ATI RN
ATI RN Pediatrics 2023 Questions
Extract:
15-year-old adolescent admitted for a vaso-occlusive crisis. Parent reports low-grade fever and vomiting for 3 days. Adolescent reports right-sided and low back pain, painful swollen hands and right knee, pain 8/10. Vital Signs: Temperature 37.8° C (100° F), Heart rate 100/min, Blood pressure 110/72 mm Hg, Respiratory rate 20/min, Oxygen saturation 95%. Assessment: Yellow sclera, tender right upper quadrant, swollen painful hands and knee. Labs: Hct 28%, Hgb 6 g/dL, WBC 20,000/mm3, ALT 50 units/L, AST 62 units/L, Total bilirubin 3.0 mg/dL. Chest X-ray: cardiomegaly, systolic flow murmur
Question 1 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: B,D,E,G
Rationale:
Correct
Answer: B, D, E, G
Rationale:
- B: Placing the client on strict bed rest helps reduce joint stress in conditions like juvenile idiopathic arthritis.
- D: Ensuring pneumococcal vaccine is current is important for preventing infections in immunocompromised adolescents.
- E: Folic acid helps with red blood cell production in conditions like sickle cell anemia.
- G: Monitoring oxygen saturation is crucial in assessing respiratory status, especially in conditions like asthma.
Incorrect
Choices:
- A: Cold compresses may provide temporary relief but do not address the underlying issues.
- C: Oral hydroxyurea is typically used for sickle cell anemia, not for general adolescent care.
- F: Meperidine IV is not recommended for general pain management in adolescents due to potential side effects and addiction risks.
Extract:
5-year-old male 18 kg (39.7 lb) admitted following a motor-vehicle crash. Surgical procedure: L leg open reduction and fixation, L arm closed reduction and fixation. Vital Signs: Pulse rate 68/min, Respiratory rate 12/min, Blood pressure 80/42 mm Hg, Temperature 38.6° C (101.5° F), Oxygen saturation 91%. Medications: 0.9% sodium chloride IV at 100 mL/hr, Morphine 0.5 mg/hr IV, Acetaminophen 200 mg PO every 4 hr PRN for temperature >38° C
Question 2 of 5
A nurse is caring for a child who is 2 hr postoperative. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale:
Step 1: Assess circulation first to ensure adequate blood flow and oxygen delivery to the extremities.
Step 2: Compare the child's pedal pulses to establish baseline perfusion status.
Step 3: This helps in early detection of any potential circulatory compromise.
Step 4: If pulses are weak or absent, immediate intervention can be initiated to prevent further complications. Comparing pedal pulses is the priority as it directly assesses perfusion status. Other options like determining sedation level, assessing pain, or rechecking temperature can be addressed after ensuring adequate circulation.
Extract:
School-age child admitted, diagnosed with cystic fibrosis at 3 months of age, has experienced failure to thrive, and has chronic obstructive pulmonary disease. The child presents with wheezing, rhonchi, paroxysmal cough, and dyspnea. The parent reports large, frothy, foul-smelling stools. The child has deficient levels of vitamin A, D, E, and K. Barrel-shaped chest, Clubbing of the fingers bilaterally, Respiratory rate 40/min with wheezing and rhonchi noted bilaterally, dyspnea, and paroxysmal cough
Question 3 of 5
A nurse is reviewing the child's medical record. Which of the following medications should the nurse expect the provider to prescribe or reconcile from the child's home medication list? Select all that apply.
Correct Answer: B,D
Rationale: The correct answers are B (Dornase alfa) and D (Pancreatic Apase) because they are specific medications used for respiratory and pancreatic conditions in children. Dornase alfa is used in cystic fibrosis to help clear mucus, and Pancreatic Apase aids in digestion. Water-soluble vitamins (
A) are typically available over the counter and not usually prescribed. Acetaminophen (
C) is a common over-the-counter pain reliever. Meperidine (E) is a narcotic pain medication not commonly used in children due to safety concerns.
Extract:
Medication Administration Record - Diphenhydramine 10 mg PO 4 times per day - Pimecrolimus 1% cream apply to skin lesions daily
Question 4 of 5
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian? Select all that apply.
Correct Answer: A,B,C,D,F,G
Rationale: The correct answer includes statements A, B, C, D, F, and G. A: Using a mild detergent is important to prevent skin irritation. B: Applying gloves can protect the hands from further damage. C: Cutting and filing fingernails prevent scratching and infection. D: Emollients after bathing help maintain skin moisture. F: Mentioning that the condition is contagious when lesions are present helps prevent spread. G: Informing about occasional flare-ups prepares the guardian for future management. These instructions aim to promote hygiene, prevent exacerbations, and manage the child's condition effectively.
Extract:
Nurses notes 0930: Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hr. Child febrile and lethargic. 0945: Notified provider of parent reports and child's fever. New prescriptions received. 1000: Urine sample obtained via sterile straight catheter.
Question 5 of 5
The child is at risk for developing ___ and ___.
Correct Answer: A,B
Rationale: The correct answer is A (pyelonephritis) and B (renal scarring). Pyelonephritis is a bacterial infection of the kidneys, common in children, leading to kidney inflammation and scarring. Renal scarring can result from untreated or recurrent pyelonephritis, impairing kidney function. Nephrotic syndrome (
C) is characterized by proteinuria and edema, not directly associated with pyelonephritis. Acute glomerulonephritis (
D) is also a kidney inflammation but typically caused by immune responses, not directly related to pyelonephritis. Polycystic kidney (E) is a genetic disorder causing cysts in the kidneys, not a risk associated with pyelonephritis.