ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
A nurse is caring for an infant who has necrotizing enterocolitis.
Question 1 of 5
Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: Vomiting and tachypnea may occur but are less specific. Hypertension isn't typical. A rounded abdomen from intestinal swelling and gas is a hallmark of necrotizing enterocolitis.
Extract:
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever.
Question 2 of 5
Which of the following laboratory tests can contribute to confirming this diagnosis? Select all that apply.
Correct Answer: A,D,E
Rationale: ASO titer confirms recent streptococcal infection, a rheumatic fever trigger. ESR and CRP indicate inflammation, supporting diagnosis. PTT and BUN are unrelated to rheumatic fever.
Extract:
Nurses' Notes (0700 hrs): Received the child awake, alert, and crying. Parent states that the child was playing with a remote control toy and when the parent heard the child crying, they noticed that a battery was missing from the toy. The parent states that the child was drooling more than usual and witnessed them gagging periodically. Child is lying on the parent's chest with eyes open and requesting a ‘sippy cup'. Continues to have expiratory wheezing in bilateral upper lobes. Preparing the child for diagnostic testing; Vital Signs (0700 hrs): Heart rate: 90/min, Blood pressure: 88/45 mm Hg, Respiratory rate: 30/min, Oxygen saturation: 96%, Axillary temperature: 36.9° C (98.4° F); Diagnostic Results (0730 hrs): X-ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies an object in the esophagus. No foreign objects visualized in the chest or abdomen; Provider's Prescriptions (0745 hrs): Keep the child NPO, Prepare the child for flexible endoscopy, Obtain informed consent from the parents, Monitor the child closely for return of gag reflex; A nurse in the emergency department is caring for a toddler.
Question 3 of 5
Complete the following sentence by using the list of options. The nurse should first:
Correct Answer: D
Rationale: Preparing the child for flexible endoscopy is a necessary step to remove the foreign object from the esophagus. However, before any procedure can be performed, it is essential to obtain informed consent from the parents. Encouraging the parents to inspect toys for easily removable parts is an important preventive measure but not the immediate priority. Monitoring the child closely for the return of the gag reflex is relevant post-procedure. Obtaining informed consent is the first priority to ensure the parents are fully informed and have given permission for the procedure.
Extract:
A nurse is preparing to collect a capillary blood specimen from the heel of a 4-month-old infant.
Question 4 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Cool packs reduce blood flow. The outer heel minimizes pain and injury. Lancets, not blades, are used. Clean with alcohol before, not after, to avoid irritation.
Extract:
Nurse's Notes: The infant presents with tachypnea, moderate retractions, and nasal flaring. Auscultation reveals crackles in all lung fields, with no nasal drainage. The infant has a dry cough that occurs periodically. The skin appears pale, the scalp is diaphoretic, and the lower extremities are cool to the touch. The infant is tachycardic with a regular rhythm, and no murmur is heard. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. Mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The diaper remains dry. The abdomen is soft, full, and round, with active bowel sounds; Medical History: The infant was born at 38 weeks gestation via vaginal delivery with no complications. The infant has had no previous hospitalizations or surgeries. The infant has been exclusively breastfed and has no known allergies. The mother reports that the infant has been feeding poorly for the past two days and has had decreased urine output. There is no family history of congenital heart disease or respiratory conditions; Diagnostic Results: Chest X-ray: Mild left ventricular hypertrophy noted. Increased pulmonary vascular markings in all lobes; Complete Blood Count (CBC): White Blood Cells (WBC): 12,000/mm³ (4,500-11,000/mm³), Hemoglobin (Hgb): 11 g/dL (11-14 g/dL), Hematocrit (Hct): 33% (33-39%), Platelets: 250,000/mm³ (150,000-450,000/mm³); Electrolytes: Sodium (Na): 138 mEq/L (135-145 mEq/L), Potassium (K): 4.2 mEq/L (3.5-5.0 mEq/L), Chloride (Cl): 102 mEq/L (98-106 mEq/L), Bicarbonate (HCO3): 22 mEq/L (22-28 mEq/L); Vital Signs: Temperature: 37.7°C (99.9°F), Heart rate: 174/min while sleeping, Respiratory rate: 72/min while sleeping, Blood pressure in right upper extremity: 60/39 mm Hg, Oxygen saturation: 90%; Physical Examination Results: The infant is alert but irritable. The skin is pale with a diaphoretic scalp and cool lower extremities. The infant exhibits tachypnea with moderate retractions and nasal flaring. Crackles are heard in all lung fields upon auscultation. The heart rate is tachycardic with a regular rhythm, and no murmur is detected. Peripheral pulses are full and bounding in the upper extremities but weak in the bilateral pedal pulses. The mucous membranes are slightly dry and pink, with slightly decreased skin turgor. Capillary refill time is 3 seconds. Periorbital edema and non-pitting edema of the feet are noted. The anterior fontanel is soft and slightly depressed. The abdomen is soft, full, and round, with active bowel sounds; A nurse is caring for a 6-week-old infant in the pediatric unit.
Question 5 of 5
Complete the diagram by dragging from the choices below to specify: 1. What condition the client is most likely experiencing 2. Two actions the nurse should take to address that condition 3. Two parameters the nurse should monitor to assess the client's progress.
Correct Answer: A,E
Rationale: Condition Most Likely Experiencing: Congestive heart failure. The infant's symptoms, including tachypnea, retractions, nasal flaring, crackles, tachycardia, weak pedal pulses, periorbital edema, and non-pitting edema, along with chest X-ray findings of left ventricular hypertrophy and increased pulmonary vascular markings, are consistent with congestive heart failure. Actions to Take: 1. Anticipate a prescription for digoxin to improve cardiac output. 2. Elevate the head of the bed to a 45° angle to reduce breathing effort and pulmonary congestion. Parameters to Monitor: Peripheral pulses to assess circulation improvement and respiratory status to track reduction in congestion.