ATI RN
ATI RN Pediatrics Nursing 2023 Questions
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 1 of 5
For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
Correct Answer: A,B,E
Rationale: A: Sulfamethoxazole and trimethoprim treat the UTI. B: Sunscreen is advised due to photosensitivity from the antibiotic. E: Perineal hygiene prevents recurrent UTIs. Contraindicated: C: Salicylic acid risks Reye's syndrome. D: Fluid restriction is inappropriate; increased fluids help flush bacteria.
Extract:
History and Physical: A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10. Vital Signs: Temperature 37.8° C (100° F), Heart rate 100/min, Blood pressure 110/72 mm Hg, Respiratory rate 20/min, Oxygen saturation 95% on room air. Assessment: Awake, alert, and oriented x 3, Yellow sclera of eyes noted bilaterally, Right upper quadrant tender to palpation, Hands painful to touch and swollen bilaterally, Right knee is swollen, warm to palpation, and the client reports pain as 8 on a scale of 0 to 10. Client is tearful and grimacing during the examination. Laboratory Results: Hct 28% (32% to 44%), Hgb 6 g/dL (10 to 15.5 g/dL), WBC count 20,000/mm3 (6,200 to 17,000/mm3), ALT 50 units/L (4 to 36 units/L), AST 62 units/L (10 to 40 units/L), Total bilirubin 3.0 mg/dL (0.3 to 1.0 mg/dL).
Question 2 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: A,C,D,E,G
Rationale:
Correct Answer: A,C,D,E,G
Rationale:
A: Monitoring oxygen saturation is crucial in assessing respiratory status, especially in adolescents with potential respiratory issues.
C: Oral hydroxyurea is commonly used in treating certain hematologic conditions in adolescents.
D: Administering meperidine IV for pain management is appropriate for adolescents experiencing severe pain.
E: Ensuring the pneumococcal vaccine is current helps prevent serious infections in adolescents.
G: Administering folic acid as prescribed is essential for adolescents with certain medical conditions.
Summary:
B: Restricting oral intake may not be appropriate unless specified by a healthcare provider.
F: Strict bed rest is not typically recommended for adolescents unless medically necessary.
Extract:
Nurse's Notes (0700hrs): The adolescent is alert and oriented but appears distressed. Reports severe pain in the right side and lower back, rating it as 8/10. Hands and right knee are painful and swollen. The adolescent's parent reports a low-grade fever and vomiting for the past 3 days. The adolescent is lying in a fetal position, clutching their abdomen. Skin is warm and dry to touch. The adolescent is tearful and intermittently moaning in pain; Medical History: Diagnosed with sickle cell disease at age 2. History of multiple hospitalizations for vaso-occlusive crises. Last hospitalization was 6 months ago. No known drug allergies. Current medications include hydroxyurea and folic acid; Vital Signs (0700hrs): Temperature: 38.2°C (100.8°F), Heart rate: 110 beats per minute, Respiratory rate: 22 breaths per minute, Blood pressure: 130/80 mmHg, Oxygen saturation: 95% on room air; Physical Examination Results (0700hrs): Abdomen: Soft, non-distended, tender in the right lower quadrant. Musculoskeletal: Swelling and tenderness in the right knee and both hands. Neurological: Alert and oriented, no focal deficits. Skin: Warm, dry, no rashes or lesions; A nurse is caring for a 15-year-old adolescent who is admitted with a vaso-occlusive crisis in the emergency department.
Question 3 of 5
Select the 4 interventions the nurse should include.
Correct Answer: C,E,F,G
Rationale: The correct interventions are C, E, F, and G. C: Administering folic acid is essential for managing sickle cell anemia. E: Oral hydroxyurea helps reduce the frequency of pain crises. F: Continuous monitoring of oxygen saturation is crucial to detect hypoxia early. G: Bed rest helps reduce oxygen demand. A: Cold compresses may not directly address the underlying cause. B: Meperidine IV is not recommended due to potential complications. D: Restricting oral intake can worsen dehydration.
Extract:
Question 4 of 5
A nurse is planning postoperative care for an adolescent following scoliosis repair with spinal instrumentation. Which of the following actions should the nurse include in the plan of care?
Correct Answer: C
Rationale: The correct answer is C: Ensure two nurses logroll the adolescent every 2 hr. This action is crucial to prevent complications and maintain proper spinal alignment post-surgery. Logrolling involves turning the patient as a unit to prevent twisting or bending of the spine. It helps to avoid putting pressure on the surgical site and reduces the risk of injury. Maintaining the head of the bed at a 30° angle (
A) may be necessary for respiratory comfort but does not address the specific postoperative spinal care needed. Assisting the adolescent to ambulate 12 hr following surgery (
B) may be too soon and could risk injury. Offering sips of water 4 hr following surgery (
D) can be appropriate, but ensuring proper positioning and spinal care is more critical in the immediate postoperative period.
Question 5 of 5
A nurse is teaching a group of parents about childhood immunizations. The nurse should identify that infants should receive the first dose of which of the following immunizations at 12 months of age?
Correct Answer: D
Rationale: The correct answer is D: Varicella. Infants should receive the first dose of varicella (chickenpox) vaccine at 12 months of age to provide protection against the varicella virus, which can cause a highly contagious and potentially severe illness. Varicella vaccine is recommended by the CDC for children at this age to prevent complications such as pneumonia, encephalitis, and skin infections. The vaccine is given in two doses, with the second dose typically administered between ages 4-6 years.
Incorrect choices:
A: Inactivated polio virus - The first dose of inactivated polio virus vaccine is usually given at 2 months of age.
B: Hepatitis B - The first dose of hepatitis B vaccine is typically administered shortly after birth.
C: Human papillomavirus - HPV vaccine is not usually given until adolescence.
E, F, G: No information provided.