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. Complete the following sentence by using the list of options. The child is at highest risk of developing------ as evidenced bt the child's------
Correct Answer: C,F
Rationale: The correct answer is C, Compartment syndrome, and F, Paresthesia. Compartment syndrome results from increased pressure within a closed anatomical space, leading to compromised blood flow and nerve function. Paresthesia, abnormal sensations like tingling or numbness, is an early sign of nerve compression in compartment syndrome. The combination of these symptoms indicates a critical condition requiring immediate intervention to prevent tissue damage.
Choices A, B, D, and E do not align with the clinical presentation of compartment syndrome, whereas choice G, weak pulses, may be seen in severe cases but are not specific enough to be the highest risk factor in this scenario.
Question 2 of 5
The nurse is continuing to care for the child. The nurse should anticipate a prescription for pain medication.
Correct Answer: B,D
Rationale: The correct answers are B and D. A surgical consultation (
B) may be needed to address the underlying cause of the child's pain. Pain medication (
D) is essential to provide comfort and manage the child's pain. Skin traction (
A) and limb immobilization (E) are interventions for orthopedic issues, not for immediate pain relief. Antibiotics (
C) are not indicated unless there is an infection. Bed rest (F) is not a proactive measure for pain management.
Question 3 of 5
The nurse is continuing to care for the child. Select the 3 priority actions that the nurse should take.
Correct Answer: A,B,F
Rationale: The correct answers are A, B, and F.
A) Reviewing cast care instructions with the child's parents ensures proper care at home.
B) Administering ibuprofen helps manage pain and inflammation. F) Elevating the affected forearm reduces swelling.
Choices C, D, and E are incorrect because
C) placing a nonadherent dressing is not a priority over cast care,
D) explaining cast application to the child is not essential for ongoing care, and E) applying ice packs to fingers and forearm is not as crucial as administering pain relief and elevating the affected area.
Extract:
Question 4 of 5
A nurse is providing teaching about home safety to the adult child of an older adult client who is postoperative following knee replacement surgery. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: The correct answer is D: Ensure that area rugs have rubber backs. This instruction is important to prevent slips and falls, as rubber-backed rugs provide better traction on smooth surfaces, reducing the risk of accidents. Placing throw rugs over electrical cords (
B) can cause tripping hazards. Marking the edges of the doorway with tape (
C) may not be effective and can be unsightly. Encouraging the client to avoid wearing shoes at home (
A) may not directly impact safety. Overall, ensuring area rugs have rubber backs (
D) is the most practical and effective approach to enhancing home safety for a postoperative older adult.
Question 5 of 5
A nurse is planning care for a school-age child who is 4 hr postoperative following appendicitis. Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Administer analgesics on a scheduled basis for the first 24 hr. This is essential postoperatively to manage pain effectively and improve the child's comfort level. Pain management is crucial in the early stages following surgery to prevent complications and aid in the child's recovery. Applying a warm compress (choice
A) may not be appropriate for the surgical site and could potentially cause harm. Giving cromolyn nebulized solution (choice
C) is not indicated for pain management postoperatively. Offering clear liquids (choice
D) too soon after surgery could increase the risk of complications such as nausea, vomiting, or aspiration.