ATI_RN Pediatric Nursing 2023 at at Baton Rouge Community College
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Free ATI_RN Pediatric Nursing 2023 at at Baton Rouge Community College Questions
A nurse is conducting a health history of an adolescent who is accompanied by a parent. Which of the following interviewing techniques should the nurse use?
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Provide an opinion when discussing the adolescent’s sexual history.
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Use open-ended questions when asking the adolescent about their health history.
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Communicate sympathy when asking the adolescent about their chief complaint.
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Interview the parent first when collecting the adolescent’s health history.
Explanation
Explanation
Using open-ended questions encourages adolescents to share information freely and honestly without feeling judged or pressured. This approach helps build trust, supports therapeutic communication, and allows the nurse to obtain more complete and accurate information about the adolescent’s physical, emotional, and social health. Open-ended questions are especially important for adolescents, who may be hesitant to discuss sensitive topics unless they feel respected and heard.Correct Answer Is:
B. Use open-ended questions when asking the adolescent about their health history.Why the other options are incorrect:
A nurse is preparing a 4-year-old child for a tonsillectomy. Which of the following statements should the nurse make?
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“Your mom will be there throughout the procedure.”
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“You will have a special sleep so you won’t feel anything.”
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“You will be put to sleep for your surgery.”
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“Your throat will feel better when you wake up.”
Explanation
Preschool-age children have limited understanding of medical procedures and may interpret language very literally. Using the phrase “special sleep” is developmentally appropriate and less frightening than saying “put to sleep,” which can cause fear or confusion. This statement reassures the child that they will not feel pain during the procedure while providing a simple, honest explanation that supports emotional comfort and reduces anxiety before surgery.
Correct Answer Is:
B. “You will have a special sleep so you won’t feel anything.”A nurse is assessing a toddler during a well-child visit. Which of the following parent statements indicates the correct use of time-out as a method of discipline?
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“I give my child one warning before she has to go in time-out.”
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“I send my child to her room and shut the door during time-out.”
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“I typically leave my child in time-out for 10 minutes.”
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“I explain to my child why her actions are wrong after I put her in time-out.”
Explanation
Effective use of time-out for toddlers includes giving a clear warning so the child understands the consequence of continued misbehavior. One warning allows the child an opportunity to correct the behavior and supports consistent, predictable discipline. Time-out should be brief, nonisolating, and used calmly as a teaching strategy rather than punishment, making the use of a warning an essential and correct component.
Correct Answer Is:
A. “I give my child one warning before she has to go in time-out.”A nurse is preparing to administer ceftriaxone 500 mg via intermittent IV infusion over 30 min to a toddler. After reconstitution, the available concentration is ceftriaxone 500 mg/15 mL. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number.)
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15 mL/hr
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20 mL/hr
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30 mL/hr
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45 mL/hr
Explanation
Explanation
The total volume to be infused is 15 mL. The medication is ordered to infuse over 30 minutes, which equals 0.5 hr. To calculate the infusion rate, divide the total volume by the infusion time: 15 mL ÷ 0.5 hr = 30 mL/hr. Setting the IV pump to 30 mL/hr ensures the medication is delivered over the prescribed time frame.Correct Answer Is:
C. 30 mL/hrWhy the other options are incorrect:
A nurse is assessing an infant who has patent ductus arteriosus. Which of the following findings should the nurse expect?
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Decreased systolic blood pressure
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Increased respiratory rate
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Increased temperature
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Decreased heart rate
Explanation
Explanation
Patent ductus arteriosus causes blood to shunt from the aorta back into the pulmonary circulation, leading to increased pulmonary blood flow and pulmonary congestion. This places extra workload on the lungs and heart, resulting in tachypnea as the infant attempts to compensate for impaired gas exchange. An increased respiratory rate is a common and expected finding, especially during feeding or activity, and reflects developing heart failure and respiratory compromise.Correct Answer Is:
B. Increased respiratory rateWhy the other options are incorrect:
A nurse is admitting an 8-year-old child to the pediatric unit.
Nurses' Notes
Day 1, 1020:
Child is a direct admit from a pediatric clinic and is accompanied by their guardian. Guardian reports that child has been sick for about 2 days with fever and chills and appears to be more irritable. Approximately 2 weeks ago, guardian reports that their child had an upper respiratory infection that was managed with over-the-counter medications. Guardian also reports that child has no prior medical conditions and has received all recommended scheduled immunizations.
