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ATI Pediatrics Proctored Test
1. Which of the following statements regarding febrile seizures in children is correct?
- A. They can occur even after a child has had a fever for longer than 24 hours.
- B. They can be caused by viral or bacterial meningitis.
- C. They do not typically occur on the first day of a fever.
- D. They typically last less than 15 minutes and often do not have a postictal phase.
Correct answer: D
Rationale: The correct answer is D. Febrile seizures in children typically last less than 15 minutes and often do not have a postictal phase, meaning there is usually no prolonged recovery period or confusion after the seizure. They are commonly associated with the rapid rise in body temperature at the onset of a fever, rather than the duration of the fever itself. Choices A, B, and C are incorrect because febrile seizures can occur even after a child has had a fever for longer than 24 hours, they can be caused by viral or bacterial meningitis, and they do not have a typical pattern of occurring on the first day of a fever.
2. What should you do immediately upon delivery of a newborn's head?
- A. Suction the nose.
- B. Dry the face.
- C. Cover the eyes.
- D. Suction the mouth.
Correct answer: D
Rationale: Upon delivery of a newborn's head, the priority is to clear the airway to ensure proper breathing. Suctioning the mouth takes precedence over suctioning the nose or other actions to prevent potential airway obstruction. Choice D is the correct answer as it addresses the immediate need to maintain a clear airway for the newborn. Choices A, B, and C are not the correct actions to take at this moment as they do not directly address the crucial need to establish a clear airway for the newborn.
3. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:
- A. placing the child supine and palpating the abdomen.
- B. separating the child from the parent to ensure a reliable examination.
- C. examining the child in the parent's arms.
- D. palpating the painful area of the abdomen first.
Correct answer: C
Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.
4. You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before but had a miscarriage at 19 weeks. You should document her obstetric history as:
- A. gravida 2, para 1.
- B. gravida 2, para 0.
- C. gravida 1, para 1.
- D. gravida 0, para 2.
Correct answer: B
Rationale: In obstetrics, gravida indicates the number of pregnancies, including the current one. Para indicates the number of pregnancies carried to viability (20 weeks or more). Since the patient has been pregnant twice but only carried one pregnancy past 20 weeks, her obstetric history should be documented as gravida 2, para 0. The miscarriage at 19 weeks does not contribute to the para count. Choice A (gravida 2, para 1) would indicate that she has had two pregnancies with one resulting in a live birth, which is incorrect. Choice C (gravida 1, para 1) would indicate that she has had one pregnancy with one live birth, which does not reflect her obstetric history. Choice D (gravida 0, para 2) would indicate that she has never been pregnant past 20 weeks, which is also inaccurate.
5. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:
- A. allowing the parents to transport the child.
- B. offering oxygen and providing transport.
- C. rapidly cooling the child in cold water.
- D. keeping the child warm and providing transport.
Correct answer: B
Rationale: After a febrile seizure, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.
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