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.
Extract:
Question 2 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 3 of 5
A nurse is planning care for a toddler who has epiglottitis. Which of the following interventions should the nurse include?
Correct Answer: C
Rationale: The correct answer is C: Initiate droplet precautions. Epiglottitis is a serious condition that involves inflammation of the epiglottis, which can lead to airway obstruction. Droplet precautions are necessary to prevent the spread of infection, as epiglottitis is usually caused by a bacterial infection. Offering a high-calorie, high-protein diet (choice
A) is not the priority in the acute phase of epiglottitis. Administering pancreatic enzymes with meals (choice
B) is unrelated to the care of a toddler with epiglottitis. Carefully suctioning the child's oropharynx to remove secretions (choice
D) can potentially worsen the condition by triggering a gag reflex and causing further airway obstruction.
Question 4 of 5
A nurse is assessing a child who has measles. Which of the following areas should the nurse inspect for Koplik spots?
Correct Answer: C
Rationale: The correct answer is C. Koplik spots are small, white, grain-like spots with a red halo that appear on the buccal mucosa opposite the molars. They are specific to measles and typically appear 2-4 days before the rash. Inspecting other areas like the skin (choice
A), scalp (choice
B), nails (choice
D), ears (choice E), throat (choice F), or feet (choice G) would not reveal Koplik spots as they are only found in the mouth.
Therefore, choice C is the correct option for assessing Koplik spots in a child with measles.
Question 5 of 5
A nurse is providing teaching to the guardian of an 11-month-old infant who has acute diarrhea. Which of the following food items should the nurse instruct the parent to provide to the infant?
Correct Answer: B
Rationale: The correct answer is B: Oral rehydration solution. This is the most appropriate choice because infants with acute diarrhea are at risk of dehydration due to fluid loss. Oral rehydration solution helps replace lost fluids and electrolytes, preventing dehydration. Children's tea (
A) and white grape juice (
C) are not recommended as they can worsen diarrhea due to their high sugar content. Applesauce (
D) is also not suitable as it may be difficult for the infant to digest during diarrhea. It's important to prioritize rehydration in infants with diarrhea to prevent complications.