ATI RN
RN Pediatric Nursing 2023 ATI
1. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?
- A. Bag-valve-mask system
- B. Sterile gauze and saline
- C. Soft arm restraints
- D. Endotracheal tube
Correct answer: D
Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.
2. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?
- A. Elevate the head of the child's bed
- B. Insert a large-bore IV catheter for the child
- C. Determine the allergen that caused the child's reaction
- D. Administer IM epinephrine to the child
Correct answer: D
Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.
3. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?
- A. Change the ostomy pouch every day.
- B. Use baby wipes to clean the stoma.
- C. Avoid using soap to clean the stoma.
- D. Apply barrier ointment to the skin around the stoma.
Correct answer: D
Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.
4. When developing a home program for self-care, which approach is the most effective?
- A. Require the parent to practice the steps regularly and track progress.
- B. Introduce new home programs weekly with clear instructions for the parent to follow.
- C. List all the steps and have the parent teach them to the child without practicing.
- D. Practice the new steps until the child is ready to independently perform them at home.
Correct answer: D
Rationale: The most effective approach when developing a home program for self-care is to practice the new steps with the child until they are capable of independently carrying them out at home. This method ensures that the child has mastered the skills before transitioning to independent implementation. It is essential for the child's success in self-care activities and promotes their autonomy and confidence. Requiring the parent to practice the steps regularly and track progress, introducing new programs weekly, or having the parent teach the steps without practice may not be as beneficial in fostering the child's independence and skill acquisition.
5. A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight � 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours?
- A. 88 mL/hr
- B. 86 mL/hr
- C. 81 mL/hr
- D. 83 mL/hr
Correct answer: B
Rationale: For 13 kg, the maintenance fluid is 1150 mL (1000 mL for first 10 kg + 3*50 mL for the remaining 3 kg). Replacement fluid is 910 mL (0.07 * 13000 mL). Total fluid is 2060 mL, divided by 24 hours is 86 mL/hr.
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