ATI RN
ATI RN Pediatrics 2023 Questions
Extract:
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 Prescriptions: 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 4
For each the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Advise child's guardian about the use of sunscreen. | ||
| Administer salicylic acid for pain and fever. | ||
| Administer sulfamethoxazole and trimethoprim. | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluid. |
Correct Answer: A: Anticipated, B: Contraindicated, C: Contraindicated, D: Anticipated, E: Contraindicated
Rationale: [1, 0, 0, 1, 0]
For choice A, educating the child about proper perineal hygiene is anticipated as it promotes health.
Choice B, advising about sunscreen, is contraindicated as it may not be relevant to the client's condition.
Choice C, administering salicylic acid, is contraindicated as it can be harmful due to potential side effects.
Choice D, administering sulfamethoxazole and trimethoprim, is anticipated for treating infections.
Choice E, limiting fluid intake, is contraindicated as it can lead to dehydration.
Extract:
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 (101° F), Heart rate 112/min, Respiratory rate 24/min, Oxygen saturation 96% on room air
Question 2 of 4
For each of the following findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia.
| Findings | Acute laryngotracheobronchitis | pneumonia |
|---|---|---|
| Temperature | ||
| Stridor | ||
| Irritability | ||
| Cough findings at 0800 |
Correct Answer: A: Both, B: Acute laryngotracheobronchitis, C: Both, D: Acute laryngotracheobronchitis
Rationale:
To determine which findings are consistent with acute laryngotracheobronchitis or pneumonia, we need to consider the typical symptoms associated with each condition.
- A: Temperature is associated with both conditions, as fever is a common symptom in both acute laryngotracheobronchitis and pneumonia.
- B: Stridor is more commonly seen in acute laryngotracheobronchitis due to upper airway inflammation and narrowing.
- C: Irritability can be present in both conditions, as respiratory distress can cause irritability in children.
- D: Cough findings at 0800 typically indicate acute laryngotracheobronchitis, as cough is a defining symptom of this condition.
Therefore, the correct answer is A: Both, B: Acute laryngotracheobronchitis, C: Both, D: Acute laryngotracheobronchitis. Other choices are incorrect as they do not
Extract:
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, resulting in bleeding. History of allergic rhinitis. Assessment: Child alert, respiratory rate 24/min, no adventitious sounds, heart rate 108/min, generalized reddish scaly patches with lichenifications and depigmentation on bilateral extremities. Medication: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream daily
Question 3 of 4
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,C,D,E
Rationale:
To properly care for a child with a skin condition, the nurse should include the following instructions in the discharge plan:
A: Cutting and filing fingernails can prevent scratching and further skin irritation.
B: Emollients help maintain skin moisture and prevent dryness.
C: Gloves can protect the skin and prevent scratching, especially at night.
D: Using a mild detergent reduces the risk of skin irritation from harsh chemicals.
E: Informing about occasional flare-ups prepares the guardian for managing the condition's fluctuations.
Rationale for incorrect choices:
F: The condition is not contagious, so this statement is incorrect.
G: Pimecrolimus cream is not typically recommended as a first-line treatment for most skin conditions.
Extract:
15-year-old adolescent admitted for a vaso-occlusive crisis. Parent reports low-grade fever and vomiting for 3 days. Adolescent reports right-sided and low back pain, painful swollen hands and right knee, pain 8/10. 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%. Assessment: Yellow sclera, tender right upper quadrant, swollen painful hands and knee. Labs: Hct 28%, Hgb 6 g/dL, WBC 20,000/mm3, ALT 50 units/L, AST 62 units/L, Total bilirubin 3.0 mg/dL. Chest X-ray: cardiomegaly, systolic flow murmur
Question 4 of 4
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: B,D,E,G
Rationale:
Correct
Answer: B, D, E, G
Rationale:
- B: Placing the client on strict bed rest helps reduce joint stress in conditions like juvenile idiopathic arthritis.
- D: Ensuring pneumococcal vaccine is current is important for preventing infections in immunocompromised adolescents.
- E: Folic acid helps with red blood cell production in conditions like sickle cell anemia.
- G: Monitoring oxygen saturation is crucial in assessing respiratory status, especially in conditions like asthma.
Incorrect
Choices:
- A: Cold compresses may provide temporary relief but do not address the underlying issues.
- C: Oral hydroxyurea is typically used for sickle cell anemia, not for general adolescent care.
- F: Meperidine IV is not recommended for general pain management in adolescents due to potential side effects and addiction risks.
Extract:
5-year-old male 18 kg (39.7 lb) admitted following a motor-vehicle crash. Surgical procedure: L leg open reduction and fixation, L arm closed reduction and fixation. Vital Signs: Pulse rate 68/min, Respiratory rate 12/min, Blood pressure 80/42 mm Hg, Temperature 38.6° C (101.5° F), Oxygen saturation 91%. Medications: 0.9% sodium chloride IV at 100 mL/hr, Morphine 0.5 mg/hr IV, Acetaminophen 200 mg PO every 4 hr PRN for temperature >38° C
Question 5 of 4
A nurse is caring for a child who is 2 hr postoperative. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale:
Step 1: Assess circulation first to ensure adequate blood flow and oxygen delivery to the extremities.
Step 2: Compare the child's pedal pulses to establish baseline perfusion status.
Step 3: This helps in early detection of any potential circulatory compromise.
Step 4: If pulses are weak or absent, immediate intervention can be initiated to prevent further complications. Comparing pedal pulses is the priority as it directly assesses perfusion status. Other options like determining sedation level, assessing pain, or rechecking temperature can be addressed after ensuring adequate circulation.