ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
History and Physical: A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 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% on room air. Assessment: Awake, alert, and oriented X 3, Yellow sclera of eyes noted bilaterally, Right upper quadrant tender to palpation, Hands painful to touch and swollen bilaterally, Right knee is swollen, warm to palpation, and client reports pain as 8 on a scale of 0-10, Client is tearful and grimacing during the examination. Laboratory Results: Hct 28% (32% to 44%), Hgb 6g/dL (10 to 15.5 g/dL), WBC count 20,000/mm3 (6,200 to 17,000/mm3), ALT 50 units/L (4 to 36 units/L), AST 62 units/L (10 to 40 units/L), Total bilirubin 3.0 mg/dL (0.3 to 1.0 mg/dL), Chest radiographic examination indicates cardiomegaly and systolic murmur
Question 1 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Correct Answer: A,C,D,E,G
Rationale: The correct interventions are A, C, D, E, and G. A: Monitoring oxygen saturation is crucial for assessing respiratory status. C: Giving oral hydroxyurea is essential for managing sickle cell disease. D: Administering meperidine IV for pain control is appropriate. E: Ensuring the pneumococcal vaccine is current helps prevent infections. G: Administering folic acid is part of managing sickle cell disease. Summary: B is incorrect as restricting oral intake may worsen dehydration. F is incorrect as strict bed rest is not recommended for adolescents.
Extract:
Question 2 of 5
A nurse is caring for an infant who has necrotizing enterocolitis. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Rounded abdomen. In necrotizing enterocolitis, the infant may present with abdominal distension due to gas accumulation in the intestine. This distension can lead to a rounded appearance of the abdomen. Vomiting (
A) is less common in necrotizing enterocolitis. Hypertension (
B) is not a typical finding in this condition; in fact, hypotension is more common due to sepsis. Tachypnea (
D) may occur due to respiratory distress associated with the condition, but it is not a defining characteristic.
Question 3 of 5
A nurse is caring for a client who is postoperative following placement of a halo vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?
Correct Answer: B
Rationale:
Correct Answer: B - Reposition the client using a turning sheet.
Rationale: Repositioning using a turning sheet helps prevent complications such as pressure ulcers and nerve damage. The halo vest immobilizes the cervical spine, making it crucial to use proper techniques to move the client safely.
Incorrect
Choices:
A: Encouraging flexion and extension of the neck is contraindicated as it can disrupt spinal alignment and lead to further injury.
C: Assessing the pin sites for infection every other day is important, but not the immediate action needed for client safety and comfort.
D: Tightening the screws on the halo device without proper instruction can lead to complications, and it is not the nurse's role to adjust the device without specific orders from the healthcare provider.
Question 4 of 5
A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?
Correct Answer: A
Rationale: The correct answer is A because vomiting can affect the absorption and effectiveness of digoxin. Vomiting can lead to decreased drug levels in the bloodstream, potentially causing subtherapeutic effects. This can result in inadequate control of the toddler's condition and may lead to worsening symptoms.
Choices B, C, and D are within acceptable ranges and do not necessarily warrant a revision of the plan of care.
Choice B indicates a digoxin level within the therapeutic range, choice C indicates a slightly elevated pulse rate which can be expected with digoxin therapy, and choice D indicates a potassium level within the normal range.
Therefore, the nurse should focus on the toddler who has vomited to ensure proper absorption of the medication and adjust the plan of care accordingly.
Question 5 of 5
A nurse is caring for a 1-year-old child who has been hospitalized. Which of the following items in the child's room is a common source of health care-associated infection?
Correct Answer: B
Rationale: The correct answer is B: Bedside computer keyboard. The keyboard is a common source of healthcare-associated infections due to frequent use and potential contamination from various sources. Keyboards are often touched by multiple healthcare providers without proper cleaning, leading to the spread of pathogens. Unopened bottles of formula (
A) are typically sterile until opened. Disposable diapers (
C) are not a common source of infection if disposed of properly. Protective plastic gowns (
D) are used to prevent contamination rather than being a source of infection.