ATI RN
ATI RN Pediatrics Nursing 2023 Questions
Extract:
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever.
Question 1 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:
Medical History (0930): Three urinary tract infections over the past year treated with antibiotics. Diagnosed at 6 months old with vesicoureteral reflux; Vital Signs (0930): Heart rate: 128/min, Temperature: 38.4°C (101.1°F), Respiratory rate: 28/min; Nurse's Notes (0930): Parent presents child to provider's office. Parent reports the child has had a fever for 2 days and that the child has cried more than usual. Parent also reports the child has had a decreased appetite for the last 24 hours. Child febrile and lethargic. Notified provider of parent reports and child's fever. New prescriptions received. Urine sample obtained via sterile straight catheter; Diagnostic Results (1030): Urinalysis: Leukocyte esterase: positive (negative), Specific gravity: 1.035 (1.005 to 1.030), Appearance: cloudy and dark amber (clear), Nitrites: present (none), WBCs: 10 (0 to 4); Provider Prescriptions (0945): Obtain urine sample for urinalysis and culture and sensitivity via sterile straight catheter; A nurse in a provider's office is caring for a 1-year-old toddler.
Question 2 of 5
The child is at risk for developing _______and__________ .
Correct Answer: A,C
Rationale:
Choice A rationale: Pyelonephritis is a type of urinary tract infection (UTI) that affects the kidneys. The toddler's history of multiple UTIs and current symptoms suggest a risk for kidney involvement.
Choice B rationale: Polycystic kidney disease is a genetic disorder not associated with recurrent UTIs.
Choice C rationale: Renal scarring can occur from recurrent UTIs and vesicoureteral reflux, impairing kidney function.
Choice D rationale: Nephrotic syndrome is not typically linked to UTIs or reflux.
Choice E rationale: Acute glomerulonephritis is not commonly associated with recurrent UTIs.
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 3 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 teaching the parent of a school-age child about bicycle safety.
Question 4 of 5
Which of the following instructions should the nurse include in the teaching?
Correct Answer: C
Rationale: This is incorrect because the child's feet should be able to touch the ground comfortably when seated on the bicycle for balance and control. Riding against the flow of traffic is dangerous and increases accident risk. Walking the bicycle through intersections ensures visibility and reduces collision risk. Keeping the bicycle 3 feet from the curb is not standard; children should ride close to the curb with traffic flow.
Extract:
A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever.
Question 5 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.