ATI RN
ATI RN Pediatrics Nursing 2023 Questions
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 1 of 5
Select the 4 interventions the nurse should include.
Correct Answer: C,E,F,G
Rationale:
Choice A: Cold compresses worsen pain by causing vasoconstriction; warm compresses are better.
Choice B: Meperidine risks neurotoxicity; morphine is preferred.
Choice C: Folic acid supports red cell production in sickle cell disease.
Choice D: Hydration is key, not restriction.
Choice E: Hydroxyurea reduces crisis frequency.
Choice F: Continuous oxygen monitoring detects hypoxia.
Choice G: Bed rest lowers metabolic demand.
Choice H: Pneumococcal vaccine prevents infections, critical in sickle cell disease.
Extract:
A nurse is caring for a 1-week-old newborn who has hyperbilirubinemia and is being treated with phototherapy.
Question 2 of 5
Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Eye checks aren't needed routinely during phototherapy. Mittens are unrelated. Temperature monitoring every 2 hours prevents hypothermia from light exposure. Lotion can block light, reducing treatment efficacy.
Extract:
A nurse is preparing to administer immunizations to a 5-year-old child who is up-to-date with the current immunization schedule.
Question 3 of 5
Which of the following immunizations should the nurse plan to administer?
Correct Answer: D
Rationale: Rotavirus, hepatitis B, and Hib are completed earlier. The second varicella dose is given at 4-6 years, appropriate for a 5-year-old.
Extract:
Nurses' Notes (0700 hrs): Received the child awake, alert, and crying. Parent states that the child was playing with a remote control toy and when the parent heard the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual and witnessed them gagging periodically. Child is lying on the parent's chest with eyes open and requesting a ‘sippy cup'. Continues to have expiratory wheezing in bilateral upper lobes. Preparing the child for diagnostic testing; Vital Signs (0700 hrs): Heart rate: 90/min, Blood pressure: 88/45 mm Hg, Respiratory rate: 30/min, Oxygen saturation: 96%, Axillary temperature: 36.9° C (98.4° F); Diagnostic Results (0730 hrs): X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies an object in the esophagus. No foreign objects visualized in the chest or abdomen; Provider's Prescriptions (0745 hrs): Keep the child NPO, Prepare the child for flexible endoscopy, Obtain informed consent from the parents, Monitor the child closely for return of gag reflex; A nurse in the emergency department is caring for a toddler.
Question 4 of 5
Complete the following sentence by using the list of options. The nurse should first:
Correct Answer: D
Rationale: Preparing the child for flexible endoscopy is a necessary step to remove the foreign object from the esophagus. However, before any procedure can be performed, it is essential to obtain informed consent from the parents. Encouraging the parents to inspect toys for easily removable parts is an important preventive measure but not the immediate priority. Monitoring the child closely for the return of the gag reflex is relevant post-procedure. Obtaining informed consent is the first priority to ensure the parents are fully informed and have given permission for the procedure.
Extract:
Nurse's Notes (0700 hrs): The client reports a sudden onset of severe abdominal pain that started 4 hours ago. He describes the pain as sharp and constant, located in the upper right quadrant of the abdomen. The client has vomited twice in the past hour, with the vomitus being greenish in color. He denies any recent trauma or injury. The client appears anxious and is clutching his abdomen. He has a history of hypertension and is currently on medication for it. The client denies any known allergies; Physical Examination Results (0700 hrs): The client is alert and oriented but appears to be in significant distress. His skin is pale and diaphoretic. The abdomen is distended and tender to palpation, especially in the upper right quadrant. There is guarding and rebound tenderness noted. Bowel sounds are hypoactive. The client exhibits mild jaundice, with yellowing of the sclera. There are no visible signs of trauma or bruising on the abdomen; Vital Signs (0700 hrs): Temperature: 38.3°C (100.9°F), Pulse: 110 beats per minute, Respiratory Rate: 24 breaths per minute, Blood Pressure: 150/90 mm Hg, Oxygen Saturation: 95% on room air; A nurse is caring for a 45-year-old male client in the emergency department who presented with severe abdominal pain and vomiting.
Question 5 of 5
Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: Pain relief is secondary to provider notification given signs of peritonitis. Ultrasound preparation follows provider orders. Nasogastric tube insertion needs authorization. Notifying the provider ensures urgent evaluation for a potentially life-threatening condition.