ATI Pediatric Proctored Exam(Q & A)(7 Versions)(Updated-2021)(Download to Score A)

1. A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying and holding a container of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. Which of the following is the pnionty action by the nurse’? a. Remove the child's contaminated clothing. c. Administer an antidote to the child. d. Establish IV access for the child. Rationale: The nurse should apply the ABC priority-setting framework when answering this item. This framework emphasizes the basic core of human functioning: having an open airway. being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these can indicate a threat to life, and is therefore the nurse’s priority concern. When applying the ARC priority setting framework, airway is always the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second highest priority in the ABC priority setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur. Circulation is the third highest priority im the ABC prionty setuing framework because delivery of oxygen to emitical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. The nurse observes that the child’s lips are edematous and inflamed and that he is drooling.