ATI RN
ATI Nur 223a Sect 4 Pediatrics Final Exam Questions
Extract:
Mother of a boy with Tetralogy of Fallot.
Question 1 of 5
The nurse would teach the mother of a boy with Tetralogy of Fallot that if the child suddenly becomes cyanotic and dyspneic, the mother should:
Correct Answer: A
Rationale: Knee-chest position increases systemic vascular resistance, reducing right-to-left shunt and improving oxygenation.
Extract:
6-year-old child who has bacterial meningitis.
Question 2 of 5
A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care?
Correct Answer: A
Rationale: Measuring head circumference is unnecessary in a 6-year-old, as it is relevant for infants to monitor intracranial pressure.
Extract:
Nurses Notes (0700hrs): Guardian reports infant has been forcefully vomiting after feedings. Guardian states the emesis is so forceful that it often lands 3 to 4 feet away. Infant is very fussy and rooting and sucks vigorously on a pacifier. Guardian mentions the vomiting started about a week ago and has progressively worsened. Infant has had fewer wet diapers over the past two days. Guardian reports the infant has been crying more than usual and seems uncomfortable. Infant's weight has decreased slightly since the last visit. Vital Signs (0700hrs): Temperature: 37.8°C (100°F), Heart Rate: 160 bpm, Respiratory Rate: 40 breaths per minute, Blood Pressure: 80/50 mmHg, Oxygen Saturation: 98% on room air. Medical History (0700hrs): Full-term infant, born via vaginal delivery. No known allergies. Up-to-date on vaccinations. No previous hospitalizations or surgeries. Family history of gastrointestinal issues. Diagnostic Results (0700hrs): Complete Blood Count (CBC): WBC: 10,000/mm³, Hemoglobin: 12 g/dL, Platelets: 300,000/mm³. Electrolytes: Sodium: 138 mEq/L, Potassium: 4.0 mEq/L, Chloride: 102 mEq/L, Bicarbonate: 22 mEq/L. Physical Examination Results (0700hrs): Abdomen is distended and firm to touch. Visible peristaltic waves observed. No signs of dehydration such as dry mucous membranes or sunken fontanelle. Infant appears irritable and cries during the examination. Bowel sounds are hyperactive. No palpable masses detected. Provider's Prescriptions (0700hrs): NPO (nothing by mouth) status. IV fluids: D5 0.45% NS at 20 mL/hr. Monitor intake and output. Abdominal ultrasound to be performed. Administer ondansetron 0.15 mg/kg IV every 8 hours as needed for vomiting.
Question 3 of 5
Which of the following actions should the nurse take? (Select all that apply)
Correct Answer: C,E
Rationale:
Choice A: FACES Scale is for older children.
Choice B: NPO status prohibits feedings.
Choice C: Head circumference monitors for intracranial issues.
Choice D: No infectious cause for precautions.
Choice E: Weighing monitors dehydration.
Choice F: Enema is inappropriate for vomiting.
Extract:
Medical History: Diagnosis: Bilateral pneumonia, Past medical history: Cystic fibrosis, Plan: Aggressive airway clearance therapy, intravenous antibiotic therapy. Nurses Notes: 0700 hrs: Caregiver reports child has had increased coughing, fatigue, and a poor appetite for the past several days. Wheezing and rhonchi auscultated bilaterally. Respirations labored with accessory muscle use. Frequent cough productive with thick, yellow blood-streaked sputum. Dyspnea noted with activity. Child reports “a bit of a stomachache†and rates the discomfort as 3 on a scale of 0 to 10. Abdomen soft and non-tender to palpation. Active bowel sounds auscultated. 0900 hrs: Respirations rapid with accessory muscle use. Dyspnea noted while at rest. Frequent cough. Thick yellow sputum expectorated following airway clearance therapy. Child reports chest discomfort as 4 on a scale of 0 to 10. Child consumes approximately 50% of meals. Denies abdominal pain. Passed three large, frothy, foul-smelling stools. Vital Signs: 0700 hrs: Oral temperature: 39.1°C (102.4°F), Heart rate: 116/min, Respiratory rate: 32/min, Blood pressure: 102/60 mm Hg, Oxygen saturation: 95% on room air. 0900 hrs: Oral temperature: 38.1°C (100.6°F), Heart rate: 128/min, Respiratory rate: 32/min, Blood pressure: 88/48 mm Hg, Oxygen saturation: 88% on room air. Diagnostic Results: 0900 hrs: Chest X-ray: Bilateral infiltrates consistent with pneumonia, CBC: WBC: 15,000/mm³, Hemoglobin: 11 g/dL, Platelets: 250,000/mm³.
Question 4 of 5
Which of the following assessment findings should the nurse report to the provider? (Select all that apply)
Correct Answer: A,B,E
Rationale:
Choice A: 88% oxygen saturation indicates hypoxemia, requiring intervention.
Choice B: Heart rate of 128/min suggests increased work of breathing or distress.
Choice C: Chest discomfort is less critical than other findings.
Choice D: Elevated WBC is expected with pneumonia.
Choice E: Frothy stools indicate malabsorption, significant in cystic fibrosis.
Extract:
Parents of a child with frequent nosebleeds.
Question 5 of 5
A nurse is teaching the parents of a child with frequent nosebleeds how to care for the child. Which statement by the parents indicates that they have understood the teaching?
Correct Answer: B
Rationale: Upright and forward position with nose pressure is the correct technique.