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. 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 2 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 3 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.
Question 4 of 5
A nurse in an emergency department is caring for a 3-year-old child who has suspected epiglottitis. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Prepare to assist with intubation. Epiglottitis is a medical emergency where the epiglottis becomes inflamed and can lead to airway obstruction. Intubation may be necessary to secure the airway and ensure the child can breathe. It is a priority action to maintain the child's oxygenation and ventilation. Obtaining a throat culture (
B) can be important for diagnosis but is not the immediate priority. Suctioning the child's oropharynx (
C) can trigger a spasm and worsen the obstruction. Cool mist tent (
D) is not indicated in the management of epiglottitis.
Question 5 of 5
A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Assign the child to a negative air pressure room. Varicella, commonly known as chickenpox, is highly contagious and spreads through respiratory droplets. Placing the child in a negative air pressure room helps prevent the spread of the virus to others by containing the infectious particles within the room. This isolation measure is crucial in protecting both the child and other patients.
Choice B is incorrect because aspirin should not be administered to children with varicella due to the risk of Reye's syndrome.
Choice C is incorrect as droplet precautions are not necessary for varicella, which primarily spreads through airborne respiratory droplets.
Choice D is incorrect as Koplik spots are associated with measles, not varicella.