ATI RN
ATI Pediatric Proctored Exam
1. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?
- A. Administer meperidine for pain.
- B. Apply cold compresses to the child's joints.
- C. Limit the child's fluid intake.
- D. Maintain bed rest for the child.
Correct answer: D
Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.
2. A healthcare professional is planning care for an infant with hyperbilirubinemia receiving phototherapy. Which of the following actions should the healthcare professional include in the plan?
- A. Dress the infant in light, breathable clothing.
- B. Turn and reposition the infant every 4 hours.
- C. Offer the infant frequent, small feedings.
- D. Avoid using lotions on the infant's skin.
Correct answer: B
Rationale: Turning and repositioning the infant every 4 hours is essential to prevent pressure sores and ensure uniform exposure to phototherapy. This practice helps prevent skin breakdown and ensures the effectiveness of the phototherapy in treating hyperbilirubinemia. Dressing the infant in light, breathable clothing (Choice A) is generally a good practice but not directly related to the effectiveness of phototherapy. Offering frequent, small feedings (Choice C) is important for infant nutrition but does not directly impact the phototherapy. Avoiding lotions on the infant's skin (Choice D) is recommended to prevent interference with the phototherapy but is not the most critical action to include in the care plan.
3. In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?
- A. The child with tachypnea and pulmonary congestion
- B. The child with hepatomegaly and normal respiratory rate
- C. The child with dependent and sacral edema and regular pulse
- D. The child with periorbital edema and normal respiratory rate
Correct answer: A
Rationale: The child with tachypnea and pulmonary congestion should be seen first. Tachypnea indicates an increased respiratory rate, a sign of possible respiratory distress. Pulmonary congestion suggests fluid accumulation in the lungs, posing a serious risk to respiratory function. Immediate attention is crucial in this case. Choice B is incorrect as hepatomegaly alone does not indicate an acute issue requiring immediate attention. Choices C and D, while showing signs of fluid-volume excess, do not present the same level of respiratory compromise as tachypnea and pulmonary congestion, making them lower priority.
4. Prior to hydrotherapy treatment for wound debridement following a burn injury, which of the following actions should be taken?
- A. Apply topical antimicrobial ointment to the child's wound
- B. Place a mesh gauze dressing over the child's wound
- C. Administer an analgesic to the child
- D. Initiate prophylactic antibiotic therapy for the child
Correct answer: C
Rationale: Corrected Rationale: Prior to hydrotherapy for wound debridement, it is crucial to administer an analgesic to the preschooler. The procedure is known to be extremely painful, and providing analgesia or sedation is essential to manage the discomfort and pain experienced by the child during the treatment. Choice A is incorrect because applying topical antimicrobial ointment is not a pre-procedural requirement but rather a post-procedure wound care step. Choice B is incorrect as placing a mesh gauze dressing does not address the pain management aspect. Choice D is also incorrect as prophylactic antibiotic therapy is not the primary intervention needed before hydrotherapy for wound debridement.
5. When educating a parent of an infant with a new prescription for digoxin, which instruction should the nurse provide?
- A. Repeat the dose if the infant vomits.
- B. Mix the medication with food.
- C. Give the medication with meals.
- D. Monitor the infant's heart rate prior to administering the medication.
Correct answer: D
Rationale: The correct answer is D: 'Monitor the infant's heart rate prior to administering the medication.' It is crucial for the nurse to monitor the infant's heart rate before giving digoxin to identify any signs of digoxin toxicity early. Heart rate assessment helps in detecting and preventing potential complications associated with digoxin use. Choices A, B, and C are incorrect. Repeating the dose if the infant vomits can lead to overdose, mixing the medication with food may alter its absorption, and giving the medication with meals can affect its effectiveness. Therefore, the priority is to monitor the infant's heart rate to ensure safe administration of digoxin.
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