ATI RN
ATI RN Pediatric Nursing 2023 Exam 3 Questions
Extract:
Nurses' Notes: The child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis. Medication Administration Record: Diphenhydramine 10 mg PO 4 times per day, Pimecrolimus 1% cream apply to skin lesions daily. Assessment: Child is alert and responsive, Respiratory rate even and nonlabored at rate of 24/min. No adventitious sounds auscultated. Heart rate 108/min, Generalized small clusters of reddish, scaly patches with lichenifications and depigmentation on the child's bilateral upper and lower extremities.
Question 1 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,D,F,G
Rationale:
Correct Answer: A, B, D, F, G
Rationale:
A: Cutting and filing fingernails frequently is important to prevent scratching and worsening of lesions.
B: Using a mild detergent helps prevent skin irritation and flare-ups in children with skin conditions.
D: Informing about occasional flare-ups prepares the guardian for potential worsening of the condition.
F: Applying gloves to the child's hands can prevent scratching and spreading of the lesions.
G: Applying emollients after bathing helps maintain skin hydration and reduce dryness, which is beneficial for the child's skin condition.
Summary:
C: Pimecrolimus cream should not be applied thickly without specific instructions from the healthcare provider.
E: The statement about the condition being contagious is not accurate for most skin conditions and can lead to unnecessary fear and stigma.
Extract:
Question 2 of 5
A nurse on a pediatric unit is caring for four children. The nurse should use droplet precautions for which of the following children?
Correct Answer: C
Rationale: The correct answer is C: a toddler who has seasonal influenza. Droplet precautions are used for illnesses transmitted through respiratory secretions, such as influenza. Seasonal influenza is a contagious respiratory illness spread through droplets when an infected person coughs or sneezes. This precaution includes wearing a mask within close proximity to the child to prevent the spread of the virus.
Incorrect choices:
A: Pediculosis capitis (head lice) is spread through direct head-to-head contact, not respiratory secretions.
B: Viral conjunctivitis is an eye infection spread through direct contact with discharge from the eye, not respiratory droplets.
D: Hepatitis A is primarily spread through the fecal-oral route, not respiratory secretions.
Question 3 of 5
A nurse is caring for a newly admitted child who has cystic fibrosis. For which of the following members of the interprofessional team should the nurse initiate a referral?
Correct Answer: A
Rationale: The correct answer is A: Dietitian. In cystic fibrosis, nutrition is crucial due to malabsorption issues. A dietitian can assess the child's nutritional needs, provide dietary recommendations, and help optimize nutrient intake. Referring to an occupational therapist (
B) would address activities of daily living, not specific to cystic fibrosis. Speech-language pathologists (
C) focus on speech and swallowing disorders, not directly related to cystic fibrosis. Physical therapists (
D) primarily address mobility and physical function, which may not be the priority in cystic fibrosis.
Extract:
History and Physical: Infant was full-term at birth. Birth weight was 3.5 kg (7.7 lb). Infant is not gaining weight as expected. One week ago at outpatient visit, weight was 3.6 kg (7.9 lb). Parent reports for past 2 days infant is breathing faster during feedings and does not finish feedings. Parent also reports decreased appetite and puffiness around the infant's eyes. Parent states that the last wet diaper was about 10 hr ago. Infant admitted for diagnostic evaluation, failure to thrive, and nutritional/fluid support. Vital Signs: Admission: Temperature 37.7° C (99.9° F), Heart rate 174/min while sleeping, Respiratory rate 72/min while sleeping. Assessment: Respirations: Tachypneic with moderate retractions and nasal flaring. Upon auscultation, crackles heard in all lung fields. No nasal drainage noted. Dry cough noted periodically. Skin: Pallor, scalp is diaphoretic, lower extremities are cool to touch. Cardiac: Tachycardic, regular rhythm, no murmur is heard. Peripheral pulses are full and bounding in the upper extremities and weak bilateral pedal pulses are noted. Fluids: Mucous membranes are slightly dry and pink. Skin turgor is slightly decreased. Capillary refill is 3 seconds. Noted periorbital edema and nonpitting edema of feet. Anterior fontanel is soft and slightly depressed. Diaper remains dry. Abdomen: Soft, full, round, bowel sounds are present and active. Blood pressure in right upper extremity 60/39 mm Hg, Oxygen saturation 90%
Question 4 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: C
Rationale: Action to Take: Provide chest physiotherapy and postural drainage; Potential Condition: Cystic fibrosis; Parameter to Monitor: Number of steatorrhea stools, Intake and output.
Rationale:
1. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system, leading to thick mucus production. Chest physiotherapy and postural drainage help clear mucus from the lungs.
2. Monitoring the number of steatorrhea stools is important as it indicates malabsorption in cystic fibrosis. Intake and output monitoring helps assess hydration status and nutritional intake.
3. Pyloric stenosis, congestive heart failure, and respiratory syncytial virus bronchiolitis are not conditions typically associated with chest physiotherapy and postural drainage.
4. Anticipating a prescription for digoxin and implementing contact precautions are not relevant actions for addressing cystic fibrosis.
5. Monitoring for periorbital edema is
Extract:
Question 5 of 5
A nurse is planning care for a child who is in the acute stage of nephrotic syndrome. Which of the following interventions should the nurse include in the plan of care?
Correct Answer: A
Rationale: The correct answer is A: Weigh the child once per day. In nephrotic syndrome, monitoring weight daily is crucial to assess fluid status and response to treatment. Weight gain indicates fluid retention, a common complication. Positioning the child supine (
B) is not relevant. Calorie intake should be sufficient to meet increased metabolic demands, so limiting it to 45 cal/kg/day (
C) is incorrect. Increasing fluid intake to 2 L/day (
D) may worsen fluid overload.