ATI RN
RN ATI Pediatric Nursing 2023 with NGN Questions
Extract:
A nurse is caring for a 7-year-old child who has a urinary tract infection (UTI). Nurses' Notes: 0700: 7-year old client who weighs 18.1kg (39.9lb) admitted with a UTI. Child reports pain and burning upon urination and feeling like they need to go to the bathroom all the time. Child's guardian reports the client has been incontinent of urine the past 2 nights and that the urine has a very strong odor. Vital Signs: 0715: Temperature: 38 °C (100.4° F). Heart rate: 80/min. Respiratory rate: 22/min. Blood pressure: 106/65 mm Hg. 0930: Temperature: 38.4°C (101.1° F). Heart rate: 90/min. Respiratory rate: 23/min. Blood pressure: 105/65 mm Hg. Provider Prescriptions: sulfamethoxazole and trimethoprim 8 mg TMP/kg/day PO. salicylic acid 20mg/kg/dose every 4hr as needed for pain and fever.
Question 1 of 5
The nurse is planning care for the client. For each of the following interventions, click to specify if the potential intervention is anticipated or contraindicated for the client.
| Potential Intervention | Anticipated | Contraindicated |
|---|---|---|
| Educate the child about proper perineal hygiene. | ||
| Administer sulfamethoxazole and trimethoprim | ||
| Administer salicylic acid for pain and fever | ||
| Ensure the child receives a maximum of 1,200 mL/day of fluids. | ||
| Advise the child's guardian about the use of cotton underwear. |
Correct Answer: A,B,E
Rationale: [1, 0, 1]
The correct answer is A, B, and E.
- A: Educating the child about proper perineal hygiene is anticipated to prevent infections.
- B: Administering sulfamethoxazole and trimethoprim is anticipated for treating infections.
- E: Advising the child's guardian about the use of cotton underwear can help maintain proper hygiene.
C: Administering salicylic acid for pain and fever is contraindicated as it is not suitable for treating infections.
D: Ensuring the child receives a maximum of 1,200 mL/day of fluids is not relevant to preventing infections.
Extract:
A nurse is caring for a school-age child who has cystic fibrosis. History and Physical: 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. Vital Signs: Temperature: 38.4°C (101.1°F). Heart rate: 100/min. Respiratory rate: 40/min. Blood pressure: 100/57 mm Hg. Laboratory Results: Sputum culture positive for Pseudomonas aeruginosa. Stool analysis positive for presence of fat and enzymes. Chest X-ray indicates obstructive emphysema. WBC count: 20,000/mm³ (normal range: 5,000 to 10,000/mm³).
Question 2 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?
Correct Answer: B,D,E
Rationale: The correct answer is B, D, and E. Dornase alfa is a medication used for cystic fibrosis, often prescribed for children with this condition. Water-soluble vitamins are commonly given to children to meet their nutritional needs. Pancreatic lipase is used to aid digestion in children with pancreatic insufficiency. Meperidine is not typically prescribed for children due to its potential for toxicity and adverse effects. Acetaminophen is a common over-the-counter medication but may not necessarily be part of the child's prescription regimen.
Therefore, A and C are less likely to be prescribed or reconciled from the child's medication list compared to B, D, and E.
Extract:
Question 3 of 5
A nurse is teaching the parent of an infant who has a new diagnosis of heart failure about nutrition. Which of the following instructions should the nurse include in the teaching?
Correct Answer: D
Rationale: The correct answer is D: Place the infant in an upright position during feeding. This position helps prevent regurgitation and aspiration, common issues in infants with heart failure. Placing the infant upright also facilitates easier breathing and digestion. Option A is incorrect because rigid feeding schedules may not be suitable for infants with heart failure. Option B does not address the specific needs of an infant with heart failure. Option C is inappropriate as it may cause distress to the infant and worsen their condition.
Extract:
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. History and Physical: 15-year-old adolescent admitted for a vaso-occlusive crisis. The parent reports low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and lower 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 mmHg. Respiratory rate: 20/min. Oxygen saturation: 95% on room air. Assessment: Awake, alert, and oriented ×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 the client reports pain as 8 on a scale of 0 to 10. Client is tearful and grimacing during the examination. Laboratory Results: Hct: 28% (32% to 44%). Hgb: 6 g/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 left flow murmur.
Question 4 of 5
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include:
Correct Answer: A,B,C,G
Rationale:
Correct Answer: A, B, C, G
Rationale:
A: Instruct the parent to ensure the pneumococcal vaccine is current to prevent pneumococcal infections in the adolescent.
B: Monitor oxygen saturation continuously to assess respiratory status and detect any potential respiratory issues.
C: Administer folic acid as prescribed to support the adolescent's growth and development.
G: Give Oral Hydroxyurea to manage conditions like sickle cell anemia in adolescents.
Incorrect
Choices:
D: Applying cold compresses to the affected joints is not relevant to the care of an adolescent unless specifically indicated for a certain condition.
E: Placing the client on strict bed rest is not typically recommended for adolescents as it can lead to deconditioning and other complications.
F: Administering meperidine (Demerol) for pain is not a standard intervention for adolescents and may have adverse effects.
Extract:
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?
Question 5 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: The correct answer is B: Reposition the client using a turning sheet. Repositioning the client using a turning sheet helps prevent skin breakdown and pressure ulcers, which are common risks associated with prolonged immobilization in a halo vest. Turning the client also promotes circulation and respiratory function.
Choice A is incorrect because tightening the screws on the halo device should be done by a healthcare provider as per specific instructions, not by the nurse.
Choice C is incorrect as encouraging flexion and extension of the neck can destabilize the cervical spine and interfere with the healing process.
Choice D is incorrect because assessing the pin sites for infection should be done daily, not every other day, to promptly detect and treat any signs of infection.