ATI RN
RN Pediatric Nursing 2023 ATI
1. In an immunization clinic, which patient will the nurse identify as not eligible to receive routine immunizations?
- A. An 8-year-old experiencing diarrhea
- B. A 2-year-old with a history of pre-term birth
- C. A 4-year-old with a fever and upper respiratory tract infection
- D. A 6-year-old who has been recently exposed to a classmate with chickenpox
Correct answer: C
Rationale: The nurse should identify the 4-year-old with a fever and upper respiratory tract infection as not eligible to receive routine immunizations. It is contraindicated to administer vaccines in the presence of moderate to severe illness, whether with or without fever, to prevent potential complications or reduced vaccine efficacy.
2. 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.
3. When providing teaching to the family of a school-age child with juvenile idiopathic arthritis, which instruction should the nurse include?
- A. Limit the child's movement of the large joints.
- B. Encourage the child to perform independent self-care.
- C. Provide the child with a soft mattress for sleeping.
- D. Schedule a 2-hour daily nap for the child in the afternoon.
Correct answer: B
Rationale: Encouraging the child to perform independent self-care is essential when managing juvenile idiopathic arthritis. This instruction helps minimize pain and stiffness in the child's joints while promoting mobility and independence. It is crucial for the child to learn self-management skills early to cope better with the condition in the long term.
4. What side effect should the nurse include in the parent teaching for a child prescribed a baclofen pump for cerebral palsy?
- A. Diarrhea
- B. Hypertonia
- C. Hypotonia
- D. Restlessness
Correct answer: C
Rationale: When a child is prescribed a baclofen pump for cerebral palsy, one of the common side effects to include in parent teaching is hypotonia. Baclofen, a muscle relaxant, can lead to decreased muscle tone, resulting in hypotonia. It is important for parents to be aware of this potential side effect and know how to respond accordingly.
5. The healthcare provider is providing care to a child who was treated with aspirin during a viral infection. Which clinical manifestations should cause the healthcare provider concern?
- A. Nausea, vomiting, and confusion
- B. Headache, vomiting, and seizures
- C. Sore throat, moist respirations, and cough
- D. Fever, rash, and photophobia
Correct answer: A
Rationale: The symptoms of nausea, vomiting, and confusion are concerning as they are indicative of Reye's syndrome, a rare but serious condition associated with aspirin use in children during viral illnesses. Reye's syndrome can lead to severe complications, including brain and liver damage, hence prompt recognition and management are crucial.
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