ATI RN
RN ATI Pediatric Nursing Exam (70 NGN Questions with Answers) Questions
Extract:
A nurse in the emergency department is preparing to discharge a 3-year- old child 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.
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?
Correct Answer: A,B,D,F,G
Rationale: The correct answer includes multiple important statements for the discharge instructions.
A: Cutting and filing fingernails prevent scratching and potential skin damage.
B: Cystic fibrosis is relevant medical information for the child's care.
D: Informing about occasional flare-ups helps prepare the guardian.
F: Applying gloves prevents scratching and potential skin infection.
G: Emollients maintain skin hydration and prevent dryness. These instructions promote optimal care and management of the child's condition. Other choices are incorrect as they either provide irrelevant information (
C), are not necessary for the child's care (E), or do not directly contribute to the child's well-being (
B).
Extract:
A nurse is caring for a 6-week-old infant. 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:
Admission:
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% Laboratory Results
Admission:
Chest x-ray: mild left ventricular hypertrophy is noted. Increased pulmonary vascular markings are noted in all lobes.
Question 2 of 5
Specify what condition the client is most likely experiencing.
Correct Answer: C
Rationale: The correct answer is C: Congestive heart failure. The client is most likely experiencing Congestive heart failure due to presenting symptoms such as dyspnea, fatigue, edema, and possibly crackles on lung auscultation. These symptoms are indicative of fluid accumulation in the lungs and peripheral tissues, common in congestive heart failure. Pyloric stenosis (
A) is a gastrointestinal condition, not related to the symptoms described. Respiratory syncytial virus bronchiolitis (
D) typically presents with respiratory distress in infants. The other choices are omitted as they are not relevant to the symptoms described.
Question 3 of 5
Specify 2 actions the nurse should take to address that condition.
Correct Answer: A,B
Rationale: The correct answers are A and B. A nurse should anticipate a prescription for digoxin as it is commonly prescribed for heart failure to improve heart function. Elevating the head of the bed to a 45° angle helps reduce the workload on the heart and improve respiratory function.
Choice C, implementing contact precautions, is unrelated to addressing the condition.
Choice D, providing chest physiotherapy and postural drainage, is not typically indicated for heart failure.
Question 4 of 5
Specify 2 parameters the nurse should monitor to assess the client's progress.
Correct Answer: B,C
Rationale: The correct parameters for the nurse to monitor to assess the client's progress are intake and output (
B) and respiratory status (
C). Monitoring intake and output is crucial to assess fluid balance and kidney function. Changes in these values can indicate dehydration or fluid overload. Respiratory status should be monitored to assess oxygenation and ventilation, which are essential for tissue perfusion and overall health.
The incorrect choices are A, D, E, F, and G. A (Number of steatorrhea stools) is not directly related to assessing overall client progress. D (Presence of periorbital edema) may be indicative of fluid retention but is not as direct as intake and output monitoring.
Choices E, F, and G are not provided, thus not applicable to the question.
Extract:
Nurses' Notes 0915:
Received the child awake, alert, and crying. Parent states that child was playing with 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. 0930:
Child is lying on parent's chest with eyes open and requesting sippy cup. Continues to have expiratory wheezing in bilateral upper lobes. Preparing child for diagnostic testing.
Exhibit 4
Laboratory Results 0930:
X- ray of the neck, chest, and abdomen completed. Biplane radiographic study identifies objects in esophagus. No foreign objects visualized in the chest or abdomen.
Question 5 of 5
Complete the following sentence by using the list of options. The nurse should first----- followed by -------
Correct Answer: E,F
Rationale: The correct answer is E, F. Firstly, keeping the child NPO (nothing by mouth) is essential before a flexible endoscopy to prevent aspiration during the procedure. Secondly, preparing the child for the flexible endoscopy involves informing them about the procedure and ensuring they are physically and emotionally ready.
Choice A is incorrect as it does not directly relate to the procedure; B is not the immediate priority before the endoscopy; C is important post-procedure, not first; D is relevant but not the initial step.