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: [
Rationale: ]
A - Irritability: Both acute laryngotracheobronchitis and pneumonia can cause irritability due to respiratory distress.
B - Cough findings at 0800: Both conditions manifest with cough, often worse in the morning.
C - Stridor: Stridor is a common sign of upper airway obstruction seen in acute laryngotracheobronchitis.
D - Temperature: Fever is a common symptom in both acute laryngotracheobronchitis and pneumonia.
Summary:
- Acute laryngotracheobronchitis and pneumonia can both present with irritability, cough, stridor, and fever.
Extract:
Nurses' Notes: 0700: 7 year old client who weighs 18.1 kg (39.9 lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor. Vital Signs: 0715: Temperature 38 C (100.4 F), Heart rate 80/min, Respiratory rate 22/min, Blood pressure 106/65 mm Hg. 0930: Temperature 38.4 C (101.1 F), Heart rate 90/min, Respiratory rate 23/min, Blood pressure 105/65 mm Hg. 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 2 of 5
The nurse is planning care for the client. For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Intervention | Anticipated |
|---|---|
| Educate the child about proper perineal hygiene | |
| Administer sulfamethoxazole and trimethoprim | |
| Administer salicylic acid for pain and fever | |
| Ensure the child receives a maximum of 1,200 mL/day of fluid | |
| Advise child's guardian about the use of sunscreen |
Correct Answer: A,B,E
Rationale: [1,0,1]
Correct
Answer: A,B,E
Rationale:
A: Educating the child about proper perineal hygiene is anticipated to prevent infections.
B: Administering sulfamethoxazole and trimethoprim is anticipated for treating infections.
E: Advising about sunscreen is anticipated to prevent sunburn.
Others are contraindicated as salicylic acid may not be suitable for pain and fever, fluid intake should be individualized.
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 3 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 4 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 5 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.