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ATI Pediatrics Proctored Test
1. 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.
2. Which of the following is an abnormal finding when assessing the abdomen of a newborn?
- A. The umbilical cord has two arteries and one vein.
- B. The presence of green vomit.
- C. The liver is palpable 1 to 2 cm below the costal margin.
- D. The abdomen is soft and nondistended.
Correct answer: B
Rationale: The correct answer is B. The presence of green vomit in a newborn is an abnormal finding and indicates a possible intestinal obstruction. This finding requires immediate attention and further investigation. Choices A, C, and D are normal findings in a newborn's abdomen assessment. A newborn typically has an umbilical cord with two arteries and one vein, a liver that may be palpable 1 to 2 cm below the costal margin due to its normal size in a neonate, and a soft, nondistended abdomen as expected in healthy newborns.
3. Which of the following is MOST likely to occur in conjunction with a breech presentation?
- A. Vertex presentation
- B. Maternal hypertension
- C. Prolapsed umbilical cord
- D. Premature rupture of the amniotic sac
Correct answer: C
Rationale: In a breech presentation, where the baby's buttocks or feet present first, there is an increased risk of the umbilical cord slipping down alongside or below the presenting part, leading to a prolapsed umbilical cord. This is a serious complication that can compromise fetal blood flow and oxygenation, necessitating prompt intervention to prevent adverse outcomes. Choices A, B, and D are less likely to occur in conjunction with a breech presentation. Vertex presentation is the normal head-first presentation, maternal hypertension is a separate condition that may not be directly related to fetal presentation, and premature rupture of the amniotic sac can happen independently of the baby's presentation.
4. When is a newborn considered premature?
- A. Weighs less than 6.5 pounds.
- B. Is born to a heroin-addicted mother.
- C. Is born before 37 weeks gestation.
- D. Has meconium in or around its mouth.
Correct answer: C
Rationale: A newborn is considered premature if it is born before 37 weeks gestation. Premature birth increases the risk of various health problems as the baby may not be fully developed. Choice A is incorrect because the weight alone does not determine prematurity. Choice B is incorrect as it refers to a specific situation but not a direct indicator of prematurity. Choice D is incorrect as the presence of meconium does not solely indicate prematurity.
5. You are dispatched to a residence for a 5-year-old child who is not breathing. Upon arrival, you find the child supine on the floor, cyanotic, and unresponsive. You should first:
- A. begin chest compressions.
- B. open the airway and give two rescue breaths.
- C. apply an AED and analyze the rhythm.
- D. ask the parent for the child's medical history.
Correct answer: B
Rationale: When encountering an unresponsive and not breathing child, the initial step is to open the airway and provide two rescue breaths. This action helps to deliver oxygen to the child's lungs and body, which is crucial in attempting to restore breathing and circulation. Chest compressions are not initiated first in pediatric cases unless the child has no signs of circulation after delivering rescue breaths. Applying an AED and analyzing the rhythm is not the initial step in a pediatric cardiac arrest scenario, as the primary focus should be on providing oxygenation. Asking the parent for the child's medical history is not the immediate priority when the child is unresponsive and not breathing, as interventions to support breathing and circulation should be the primary concern.
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