ATI RN
RN Pediatric Nursing 2023 ATI
1. The healthcare provider is planning care for a patient receiving morphine sulfate via a patient-controlled analgesia pump. Which intervention may be required due to a potential adverse effect of this drug?
- A. Administering a cough suppressant
- B. Inserting a Foley catheter
- C. Administering an anti-diarrheal
- D. Monitoring urinary output
Correct answer: B
Rationale: Morphine can lead to urinary retention and urinary hesitancy. If a patient shows signs of bladder distention or inability to void, the healthcare provider should be notified, and urinary catheterization may be necessary. Administering a cough suppressant or an anti-diarrheal is not typically required to address adverse effects of morphine. Liver function tests (LFTs) are not directly related to the potential adverse effects of morphine on the urinary system.
2. Which statement best reflects the role of the therapeutic relationship in fostering positive behaviors in children?
- A. It may be used as an intervention strategy to help a child with positive behaviors
- B. The relationship with parents or teachers is more important
- C. It is not essential for the child's behaviors
- D. Children will not pay attention to the therapist
Correct answer: A
Rationale: A strong therapeutic relationship can significantly influence the development of positive behaviors in children. When a child feels connected, understood, and supported by a therapist, it can lead to better outcomes in promoting positive behaviors and emotional well-being.
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. Which assessment finding would necessitate action by the nurse for a 10-month-old child who is 4 hours postoperative for the placement of a urethral stent?
- A. Bloody urine
- B. One void since returning from surgery
- C. Bladder spasms responding to pharmacologic intervention
- D. Double diapering from the previous shift
Correct answer: B
Rationale: In a postoperative scenario after the placement of a urethral stent, monitoring the child's voiding frequency is crucial. Having only one void since returning from surgery could indicate potential issues like urinary retention, which necessitates prompt nursing intervention to prevent complications.
5. 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.
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