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ATI PN Paediatrics Nursing 2023
Total Questions : 64
Showing 10 questions, Sign in for moreA nurse is preparing to obtain the length and weight of a 6-month-old infant during a well-child visit. Which of the following actions should the nurse plan to take? (Select all that apply.)
A nurse is preparing to administer liquid ibuprofen to a school-age child. The prescription reads 200 mg every 8 hr. The amount available is 100 mg/5 mL. How many mL of ibuprofen should the nurse administer over a 24-hr period? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
To calculate the dosage of ibuprofen in milliliters for a 24-hour period, we start by determining the total milligrams required per day. Since the prescription is for 200 mg every 8 hours, the child will need three doses in 24 hours (200 mg x 3 = 600 mg). Next, we convert the total milligrams into milliliters using the concentration provided. The formula is: (Total mg needed / Concentration of mg) x Volume of each concentration = Total mL. Plugging in the numbers: (600 mg / 100 mg) x 5 mL = 30 mL.
A nurse is reinforcing teaching with the parents of a 2-month-old infant who has gastroesophageal reflux. The parents are feeding the infant formula. Which of the following instructions should the nurse include in the teaching?
Chest x-ray shows infiltrate and an increased anteroposterior diameter
WBC count 22,000/mm3 (5,000 to 10,000/mm3)
Cystic fibrosis
Blood-streaked sputum
0900:
Tympanic temperature 37.7° C (99.9° F)
Heart rate 130/min
Respiratory rate 36/min
Blood pressure 110/65 mm Hg
Oxygen saturation 92% on 2 L oxygen via nasal cannula
1300:
Tympanic temperature 37.5° C (99.5° F)
Heart rate 130/min
Respiratory rate 32/min
Blood pressure 100/60 mm Hg
Oxygen saturation 95% on 2 L oxygen via nasal cannula
A nurse is assisting with the care of a 15-year-old adolescent who has Streptococcus pneumonia.
The nurse is collecting data on the adolescent 24 hr later. How should the nurse interpret the findings?
For each finding, click to specify whether the finding is unrelated to the admitting diagnosis, an indication of potential improvement, or an indication of potential worsening condition.
Explanation
WBC count 17,000/mm3: Indication of Potential Improvement. The initial WBC count was 22,000/mm3, and 24 hours later, it has decreased to 17,000/mm3, indicating improvement.
Steatorrhea: Unrelated to Diagnosis. This symptom is typically associated with cystic fibrosis rather than pneumonia.
Oxygen saturation 95% on 1 L oxygen via nasal cannula: Indication of Potential Improvement. The decrease in oxygen requirement from 2 L to 1 L suggests the adolescent's respiratory status may be improving.
Barrel chest: Unrelated to Diagnosis. This physical finding is more indicative of chronic conditions such as cystic fibrosis rather than an acute pneumonia presentation.
Hemoptysis 300 mL: Indication of Potential Worsening Condition. The presence of significant hemoptysis indicates a worsening condition, possibly due to progression or complications of pneumonia.
Respiratory rate 32/min: Indication of Potential Improvement. The decrease in respiratory rate from 36/min to 32/min suggests a possible improvement in respiratory status.
A nurse is collecting data from an adolescent who has hypocalcemia. Which of the following findings should the nurse expect?
0730:
Adolescent presented with new onset shortness of breath, fatigue, and cough. Adolescent is receiving treatment for osteosarcoma. Prescriptions received for chest x-ray and laboratory testing.
0830:
Provider discussed results of laboratory tests and chest x-ray with adolescent's parent outside of adolescent's room. Parent tearful and states, "I don't want my child to know that the cancer has spread to their lungs."
0730:
Blood pressure 110/72 mm Hg
Heart rate 80/min
Respiratory rate 22/min
Temperature 38.2° C (100.8° F)
SaO2 95% on room air
A nurse in an emergency department is assisting in the care of a 13-year-old adolescent.
Complete the following sentence by using the lists of options. The nurse identifies the parent is having difficulty discussing the metastasis of the cancer with their adolescent. The nurse should
Explanation
In a sensitive and challenging situation such as this, the nurse should consult the child life specialist for guidance and reinforce teaching to the parent regarding the adolescent's potential emotional responses. The child life specialist is trained to support children and families during difficult medical experiences, providing them with the necessary tools to cope with the situation. Reinforcing teaching to the parent about the adolescent's potential emotional responses ensures that the parent is prepared to support their child's emotional well-being, fostering an environment of open communication and trust. This approach respects the family's needs and the adolescent's right to be informed, while also providing the support needed to navigate the complexities of a cancer diagnosis.
0730:
3-year-old toddler presents to the clinic with guardian. Guardian reports toddler woke up coughing and had a low-grade fever. Alert and restless in guardian's arms. Respirations easy, no cough noted.
0800:
Toddler became agitated. Hoarse cry noted with audible, inspiratory stridor. Barking, non-productive cough present.
0730:
Tympanic temperature 38.1 C (100.6 F)
Heart rate 95/min
Respiratory rate 20/min
Oxygen saturation 98% on room air
0800:
Tympanic temperature 38.2 C (100.6 F)
Heart rate 95/min
Respiratory rate 20/min
Oxygen saturation 96% on room air
A nurse in a clinic is assisting with the care of a 3-year-old toddler.
The nurse is reviewing the collected data.
For each finding, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than 1 disease process.
Explanation
Acute Laryngotracheobronchitis (Croup): This condition typically presents with a barking, seal-like cough and inspiratory stridor due to inflammation of the upper airway, often caused by a viral infection such as parainfluenza virus.
