ATI RN
ATI Pediatric Proctored Exam
1. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?
- A. Providing activities for the child on restricted activity
- B. Feeding the child a protein-restricted diet
- C. Carefully handling edematous extremities
- D. Observing the child for evidence of hypotension
Correct answer: A
Rationale: The most appropriate nursing intervention for a 7-year-old child with acute glomerulonephritis experiencing gross hematuria and bed rest is to provide activities for the child on restricted activity. It is important to keep the child engaged in light activities to prevent boredom and maintain some level of physical and mental well-being. Feeding a protein-restricted diet (Choice B) is not typically indicated in this scenario unless ordered by a healthcare provider to manage kidney function. Carefully handling edematous extremities (Choice C) is important in conditions like nephrotic syndrome but is not directly related to providing appropriate care for a child with acute glomerulonephritis. Observing the child for evidence of hypotension (Choice D) is important in general nursing care but is not the most immediate or specific intervention needed for a child with acute glomerulonephritis experiencing gross hematuria and bed rest.
2. When planning care for a newborn with esophageal atresia and tracheoesophageal fistula, which is the priority nursing diagnosis?
- A. Ineffective Tissue Perfusion
- B. Ineffective Infant Feeding Pattern
- C. Acute Pain
- D. Risk for Aspiration
Correct answer: D
Rationale: The priority nursing diagnosis for a newborn with esophageal atresia and tracheoesophageal fistula is 'Risk for Aspiration' because of the potential respiratory complications associated with these conditions. The newborn is at a higher risk of aspirating oral or gastric contents due to the abnormal connections between the esophagus and trachea, posing a serious threat to the airway and lungs. Addressing this risk is crucial to prevent respiratory distress and maintain the airway's patency, making it the priority nursing diagnosis in this scenario. 'Ineffective Tissue Perfusion' is not the priority as respiratory compromise takes precedence over perfusion concerns. 'Ineffective Infant Feeding Pattern' may be relevant but addressing the risk of aspiration is more critical. 'Acute Pain' is not the priority compared to the life-threatening risk of aspiration.
3. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?
- A. 0.9% normal saline (NS)
- B. D5 0.2% (�) normal saline
- C. D5W
- D. Albumin
Correct answer: A
Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.
4. A patient with Parkinson�s disease who takes levodopa/carbidopa (Sinemet) comes to the clinic for a semi-annual physical examination. Which question is the most important for that nurse to ask?
- A. Have you noticed any swelling in your feet?
- B. Are you having vivid dreams or hallucination?
- C. Have you noticed any changes in your stool?
- D. Have you had your flu vaccine?
Correct answer: B
Rationale: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug.
5. A healthcare provider is assessing an infant who has hydrocephalus and is 6 hours postoperative following placement of a ventriculoperitoneal shunt. Which of the following findings should the provider report to the healthcare provider?
- A. Decreased urine output
- B. Temperature of 37.5 degrees C (99.5 degrees F)
- C. Heart rate 130/min
- D. Leakage of cerebrospinal fluid
Correct answer: D
Rationale: The provider should report the leakage of cerebrospinal fluid to the healthcare provider as it may indicate shunt malfunction or infection, requiring immediate attention to prevent complications. Decreased urine output, a temperature of 37.5 degrees C, and a heart rate of 130/min are common postoperative findings and may not be directly related to shunt function. While these findings should still be monitored, they do not require immediate reporting like cerebrospinal fluid leakage.
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