ATI RN
RN Pediatric Nursing 2023 ATI
1. 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.
2. A nurse is preparing to administer medications to four clients. The nurse should administer medications to which client first?
- A. A client who has pneumonia and a WBC count of 11,500/mm3 prescribed piperacillin
- B. A client who has renal failure and a serum potassium of 5.8 mEq/L prescribed sodium polystyrene sulfonate
- C. A client who is post-coronary artery bypass graft (CABG) prescribed atorvastatin
- D. A client who has anemia and a hemoglobin level of 11g/dL prescribed epoetin alfa
Correct answer: B
Rationale: The correct answer is B. The client with renal failure and high potassium levels requires immediate attention because hyperkalemia can lead to life-threatening cardiac complications. Administering sodium polystyrene sulfonate helps lower the potassium levels. Choice A, the client with pneumonia and a high WBC count, although important, does not present an immediate life-threatening condition. Choice C, the post-CABG client prescribed atorvastatin, and Choice D, the client with anemia and a hemoglobin level of 11g/dL prescribed epoetin alfa, do not require immediate intervention compared to managing hyperkalemia in a client with renal failure.
3. What is the most useful application of ultrasonography for diagnostic examination?
- A. dense organs, such as bones.
- B. air-filled organs, such as lungs.
- C. soft internal structures, such as fetuses.
- D. microscopic structures.
Correct answer: soft internal structures, such as fetuses.
Rationale: Ultrasonography is a medical imaging technique that uses sound waves to visualize internal body structures. It is particularly effective for examining soft tissues like organs, blood vessels, and fetuses. Choice A is incorrect because bones are better visualized using techniques like X-rays. Choice B is incorrect as air-filled organs like lungs are not well visualized with ultrasound due to air being a poor conductor of sound waves. Choice D is incorrect since ultrasonography cannot visualize structures at a microscopic level, as it is used for larger internal structures.
4. Which of the following is inappropriate in collecting mid stream clean catch urine specimen for urine analysis?
- A. Collect early in the morning, First voided specimen
- B. Do perineal care before specimen collection
- C. Collect 5 to 10 ml for urine
- D. Discard the first flow of the urine
Correct answer: A
Rationale: When collecting a mid-stream clean catch urine specimen for urine analysis, it is important to collect an adequate amount of urine for accurate testing. A volume of 30 to 60 ml is usually recommended for optimal results, so collecting only 5 to 10 ml would not provide enough urine for testing purposes. It is essential to follow proper collection techniques to ensure accurate and reliable test results.
5. In reviewing a client's health record, which condition would be a contraindication for using Propranolol to treat hypertension?
- A. Asthma
- B. Glaucoma
- C. Hypertension
- D. Tachycardia
Correct answer: A
Rationale: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blocking beta2 receptors in the lungs can lead to bronchoconstriction, making it unsuitable for clients with asthma. Therefore, asthma is a contraindication for taking Propranolol. Glaucoma, hypertension, and tachycardia are not contraindications for using Propranolol to treat hypertension.
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