Pneumonia: While irritability and fever can be present in both conditions, the presence of stridor (especially inspiratory) is more characteristic of Acute Laryngotracheobronchitis. Pneumonia typically presents with a productive cough, fever, and signs of lower respiratory tract involvement such as crackles or decreased breath sounds on auscultation.
Weight 30 kg (66 lb)
Temperature 38.6°C (101.5°F)
Heart rate 124/min
Respiratory rate 26/min
Oxygen saturation 95% on 2 L oxygen via nasal cannula
Cystic fibrosis
Three-day history of fever, malaise, and coughing Chest x-ray indicates pneumonia
WBC count 21,000/mm3 (5,000 to 10,000/mm3)
Sodium 140 mEq/L (136 to 145 mEq/L)
Potassium 6.2 mEq/L (3.4 to 4.7 mEq/L)
Chloride 95 mEq/L (90 to 110 mEq/L)
High-protein, high-fat diet
Chest physiotherapy every 4 hr
Airway clearance therapy BID
Pancrelipase 8,000 units with meals
Dornase alfa 2.5 mg inhalation every day
Piperacillin and tazobactam 4 g IV every 8 hr
Albuterol nebulizer 2.5 mg inhalation every 4 hr
Dextrose 5% in 0.45% sodium chloride with 20 mEq potassium chloride/L at 75 mL/hr
A nurse is preparing to assist with the administration of scheduled medications for a school-age child.
Drag 1 medication and 1 child finding to fill in each blank in the following sentence. The nurse should clarify the child's prescription of
Explanation
The nurse should clarify the child's prescription of dextrose 5% in 0.45% sodium chloride with 20 mEq potassium chloride/L at 75 mL/hr because of the child's laboratory values. The elevated potassium level of 6.2 mEq/L, which is above the normal range of 3.4 to 4.7 mEq/L, indicates hyperkalemia. Administering additional potassium could exacerbate this condition, therefore, it is crucial to review the prescription and adjust it accordingly to ensure the safety and well-being of the child.
Temperature 37.6° C (99.6° F) Axillary
Heart rate 148/min
Respiratory rate 28/min
SaO2 98% on room air
Infant irritable and difficult to console
Anterior fontanel bulging and tense
Small amount of stool continually oozing from rectum
No spontaneous movement of lower extremities observed
A nurse is assisting in the care of an 8-month-old infant.
Complete the diagram by dragging from the choices below to specify what condition the infant is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters where the nurse should collect data to monitor the infant's progress.
Explanation
Potential Condition: Increased intracranial pressure
Actions to Take:
Measure head circumference: This action is important to monitor for signs of increasing intracranial pressure, as a bulging and tense fontanel suggests possible hydrocephalus or other intracranial pathology.
Plan to assist with administration of antibiotics: Antibiotics may be necessary if there is suspected meningitis or another infectious cause contributing to increased intracranial pressure.
Parameters to Monitor:
Behavioral changes: Monitor for irritability, difficulty to console, and other behavioral changes which can indicate neurological distress.
Pupillary response: Assess for changes in pupillary size and reactivity, as altered pupillary responses can indicate neurological involvement and increased intracranial pressure.
2300:
Temperature 37° C (97.9° F) Apical pulse rate 170/min Respiratory rate 62/min
Blood pressure 85/50 mm Hg
Sao, 95% on oxygen via nasal cannula at 2 L/min
Weight 5,440 g (12 lb)
2315:
Temperature 37° C (97.9° F)
Apical pulse rate 168/min
Respiratory rate 62/min
Blood pressure 86/52 mm Hg
SaO, 95% on oxygen via nasal cannula at 2 U/min
2300:
Infant awake, crying, and being held by parent. Infant has occasional dry cough. Lung sounds with wheezes noted bilaterally on inspiration. Capillary refill 4 seconds in bilateral upper extremities. Extremities cool and pale. Diaphoresis noted.
Infant born at 32 weeks of gestation via vaginal birth, weighing 2,722 g (6 lb).
Diagnosed with patent ductus arteriosus after birth. Treated with indomethacin with no surgical intervention necessary. Discharged to home 4 weeks post-birth with apneic monitor and supplemental oxygen as needed.
No significant family medical history.
2300:
Received infant from emergency department. Parent states the infant, "has not rested well and has been breathing fast over the past 12 hours." Infant was placed on oxygen while at home, but parent states it did not help with breathing, Infant has not been eating well, consuming about, "half a bottle in the past 24 hours and one wet diaper." Parent states the infant will not lie down but prefers to be held upright and has developed a slight cough.
2315:
Infant sitting upright on parent's chest with eyes closed. Slight costal retractions noted with labored breathing when lifting infant and when attempting to feed. Nasal flaring noted at this time. Provider notified.
A nurse is assisting with the care of a 5-month-old infant who was just admitted to the pediatric unit.
For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the infant.
Explanation
Continuous pulse oximetry: Anticipated because the infant has respiratory distress and requires continuous monitoring of oxygen saturation.
Chest x-ray: Anticipated to assess the extent of lung involvement due to the respiratory distress and wheezing noted.
Peripheral IV line: Anticipated since the peripheral line will be used to administer intravenous medications and fluids.
Supine position: Contraindicated because the infant prefers to sit upright and shows signs of respiratory distress, such as nasal flaring and retractions.
Small, frequent feedings: Anticipated to ensure adequate nutrition despite feeding difficulties.
Monitor intake and output: Anticipated to assess hydration status, especially since the infant has had decreased intake and output.
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