ATI RN
RN Pediatric Nursing 2023 ATI
1. What is the priority nursing action when preparing a neonate born with a gastroschisis defect for transport to a pediatric hospital for corrective surgery?
- A. Covering the exposed intestines with sterile moist gauze
- B. Wrapping the newborn warmly in two or three blankets
- C. Providing sterile water feeding to maintain hydration during transport
- D. Allowing the parents of the newborn to see their child prior to transport
Correct answer: A
Rationale: The priority nursing action when preparing a neonate born with a gastroschisis defect for transport is to cover the exposed intestines with sterile moist gauze. This action helps prevent infection and keeps the tissue viable during transportation to the pediatric hospital for corrective surgery.
2. A healthcare provider is assessing the pain level of a three-year-old toddler. Which of the following pain assessment scales should the healthcare provider use?
- A. FACES Pain rating scale
- B. Numeric pain rating scale
- C. CRIES pain assessment scale
- D. Non-communicating children's pain checklist
Correct answer: A
Rationale: The healthcare provider should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale allows the toddler to point to the face that depicts the current level of pain, making it a suitable choice for non-verbal or young children who may have difficulty expressing their pain verbally.
3. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?
- A. This is atypical behavior and should be addressed
- B. The infant should remain on high alert when awake
- C. This shows the infant is making neurological gains
- D. The family is disrupting the child's sleep patterns
Correct answer: C
Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.
4. A child is being assessed for possible appendicitis with perforation. Which of the following findings should the nurse expect?
- A. Hyperactive bowel sounds
- B. Abdominal distension
- C. Hypoactive bowel sounds
- D. Bradycardia
Correct answer: D
Rationale: In a child with appendicitis and possible perforation, the nurse should expect bradycardia due to peritoneal irritation. Bradycardia is a common response to peritoneal inflammation or infection, indicating a possible serious complication. Hyperactive bowel sounds, abdominal distension, and hypoactive bowel sounds are more commonly associated with other gastrointestinal conditions and are less likely to be present in a child with appendicitis and perforation. Therefore, the correct answer is bradycardia (D) as it aligns with the expected physiological response in this scenario.
5. Which type of play involves actions such as looking and touching the mother's face, putting hands in one's mouth, and responding to familiar people?
- A. Exploratory
- B. Functional or relational
- C. Pretend
- D. Symbolic or imaginary
Correct answer: A
Rationale: Exploratory play is characterized by exploring sensory experiences and learning about the environment. In this type of play, infants engage in activities like looking, touching, and responding to familiar stimuli to understand the world around them.
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