1030:
Child reports nausea and headache and rates the pain as 7 on a scale of 0 to 10. Lethargic and responsive to verbal stimuli. Agitation and irritability noted. Nuchal rigidity noted. Pupils equal, round, and reactive to light. Mucous membranes pink dry, and sticky. Cervical lymph slightly enlarged. Respirations irregular. No accessory muscle use noted. Breath sounds clear anterior posterior bilaterally. Heart rhythm regular without murmurs. Radial and pedal pulses 1+ bilateral. Capillary refill seconds. Abdomen flat and non-distended. Bowel sounds ac in all 4 quadrants. Extremities are warm and dry to touch
Flow Sheet
Day 1, 1030:
Temperature 38.7° C (101.7° F)
Heart rate 114/min
Respiratory rate 26/min
Blood pressure 114/80 mm Hg
SpO2 97% on room air
Height 122 cm (48 in)
Weight 29 kg (64 lb)
Diagnostic Results
Day 1, 1040:
Potassium 3.8 mEq/L (3.4 to 4.7 mEq/L)
Hemoglobin 9.5 g/dL (10 to 15.5 g/dL)
Hematocrit 30% (32% to 44%)
RBC count 4.2 x 106/pL (4.0 to 5.5 x 106/pL)
WBC count 14,000 mm3 (5,000 to 10,000 mm3)
Platelets 350,000/mm3 (150,000 to 400,000/mm3)
Glucose 90 mg/dL (< 200 mg/dL)
Blood cultures pending
Provider Prescriptions
Day 1, 1020:
Admit directly to pediatric unit.
Keep child NPO.
Obtain comprehensive metabolic panel and blood cultures
STAT.
Vital signs every 30 min, then every hr x 4, then every 4 hr.
Exhibit 1
Nurses' Notes
Day 1, 1020:
Child is a direct admit from a pediatric clinic and is accompanied by their guardian. Guardian reports that child has been sick for about 2 days with fever and chills and appears to be more irritable. Approximately 2 weeks ago, guardian reports that their child had an upper respiratory infection that was managed with over-the-counter medications. Guardian also reports that child has no prior medical conditions and has received all recommended scheduled immunizations.
1030:
Child reports nausea and headache and rates the pain as 7 on a scale of 0 to 10. Lethargic and responsive to verbal stimuli. Agitation and irritability noted. Nuchal rigidity noted. Pupils equal, round, and reactive to light. Mucous membranes pink dry, and sticky. Cervical lymph slightly enlarged. Respirations irregular. No accessory muscle use noted. Breath sounds clear anterior posterior bilaterally. Heart rhythm regular without murmurs. Radial and pedal pulses 1+ bilateral. Capillary refill seconds. Abdomen flat and non-distended. Bowel sounds ac in all 4 quadrants. Extremities are warm and dry to touch
Exhibit 2
Flow Sheet
Day 1, 1030:
Temperature 38.7° C (101.7° F)
Heart rate 114/min
Respiratory rate 26/min
Blood pressure 114/80 mm Hg
SpO2 97% on room air
Height 122 cm (48 in)
Weight 29 kg (64 lb)
Exhibit 3
Diagnostic Results
Day 1, 1040:
Potassium 3.8 mEq/L (3.4 to 4.7 mEq/L)
Hemoglobin 9.5 g/dL (10 to 15.5 g/dL)
Hematocrit 30% (32% to 44%)
RBC count 4.2 x 106/pL (4.0 to 5.5 x 106/pL)
WBC count 14,000 mm3 (5,000 to 10,000 mm3)
Platelets 350,000/mm3 (150,000 to 400,000/mm3)
Glucose 90 mg/dL (< 200 mg/dL)
Blood cultures pending
Exhibit 4
Provider Prescriptions
Day 1, 1020:
Admit directly to pediatric unit.
Keep child NPO.
Obtain comprehensive metabolic panel and blood cultures
STAT.
Vital signs every 30 min, then every hr x 4, then every 4 hr.
A nurse is reviewing the child's electronic medical record (EMR). Which of the following findings should the nurse identify as requiring immediate follow-up?
Select the 5 findings that require immediate follow-up.
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Hemoglobin
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Glucose
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Pain assessment
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Peripheral pulses
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Temperature
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Abdominal assessment
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Neurologic assessment
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WBC
Explanation
Explanation
C. Pain assessmentThe child reports a headache rated 7/10 accompanied by nausea, lethargy, and irritability. Severe headache in combination with nuchal rigidity and altered responsiveness is concerning for meningeal irritation or increased intracranial pressure. This finding requires immediate follow-up to guide urgent neurologic evaluation and intervention.
