ATI RN
RN ATI Pediatric Nursing Proctored Exam with NGN 2023 Questions
Extract:
Nurses’ Notes
1000:
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside. The child states, "I was running when we were playing, and tripped over a curb.” Child is supporting their arm across their body.
Assessment
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen non-distended. Right forearm and fingers are edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse =2. Fingers slightly cool to touch. Child can move fingers and reports a mild “tingling” sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Multiple areas of bruising are noted on lower extremities in various stages of healing
Vital Signs
1000
Temperature 368° C (98.2°F)
Heart rate 102/min
Respirator ate 22min '
BP 100/60 mm Hg
Oxygen saturation 98% on room air
Provider Prescriptions
1030;
Obtain x-rays of right arm, wrist, and elbow.
1145:
Ibuprofen 200 mg PO PRN pain rating of 5 on a scale of 00 10
Consult orthopedic department for cast application
1400:
Discharge to home.
Follow-up in office in 2 weeks.
Review synthetic cast care instructions with child and family.
Question 1 of 5
The nurse is continuing to care for the child. After reviewing the discharge instructions with the family, which of the following statements by a parent indicate an understanding of the discharge teaching?
| Parent Statement | Reflects Understanding | Needs Reinforcement |
|---|---|---|
| We should notify the provider if the cast becomes loose over time. | ||
| It is important that our child avoids placing anything inside the cast. | ||
| We should prop the casted arm on pillows for the next 24 hours. | ||
| We should expect the swelling to get better. | ||
| We need to be very careful about how we handle the cast for the first 2 days while it dries. |
Correct Answer: A,B,C,D,E
Rationale: [1,1,1,1,1]
Parent Statement: We should notify the provider if the cast becomes loose over time.
Reflects Understanding: This statement shows awareness of the need for prompt action in case of an issue with the cast, ensuring proper care.
Needs Reinforcement: None. This statement is crucial for the child's well-being.
Parent Statement: It is important that our child avoids placing anything inside the cast.
Reflects Understanding: This statement highlights the importance of maintaining the integrity of the cast to prevent complications.
Needs Reinforcement: None. Preventing foreign objects from entering the cast is essential.
Parent Statement: We should prop the casted arm on pillows for the next 24 hours.
Reflects Understanding: Proper elevation helps reduce swelling and promotes healing.
Needs Reinforcement: None. Elevation is a standard practice in cast care.
Parent Statement: We should expect the swelling to get better.
Reflects Understanding: Knowing that swelling should improve indicates awareness of the expected healing process
Extract:
Question 2 of 5
A nurse is caring for a client who has a history of depression and is experiencing a situational crisis. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Confirm the client's perception of the event. This is the first step because it helps the nurse understand the client's perspective, emotions, and triggers, which are crucial in crisis intervention. By confirming the client's perception, the nurse can establish rapport, validate the client's feelings, and assess the severity of the crisis. This information guides the nurse in developing an appropriate care plan and intervention strategies.
Choice A (Notify the client's support person) may be important but not the first step in crisis intervention.
Choice B (Teach the client relaxation techniques) and C (Help the client identify personal strengths) are valuable interventions but should come after assessing the client's perception.
Question 3 of 5
A nurse is assessing the fontanels of an infant. Which of the following findings should the nurse recognize as an expected finding?
Correct Answer: B
Rationale: The correct answer is B: The anterior fontanel is open. The anterior fontanel is typically open in infants to allow for brain growth and development. It is a normal finding during infancy and should close by around 18 months of age.
Choice A is incorrect because the posterior fontanel closes shortly after birth.
Choice C is incorrect because the fontanels are not expected to be the same size; the anterior fontanel is larger than the posterior fontanel.
Choice D is incorrect because the presence of molars in the fontanels would not be expected and could indicate a medical issue.
Question 4 of 5
A nurse is providing teaching about the administration of gastrostomy tube feedings to the parents of a school-age child. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: The correct answer is A: Administer the feeding over 30 min. This instruction is important to prevent complications such as aspiration and dumping syndrome. Administering the feeding slowly over 30 minutes allows for proper digestion and absorption.
Choice B is incorrect because feeding bags and tubing should be changed every 24 hours to prevent bacterial growth.
Choice C is incorrect because the child should be placed in an upright position, not supine, after the feeding to reduce the risk of aspiration.
Choice D is incorrect because warming formula in the microwave can create hot spots and lead to burns.
Extract:
Nurses' Notes
4 weeks ago:
21-year-old client reports increased stress and worry for the last 3 months. Client is worried about academic performance due to Inability to focus on studies. School performance is suffering. Denies illicit drug use and drinks in moderation socially on the weekends.
Discussed lifestyle modifications to reduce stress. Instructed client to return in 1 month to reevaluate symptoms.
Today:
Client reports a slight improvement in stress but is now having loss of appetite and difficulty sleeping.
Instructed client to begin trazodone per provider's prescription.
Question 5 of 5
A nurse is caring for a client in the outpatient health clinic. For each potential nursing Intervention, click to specify if the intervention is indicated or not indicated.
| Nursing intervention | Indicated | Not indicated |
|---|---|---|
| Encourage naps during the day when client is tired. | ||
| Encourage a regular sleep-wake schedule. | ||
| Encourage high-calorie finger foods. | ||
| Advise client to notify provider if pregnant. | ||
| Instruct client to avoid foods that have been fermented or aged. | ||
| Advise client to rise slowly from sitting position. | ||
| Encourage client to sleep until later in the morning. |
Correct Answer:
Rationale:
Correct Answer:
Rationale:
- Encouraging naps during the day when the client is tired is indicated for managing fatigue.
- Encouraging a regular sleep-wake schedule helps promote better sleep hygiene.
- Advising the client to notify the provider if pregnant is crucial for appropriate prenatal care.
- Other options are not indicated: high-calorie finger foods may not be suitable for all clients, avoiding fermented or aged foods is specific dietary advice, rising slowly is for orthostatic hypotension, and sleeping until later in the morning may disrupt the sleep-wake cycle.