NGN ATI RN Pediatrics Exam 2023 B Version 2 | Questions and Verified Answers| 100% Correct| A Grade
QUESTION
***NGN* A nurse in an emergency
... [Show More] department is caring for a 4-year-old child who was rescued from a home fire by emergency medical services (EMS).
Which of the following potential provider prescriptions should the nurse identify as anticipated or contraindicated? For each potential provider's pre- scription, click to specify if the potential provider's prescription is anticipated or contraindicated for the child.
-Apply sterile gauze soaked with cool 0.9% sodium chloride to the burn areas.
-Insert indwelling urinary catheter.
-Provide 100% oxygen via face mask.
-Weight the child.
Answer:
-Apply sterile gauze soaked with cool 0.9% sodium chloride to the burn areas is contraindicated.
Rationale: Applying sterile gauze soaked with cool 0.9% sodium chloride to a child who has 18% TBSA might cause hypothermia. The nurse should cover the burn with a clean, dry cloth to prevent contamination and hypothermia.
-Insert indwelling urinary catheter is anticipated.
Rationale: Inserting an indwelling urinary catheter is essential and allows for accu- rate measurement of urine output. Urine output is an indicator of the fluid status of the child. A child who has major burns will lose a significant amount of fluid due to increased capillary permeability, which increases the risk for hypovolemic shock. It is important to maintain accurate hourly I&O to manage fluid replacement.
Provide 100% oxygen via face mask is anticipated.
Rationale: Upon admission to the emergency department, the nurse should recog- nize the need to provide 100% oxygen via face mask as an essential prescription. The child's SaO2 is below the expected reference range their RR is increased.
Weigh the child is anticipated.
Rationale: The nurse should recognize the need to weigh the child as an essential. Children of the same age weigh different amounts. The amount of fluid resuscitation and medication a pediatric patient receives is based on their weight.
QUESTION
***NGN* The nurse is caring for the child 4 days after admission. Tem- perature 38.8° C (101.8° F) Heart rate 124/minRespiratory rate 22/min Blood pressure 100/56 mm HgSaO2 97% on room airWeight 17.1 kg (37.7 lb) Urine output 15 mL in past hour. Dressings to left arm and hand, anterior neck,
and anterior chest are moderately saturated with serous drainage and several small spots of serosanguineous drainage. Dressings remain intact and smell malodorous.
After reviewing the child's assessment, which of the following findings should
the nurse address first? Complete the following sentence by using the lists of options.
Dropdown 1: Temperature Saturated dressing Urine output
BP
Respiratory status
Dropdown 2: Pain Sensorium Nutrition
Drainage on dressing
Fluid status
Answer:
-Dropdown 1: Temperature
Rationale: When using the urgent vs nonurgent approach to client care, the nurse should determine that an increased temperature is a priority finding because it can indicate an infection and sepsis. Wound sepsis is most likely to occur between the third and fifth day after a burn. Therefore, the nurse should first address the child's temperature.
-Dropdown 2: Pain
Rationale: When using the urgent vs nonurgent approach to client care, the nurse should determine that an 8 out of 10 pain rating on the FACES scale is a priority finding and should be addressed next. Severe pain impacts the stress response, which can lead to complications and adversely affect healing.
QUESTION
***NGN* The nurse is continuing to care for the child.
After examining the child during hydrotherapy, the provider enters prescrip- tions into the child's medical record. For each potential provider's prescrip- tion, click to specify if the potential prescription is anticipated or contraindi- cated for the child.
-Change the morphine route to family-controlled analgesia via a PCA pump.
-Obtain a wound culture.
-Place the child on a pressure-reduction mattress.
-Limit daily protein intake.
Answer:
-Change the morphine route to family-controlled anal- gesia via a PCA pump is anticipated.
Rationale: A pain rating of 8 indicates severe pain. the use of a PCA pump should increase the effectiveness of pain management during movement and procedures. The nurse should teach the child's primary caregiver about the use of the PCA pump.
-Obtain a wound culture is anticipated.
Rationale: The child has an elevated temperature and malodorous green wound drainage. The nurse should obtain a wound culture to determine the causative organism and an abx should be administered.
-Place the child on a pressure-reduction mattress is anticipated.
Rationale: The child has developed a stage 1 pressure injury on their occiput. A
pressure-reduction mattress can help prevent further tissue injury.
-Limit daily protein intake is contraindicated.
Rationale: Children who have major burns require a high-protein, high-calorie diet to help with wound healing. The nurse should provide high-protein snacks to the child between meals.
QUESTION
***NGN* The nurse is caring for the child 14 days after admission.
The child has returned to the unit following the procedure. (1300:) Temperature
35.8° C (96.4° F) Heart rate 68/minRespiratory rate 14/min Blood pressure
90/50 mm Hg SaO2 88% on room air. Neck and left anterior chest dressings are dry and intact. Left thigh dressing has a moderate amount of bloody drainage. Surgical placement of permanent skin graft of the anterior neck and left anterior chest. Maintain IV of dextrose 5% in 0.9% sodium chloride at 56 mL/hr. Which of the following actions should the nurse take? SATA
A. Monitor SaO2 every 2 hr.
B. Provide 100% oxygen via face mask.
C. Check anterior neck and chest dressing for bleeding. D. Replace the dressing on the left thigh.
E. Place a warm blanket on the child.
F. Keep the child's head in a neutral position.
Answer:
B. Provide 100% oxygen via face mask.
Rationale: The nurse should provide 100% oxygen via a face mask to the child because of their SaO2 and RR. The SaO2 should be maintained at 95% or higher and if the SaO2 falls below 95%, supplemental oxygen should be initiated.
C. Check anterior neck and chest dressing for bleeding.
Rationale: Upon return from the procedure, all surgical dressings should be as-
sessed for drainage and to ensure the dressing is intact.
E. Place a warm blanket on the child.
Rationale: The child is exhibiting hypothermia. It is important for the child to have a stable body temperature because vasoconstriction can diminish blood flow to the surgical sites and impair healing.
F. Keep the child's [Show Less]