D. Peripheral pulses
Radial and pedal pulses documented as 1+ bilaterally indicate decreased peripheral perfusion. In the setting of fever, lethargy, and suspected infection, weak pulses may signal early circulatory compromise or sepsis. This finding requires prompt reassessment and close monitoring.
E. Temperature
A temperature of 38.7° C (101.7° F) with chills and irritability suggests an acute infectious process. Fever combined with neurologic signs raises concern for meningitis or systemic infection, requiring immediate follow-up for rapid evaluation and treatment.
G. Neurologic assessment
Lethargy, agitation, irritability, nuchal rigidity, and irregular respirations are significant neurologic red flags. These findings strongly suggest central nervous system involvement, such as meningitis or rising intracranial pressure, and require immediate provider notification and intervention.
H. WBC
An elevated WBC count of 14,000/mm³ indicates an active inflammatory or infectious process. When paired with fever and neurologic symptoms, this finding supports possible serious bacterial infection and requires urgent follow-up to prevent rapid deterioration.
Correct Answer Is:
C. Pain assessmentD. Peripheral pulses
E. Temperature
G. Neurologic assessment
H. WBC
A nurse is preparing to administer ampicillin 50 mg/kg/day divided equally every 6 hr to a child who weighs 30 kg (66 lb). Available is ampicillin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest whole number.)
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10 mL
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12 mL
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15 mL
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18 mL
Explanation
Explanation
The total daily dose is 50 mg/kg/day × 30 kg = 1,500 mg/day. The medication is given every 6 hours, which equals 4 doses per day. Each dose is 1,500 mg ÷ 4 = 375 mg per dose. The concentration is 125 mg per 5 mL, which equals 25 mg/mL. Dividing 375 mg by 25 mg/mL results in 15 mL per dose.Correct Answer Is:
C. 15 mLA nurse is caring for an adolescent who has acute glomerulonephritis. Which of the following actions should the nurse take?
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Increase the client’s dietary protein intake.
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Assess the client’s blood pressure every 8 hr.
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Weigh the client daily.
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Avoid palpating the client’s abdomen.
Explanation
Acute glomerulonephritis causes decreased kidney filtration, leading to fluid retention and edema. Daily weight measurement is the most sensitive and accurate method for evaluating fluid balance and detecting subtle changes in fluid status. Monitoring weight allows the nurse to assess the effectiveness of treatment, identify worsening fluid overload early, and guide interventions to prevent complications such as hypertension and pulmonary edema.
Correct Answer Is:
C. Weigh the client daily.A nurse is caring for a 3-year-old toddler who has heart failure. Which of the following actions should the nurse take to promote rest for the toddler?
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Allow the toddler to visit the playroom 30 min prior to bedtime.
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Establish a daily schedule with the toddler and their family.
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Administer diuretics with the toddler’s lunch.
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Keep the television on in the toddler’s room.
Explanation
Children with heart failure fatigue easily due to decreased cardiac output and increased metabolic demands. Establishing a consistent daily schedule that balances activity, rest, meals, and medications helps conserve energy and prevents overstimulation. Predictable routines reduce stress and promote adequate rest periods throughout the day, which is essential for minimizing cardiac workload and supporting optimal growth, healing, and overall physiologic stability in a toddler with heart failure.
Correct Answer Is:
B. Establish a daily schedule with the toddler and their family.A nurse is teaching a parent of a 10-month-old infant about home safety. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
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Remove labels from containers that contain toxic substances.
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Keep toilet lids in the upright position.
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Place gates at the top and bottom of the stairs.
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Ensure the crib mattress is in the lowest position.
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Select a toy chest that has a heavy, hinged lid.
Explanation
Explanation
C. Place gates at the top and bottom of the stairs.At 10 months of age, infants are highly mobile and often crawl, pull to stand, or cruise along furniture. They do not have the coordination or judgment to safely navigate stairs. Installing safety gates at both the top and bottom of stairways significantly reduces the risk of falls, which are a leading cause of serious injury in infants.
D. Ensure the crib mattress is in the lowest position.
As infants grow, they gain the ability to pull themselves into a standing position. Keeping the crib mattress at the lowest level prevents the infant from climbing or falling out of the crib. This intervention reduces the risk of head injury and other fall-related trauma and is an essential safety measure for this developmental stage.
Correct Answer Is:
C. Place gates at the top and bottom of the stairs.D. Ensure the crib mattress is in the lowest position.
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