ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
A nurse is providing peritoneal dialysis to a child and observes there is minimal dialysate outflow at the end of the outflow time.
Question 1 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Instruct the child to change position. This action helps prevent complications such as clotting or kinking of the catheter during peritoneal dialysis. Changing positions can improve fluid flow and ensure proper dialysis efficiency. Increasing dwell time (choice
A) may lead to complications. Increasing oral fluid intake (choice
C) is important but not the immediate action needed. Assessing for a bruit (choice
D) is not relevant to peritoneal dialysis.
Extract:
A nurse is reviewing the laboratory results of a preschool-age child who has iron deficiency anemia.
Question 2 of 5
Which of the following actions should the nurse take?
Correct Answer: A
Rationale:
Correct
Answer: A - Request a provider prescription for ferrous sulfate.
Rationale: The nurse should request a prescription for ferrous sulfate as it is commonly used to treat iron deficiency anemia. By obtaining a prescription, the nurse can ensure that the appropriate dosage and monitoring are in place to address the underlying condition effectively.
Summary of other choices:
B: Administering factor VII concentrate is not appropriate without indication of a coagulation disorder.
C: While promoting oral hygiene is important, the use of a soft sponge toothbrush does not address any immediate medical need.
D: Placing the child in protective precautions is too vague and not specific to the given scenario about the action needed by the nurse.
Extract:
A nurse is caring for a 10-year-old child who is receiving chemotherapy. The child's guardian asks about managing adverse effects.
Question 3 of 5
Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct statement is D: "Use a soft-bristled toothbrush when platelet levels are low." This is important because during low platelet levels, there is an increased risk of bleeding. Using a soft-bristled toothbrush helps prevent gum bleeding and oral trauma.
Explanation of why other choices are incorrect:
A: "Rinse your child's mouth with chlorhexidine mouthwash if they develop stomatitis." - Chlorhexidine mouthwash may cause irritation and is not typically used for stomatitis in children.
B: "Ensure you administer an antiemetic for 12 hours after chemotherapy." - Antiemetics are usually given before or during chemotherapy to prevent nausea and vomiting, not necessarily after.
C: "Encourage eating by providing your child with their favorite foods." - Encouraging favorite foods may not always be suitable during certain treatments, especially if they are high in sugar or difficult to digest.
Extract:
Nurse's Notes (0700 hrs): The client reports a sudden onset of severe abdominal pain that started 4 hours ago. He describes the pain as sharp and constant, located in the upper right quadrant of the abdomen. The client has vomited twice in the past hour, with the vomitus being greenish in color. He denies any recent trauma or injury. The client appears anxious and is clutching his abdomen. He has a history of hypertension and is currently on medication for it. The client denies any known allergies; Physical Examination Results (0700 hrs): The client is alert and oriented but appears to be in significant distress. His skin is pale and diaphoretic. The abdomen is distended and tender to palpation, especially in the upper right quadrant. There is guarding and rebound tenderness noted. Bowel sounds are hypoactive. The client exhibits mild jaundice, with yellowing of the sclera. There are no visible signs of trauma or bruising on the abdomen; Vital Signs (0700 hrs): Temperature: 38.3°C (100.9°F), Pulse: 110 beats per minute, Respiratory Rate: 24 breaths per minute, Blood Pressure: 150/90 mm Hg, Oxygen Saturation: 95% on room air; A nurse is caring for a 45-year-old male client in the emergency department who presented with severe abdominal pain and vomiting.
Question 4 of 5
Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Notify the healthcare provider immediately. This is the priority action because it involves seeking guidance from the healthcare provider to address the situation effectively. By notifying the healthcare provider, the nurse can ensure timely and appropriate intervention based on the client's condition. Administering pain medication (
A) can wait until the healthcare provider is informed. Preparing for an abdominal ultrasound (
B) and inserting a nasogastric tube (
C) are important but not urgent in this scenario.
Therefore, they can be done after notifying the healthcare provider.
Extract:
Nurses' Notes (0800 hrs): The client's guardian reports that the child has been unable to sleep recently and has been very irritable. The guardian expresses concern about the child's skin condition worsening and the child scratching excessively, which results in the areas bleeding. The guardian states the child has a history of allergic rhinitis. The child appears alert and responsive but frequently scratches at the affected areas. The guardian mentions that the child has been using a new laundry detergent recently. The child has been given diphenhydramine 10 mg PO for itching. The guardian is worried about the potential for infection due to the open sores; Vital Signs (0800 hrs): Temperature: 37.2°C (99°F), Heart rate: 110/min, Respiratory rate: 22/min, Blood pressure: 100/60 mmHg; Physical Examination Results (0800 hrs): Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities. The affected areas are dry and rough to the touch. Some areas show signs of excoriation and minor bleeding. No signs of systemic infection observed. The child appears to be in mild distress due to itching; Medication Administration Record: Diphenhydramine 10 mg PO, 4 times per day, Pimecrolimus 1% cream, apply to skin lesions daily; A nurse is caring for a 3-year-old male client in the emergency department. The client presents with a history of irritability, scratching, and bleeding from skin lesions. The nurse is preparing to discharge the client.
Question 5 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,E,G
Rationale:
Correct
Answer: A, B, C, E, G
Rationale:
A: "You should use a mild detergent for your child's laundry." This is important to prevent skin irritation in sensitive skin.
B: "You should apply emollients to your child's skin after bathing." Emollients help in moisturizing and soothing the skin.
C: "You can apply gloves to your child's hands." Gloves can protect the skin from further irritation and damage.
E: "You should cut and file your child's fingernails frequently." Short nails help prevent scratching and worsening of skin lesions.
G: "Your child will experience occasional flare-ups of this condition." Setting realistic expectations about the condition helps in long-term management.
Summary:
D: "You should apply a thick layer of pimecrolimus cream to your child's lesions." Pimecrolimus cream is not usually recommended for all types of skin conditions.
F: "Your child's condition is contagious when lesions