ATI RN
RN Pediatric Nursing 2023 ATI
1. At what age may an infant close their eyes to bright lights and show improved head control?
- A. 30-33 weeks after conception
- B. 34-36 weeks after conception
- C. Less than 30 weeks after conception
- D. 37-40 weeks after conception
Correct answer: A
Rationale: Around 30-33 weeks after conception, infants usually start closing their eyes in response to bright lights and exhibit enhanced head control. This developmental milestone indicates progress in their visual and motor abilities, reflecting the maturation of their neurological system. As preterm infants continue to grow and develop, they gradually acquire these skills, showcasing the natural progression of their sensory and motor functions.
2. The healthcare provider is assessing abdominal girth for a pediatric client who presents with abdominal distension. Which nursing action is appropriate?
- A. Measuring the girth just below the umbilicus
- B. Measuring the girth just below the sternum
- C. Measuring the girth just above the pubic bone
- D. Measuring the girth around the largest portion of the abdomen
Correct answer: D
Rationale: Measuring the girth around the largest portion of the abdomen ensures accurate assessment and tracking of abdominal distension. This method provides a more comprehensive measurement and helps healthcare providers monitor changes effectively.
3. 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.
4. A nurse is caring for a school-age child with primary nephrotic syndrome who is taking prednisone. After 1 week of treatment, which manifestation indicates to the nurse that the medication is effective?
- A. Decreased edema
- B. Increased abdominal girth
- C. Decreased appetite
- D. Increased protein in the urine
Correct answer: A
Rationale: In a child with nephrotic syndrome, the presence of edema is due to fluid retention caused by protein loss in the urine. Prednisone, a corticosteroid, helps reduce inflammation and decrease the loss of protein in the urine, leading to a decrease in edema. Therefore, decreased edema is an indication that the prednisone treatment is effective in managing the nephrotic syndrome. Increased abdominal girth would indicate fluid retention and worsening of the condition. Decreased appetite is a nonspecific symptom and not a direct indicator of prednisone efficacy. Increased protein in the urine would indicate ongoing renal impairment and the ineffectiveness of the treatment.
5. When a patient is taking glucocorticoids and digoxin, which electrolyte should the nurse prioritize monitoring?
- A. Calcium
- B. Magnesium
- C. Sodium
- D. Potassium
Correct answer: D
Rationale: The nurse should primarily monitor potassium levels in a patient taking glucocorticoids and digoxin. Glucocorticoids can lead to potassium loss, potentially increasing the risk of digoxin toxicity. Additionally, glucocorticoids may worsen hypokalemia induced by diuretics like thiazides and loops. While calcium, magnesium, and sodium are important electrolytes to monitor in various clinical situations, they are not the priority in this specific scenario of a patient on glucocorticoids and digoxin.
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