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. When caring for an infant with respiratory syncytial virus (RSV), which of the following actions should the nurse take?
- A. Administer antibiotics IM once per day.
- B. Initiate droplet precautions.
- C. Place the infant in a negative-pressure isolation room.
- D. Suction the nasopharynx as needed.
Correct answer: D
Rationale: When caring for an infant with respiratory syncytial virus (RSV), maintaining a patent airway is crucial. Suctioning the nasopharynx as needed helps clear secretions, prevent airway obstruction, and promote effective breathing. This intervention can aid in improving the infant's respiratory status and overall comfort. Administering antibiotics IM once per day (Choice A) is not indicated for RSV as it is caused by a virus, not bacteria. Initiating droplet precautions (Choice B) is important to prevent the spread of respiratory infections like RSV, but directly caring for the infant involves more specific interventions. Placing the infant in a negative-pressure isolation room (Choice C) is generally reserved for airborne infections, not RSV which spreads through respiratory droplets.
3. What important information should the nurse provide to a patient taking a tetracycline antibiotic?
- A. Take the medication on an empty stomach.
- B. Avoid exposure to sunlight and tanning beds.
- C. Do not take the medication with milk or other dairy products.
- D. The medication may cause permanent staining of your teeth.
Correct answer: D
Rationale: The correct answer is D. Tetracycline antibiotics can bind to calcium in dairy products, decreasing the absorption of the antibiotic. This may result in reduced effectiveness of the medication. Additionally, tetracycline antibiotics can cause permanent staining of teeth, especially in children below 8 years of age and in pregnant women. Therefore, it is crucial for the patient to be aware of this potential side effect and to discuss any concerns with their healthcare provider. Choices A, B, and C are incorrect because tetracycline antibiotics should be taken with food to reduce gastrointestinal upset, exposure to sunlight is not a significant concern with tetracycline antibiotics, and the issue with dairy products is related to calcium binding and reduced absorption rather than an issue of empty stomach intake.
4. What does a Z-score of -3.00 indicate?
- A. The child's score indicates he is ahead of his peers and performing well
- B. The child's score places him within normal limits on this test item
- C. The test is inconclusive
- D. The child's score falls below the majority of his peers on this test
Correct answer: D
Rationale: A Z-score of -3.00 indicates that the child's performance is significantly below the average of their peers. It represents an extreme low score, indicating a substantial deviation from the mean performance of the group.
5. Which statement fosters cultural competence?
- A. Treat everyone the same regardless of their culture
- B. Provide an outline of your beliefs as a starting point
- C. Acknowledge and respond to influences of cultural beliefs in the intervention plan
- D. Ask the family to outline how their beliefs will influence therapy
Correct answer: C
Rationale: Cultural competence involves recognizing and considering the impact of cultural beliefs on individuals. By acknowledging and responding to these cultural influences in the intervention plan, professionals can tailor their approach effectively and respectfully. This approach helps build trust, enhances communication, and improves outcomes in culturally diverse settings.
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