ATI RN
RN Pediatric Nursing 2023 ATI
1. A child has Wilms' tumor and is scheduled for surgery. Which of the following actions should the nurse include in the plan of care?
- A. Palpate the child's abdomen daily for tumor size.
- B. Reposition the child frequently.
- C. Prepare the child for chemotherapy.
- D. Avoid palpating the abdomen.
Correct answer: D
Rationale: Palpating the abdomen of a child with Wilms' tumor should be avoided to prevent the risk of rupturing the tumor and spreading cancer cells. This action is crucial to maintain the child's safety and prevent potential complications before surgery.
2. Which of the following is not a common causative agent of bacterial meningitis?
- A. Streptococcus pneumoniae
- B. Neisseria meningitidis
- C. Staphylococcus aureus
- D. Haemophilus influenzae
Correct answer: C: Staphylococcus aureus
Rationale: Bacterial meningitis is commonly caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Staphylococcus aureus is not a typical causative agent of bacterial meningitis. This bacterium is more commonly associated with skin and soft tissue infections rather than meningitis.
3. The client is diagnosed with hereditary spherocytosis. Which treatment/procedure would the nurse prepare the client to receive?
- A. Bone marrow transplant
- B. Splenectomy
- C. Frequent blood transfusions
- D. Liver biopsy
Correct answer: B
Rationale: The correct answer is B: Splenectomy. Splenectomy is the treatment of choice for hereditary spherocytosis. By removing the spleen, the excessive destruction of red blood cells is reduced, preventing hemolysis and improving anemia. Bone marrow transplant (A) is not a standard treatment for hereditary spherocytosis. Frequent blood transfusions (C) may temporarily address anemia but do not treat the underlying cause. Liver biopsy (D) is not indicated as a primary treatment for hereditary spherocytosis.
4. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?
- A. Dry cough
- B. Weight gain
- C. Diarrhea
- D. Nausea
Correct answer: A
Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.
5. A client with a DNR order has requested resuscitation during a visit from the family. What is the nurse's best course of action?
- A. Follow the family's request and perform CPR.
- B. Explain to the family that the DNR must be honored.
- C. Call the healthcare provider to cancel the DNR order.
- D. Delay resuscitation until further clarification can be made.
Correct answer: B
Rationale: The correct course of action for the nurse is to explain to the family that the DNR (Do Not Resuscitate) order must be honored. It is essential for the nurse to uphold the client's wishes as documented in the DNR order. Performing CPR against the client's expressed wishes in the DNR order would violate ethical and legal standards. Calling the healthcare provider to cancel the DNR order without the client's consent is inappropriate and goes against the client's autonomy. Delaying resuscitation can be detrimental in an emergency situation and may not align with the client's wishes as outlined in the DNR order.
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