ATI RN
ATI Pediatric Proctored Exam
1. A child receives a vaccine for MMR. Six hours after the injection, the child�s parent reports local soreness, erythema, lethargy, and a fever of 101�F to a nurse. Which action should the nurse take?
- A. Give instructions on relieving symptoms with acetaminophen
- B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
- C. Tell the parent that a live vaccine will cause a mild case of measles
- D. Obtain and fill out a Vaccine Adverse Event Report form
Correct answer: A
Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.
2. 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.
3. When preparing to insert an intravenous catheter for a 7-year-old child, which of the following actions should a healthcare professional take?
- A. Apply an anesthetic cream to the insertion site 1 hr before the procedure.
- B. Use a 16-gauge needle for the insertion.
- C. Insert the catheter into a vein of the child's dominant hand.
- D. Choose a site over the child's metacarpal veins.
Correct answer: A
Rationale: Applying an anesthetic cream to the insertion site 1 hr before the procedure is crucial when inserting an intravenous catheter in a child to minimize pain and discomfort during the procedure. This practice is especially important in pediatric patients to ensure a more comfortable experience and improve cooperation during the insertion process. Choice B is incorrect as a 16-gauge needle is too large for a child, and a smaller gauge needle is typically used. Choice C is incorrect as the catheter should be inserted into a suitable vein, not specifically the dominant hand vein. Choice D is incorrect as metacarpal veins are usually avoided due to their small size and the potential for complications.
4. When a patient is taking glucocorticoids and digoxin, which electrolyte should the nurse prioritize monitoring?
- A. Calcium
- B. Magnesium
- C. Sodium
- D. Potassium
Correct answer: D
Rationale: The nurse should primarily monitor potassium levels in a patient taking glucocorticoids and digoxin. Glucocorticoids can lead to potassium loss, potentially increasing the risk of digoxin toxicity. Additionally, glucocorticoids may worsen hypokalemia induced by diuretics like thiazides and loops. While calcium, magnesium, and sodium are important electrolytes to monitor in various clinical situations, they are not the priority in this specific scenario of a patient on glucocorticoids and digoxin.
5. 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.
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