ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
A nurse is planning care for a child who has a prescription to transfuse 2 units of packed RBCs.
Question 1 of 5
Which of the following interventions should the nurse include in the plan of care?
Correct Answer: B
Rationale: Blood shouldn't stay at room temperature over 30 minutes. Infuse within 4 hours to avoid contamination. Use filtered tubing to prevent clots. Dextrose can cause hemolysis; use saline.
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 2 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.
Extract:
A nurse is caring for an infant who has heart failure and vomited following administration of digoxin.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Increased fluids risk overload. Antiemetics need provider approval. Administer the next dose on schedule; don't repeat vomited doses. Mixing with large formula volumes affects absorption.
Extract:
A nurse is assessing a school-age child who is receiving prednisolone.
Question 4 of 5
For which of the following adverse effects should the nurse monitor?
Correct Answer: B
Rationale: Prednisolone causes hypertension, not hypotension. It delays wound healing due to immunosuppression. Renal failure and Stevens-Johnson syndrome are not common side effects.
Extract:
A nurse is working in a nursing home.
Question 5 of 5
What is the first priority for the nurse in this situation?
Correct Answer: A
Rationale: Moving patients from harm ensures immediate safety, the top priority in a fire. Removing flammables or extinguishing fires is secondary. Reporting to the fire area risks safety. Full evacuation may follow after initial safety measures.