ATI RN
RN Pediatric Nursing 2023 ATI
1. 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.
2. Which best describes the role of a community health nurse in promoting health?
- A. Advocating for health policy changes
- B. Providing direct care to individuals and families
- C. Educating the community about healthy lifestyles
- D. Conducting research on community health issues
Correct answer: A
Rationale: A community health nurse plays a vital role in promoting health by advocating for health policy changes. By advocating for policy changes that support healthy environments, access to care, and addressing social determinants of health, community health nurses work towards improving the overall health and well-being of the community they serve. While providing direct care to individuals and families, educating the community about healthy lifestyles, and conducting research on community health issues are important aspects of nursing practice, advocating for health policy changes has a broader impact on population health outcomes.
3. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?
- A. Seizure disorder
- B. Narcotic withdrawal
- C. Placental insufficiency
- D. Meconium aspiration syndrome
Correct answer: B
Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.
4. Which of the following theories explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences?
- A. Contingency theory
- B. Closed system theory
- C. Open system theory
- D. Chaos theory
Correct answer: D
Rationale: The chaos theory explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. Choice A, Contingency theory, focuses on how organizations adapt to their environment. Choice B, Closed system theory, suggests that organizations are self-contained and do not interact with their environment. Choice C, Open system theory, emphasizes that organizations interact with their environment but does not specifically address intertwined links and diversified choices generating unanticipated consequences.
5. The nurse is admitting a patient with a suspected fluid imbalance. The most sensitive indicator of body fluid balance is:
- A. Daily weight
- B. Serum sodium levels
- C. Measured intake and output
- D. Blood pressure
Correct answer: A
Rationale: Daily weight is the most sensitive indicator of body fluid balance because it can show trends over time, helping in assessing the effectiveness of interventions and medications. While serum sodium levels provide objective data on electrolyte balance, they may not accurately reflect fluid balance, especially if a patient is dehydrated. Measured intake and output are crucial for assessing fluid balance, but it can be challenging to match the two due to various ways fluid is lost from the body. Blood pressure and other vital signs may not always be reliable indicators of fluid balance as they can be influenced by other factors beyond fluid status.
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