ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Nurse Notes: Child presents to the emergency department (ED). Guardians report the child woke up coughing with a low-grade fever. Child appears alert and restless in guardian's arms. Respirations easy, no cough noted. 0800: Child became agitated. Hoarse cry noted with audible inspiratory stridor. Barking, non-productive cough present. Vital Signs: 0730: Tympanic temperature 38.1 C (100.6 F), Heart rate 95/min, Respiratory rate 20/min, Oxygen saturation 98% on room air. 0800: Tympanic temperature 38.2 C (100.6 F), Heart rate 95/min, Respiratory rate 20/min, Oxygen saturation 96% on room air. Provider Prescription: Sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO, Salicylic acid 20 mg/kg/dose every 4 hr as needed for pain and fever
Question 1 of 5
For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process.
| Finding | Acute laryngotracheobronchitis | pneumonia |
|---|---|---|
| Irritability | ||
| Cough findings at 0800 | ||
| Stridor | ||
| Temperature |
Correct Answer: A,B,C,D
Rationale: A. Both acute laryngotracheobronchitis (croup) and pneumonia can cause irritability in a child due to discomfort from respiratory symptoms and fever. B. The presence of a barking, non-productive cough at 0800 is consistent with acute laryngotracheobronchitis (croup), as it is a characteristic symptom. Pneumonia can also present with cough, but it is typically productive and associated with other respiratory symptoms such as dyspnea and crackles. C. Stridor, an inspiratory wheezing sound, is a hallmark symptom of acute laryngotracheobronchitis (croup) due to inflammation and narrowing of the upper airway. It is not typically associated with pneumonia. D. Fever can occur in both acute laryngotracheobronchitis (croup) and pneumonia. In this case, the tympanic temperatures of 38.1°C and 38.2°C are consistent with both conditions. However, pneumonia may present with higher fevers compared to croup.
Extract:
Question 2 of 5
A nurse is caring for a newly admitted child who has cystic fibrosis. For which of the following members of the interprofessional team should the nurse initiate a referral?
Correct Answer: A
Rationale: A. Nutritional management is crucial in cystic fibrosis due to malabsorption issues. A dietitian can provide guidance on appropriate dietary intake and may recommend enzyme replacement therapy. B. Occupational therapists may assist with activities of daily living, but their primary role may not be as critical initially as nutritional management. C. Speech-language pathologists primarily focus on speech and swallowing disorders, which may not be the primary concern at the time of admission. D. Physical therapists may assist with physical activity and mobility, but their primary role may not be as critical initially as nutritional management.
Question 3 of 5
A nurse is caring for a child who has epiglottitis due to an infection with Haemophilus influenzae type B. Which of the following actions should the nurse take? Select all that apply.
Correct Answer: C,D,E
Rationale: A. Inspecting the epiglottis is contraindicated in suspected cases of epiglottitis as it may trigger laryngospasm and compromise the airway. B. Obtaining a throat culture may be indicated to confirm the presence of Haemophilus influenzae type B but is not an immediate priority in the management of epiglottitis. C. Monitoring oxygen saturation is crucial as respiratory distress and hypoxia are common complications of epiglottitis. D. Beginning droplet precautions is important to prevent the spread of the infectious agent to others. E. Initiating IV access is necessary for administering fluids and medications, as well as for potential airway management in severe cases of epiglottitis.
Question 4 of 5
A nurse is assessing a preschool-age child who is in the immediate postoperative period following a tonsillectomy. Which of the following assessment findings is the priority?
Correct Answer: D
Rationale: A. The child's throat pain increasing is expected post-tonsillectomy and can be managed with pain medication. While important to address, it is not the priority in this situation. B. The child refusing clear liquids may indicate discomfort or difficulty swallowing, but it is not as immediately concerning as other assessment findings. C. The child crying often may be a response to pain or discomfort but does not indicate a physiological problem requiring immediate attention. D. The child swallowing frequently is a priority finding because it could indicate bleeding, which is a significant complication after tonsillectomy and requires immediate intervention to prevent further complications or deterioration in the child's condition.
Question 5 of 5
A nurse is assessing a 7-year-old child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
Correct Answer: B
Rationale: A. Increased capillary refill is not typically associated with hypoglycemia but may indicate poor peripheral circulation. B. Shakiness is a common manifestation of hypoglycemia due to the release of epinephrine in response to low blood sugar levels. C. Thirst is more commonly associated with hyperglycemia (high blood sugar levels) rather than hypoglycemia. D. Decreased appetite may occur in hypoglycemia, but it is not as specific a symptom as shakiness.