for toddlers.