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ATI Pediatrics Proctored Exam 2023 with NGN
1. When discussing heart conditions, a healthcare provider explains a condition in which the lungs retain extra fluid due to left ventricular impairment. What is this condition?
- A. Whooping cough
- B. Pneumonia
- C. Asthma
- D. Pulmonary edema
Correct answer: D
Rationale: Pulmonary edema is the correct answer. It is a condition characterized by the retention of extra fluid in the lungs, often due to left ventricular impairment. This fluid buildup can lead to symptoms such as shortness of breath, coughing, and difficulty breathing. Whooping cough (Choice A), pneumonia (Choice B), and asthma (Choice C) are not conditions related to the retention of fluid in the lungs due to left ventricular impairment. Whooping cough is a bacterial respiratory infection, pneumonia is an infection that inflames the air sacs in one or both lungs, and asthma is a chronic respiratory condition characterized by airway inflammation and constriction.
2. What intervention should the nurse encourage for a postpartum client complaining of perineal pain?
- A. Use of ice packs for the first 24 hours
- B. Application of heat packs immediately
- C. Avoiding the use of peri-bottles
- D. Using tampons to manage lochia
Correct answer: A
Rationale: The correct intervention for perineal pain in a postpartum client is the use of ice packs for the first 24 hours. Ice packs help reduce swelling and discomfort in the perineal area, especially during the initial post-delivery period. Applying heat packs can exacerbate swelling and discomfort. Avoiding peri-bottles may lead to poor perineal hygiene. Using tampons is contraindicated postpartum as it increases the risk of infection.
3. When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?
- A. Arm recoil
- B. Square window sign
- C. Scarf sign
- D. Popliteal angle
Correct answer: A
Rationale: The correct answer is Arm recoil. Arm recoil is slower in healthy but fatigued newborns after birth, making it best elicited after the first hour of birth when the baby has had time to recover from the stress of birth. This assessment helps evaluate neuromuscular maturity in newborns and is more accurate when performed after the initial recovery period. The other choices, Square window sign, Scarf sign, and Popliteal angle, are not specifically assessed using the Ballard gestational assessment tool and do not relate to the recovery period after birth.
4. The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby's head is so pointed and puffy-looking. What is the best response by the nurse?
- A. His head is molded from fitting through the birth canal. It will become more round.
- B. We refer to that as 'cone head,' which is a temporary condition that goes away.
- C. It might mean that your baby sustained brain damage during birth, and could have delays.
- D. I think he looks just like you. Your head is much the same shape as your baby's.
Correct answer: A
Rationale: The corrected response 'His head is molded from fitting through the birth canal. It will become more round.' is the best answer as it explains the physiological reason for the baby's appearance after birth. It reassures the father that the pointed and puffy-looking head is a normal part of the birthing process and will resolve on its own. Choice B is incorrect because while 'cone head' is a term used colloquially, it does not provide a detailed explanation. Choice C is incorrect and should be avoided as it introduces unnecessary worry by suggesting brain damage. Choice D is not an appropriate response as it doesn't address the father's concern or provide accurate information about newborn physiology.
5. A breastfeeding mother complains of sore nipples. Which intervention should the nurse suggest?
- A. Use a breast pump until nipples heal
- B. Apply lanolin cream after each feeding
- C. Wash nipples with soap and water before and after each feeding
- D. Reduce the frequency of breastfeeding
Correct answer: B
Rationale: The correct intervention for sore nipples in a breastfeeding mother is to suggest applying lanolin cream after each feeding. Lanolin cream can help soothe and protect the nipples, promoting healing and reducing discomfort. Using a breast pump may not address the underlying issue causing soreness. Washing nipples with soap and water excessively can lead to dryness and further irritation. Reducing breastfeeding frequency may impact milk supply and bonding. Therefore, recommending lanolin cream is the most appropriate intervention to alleviate soreness in this situation.
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