ATI RN
ATI Pediatric Proctored Exam
1. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?
- A. Administer aspirin for pain.
- B. Avoid administering NSAIDs.
- C. Restrict physical activities.
- D. Apply heat to joints.
Correct answer: B
Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.
2. A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?
- A. Promethazine
- B. Epinephrine
- C. Diphenhydramine
- D. Hydroxyzine
Correct answer: B
Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.
3. When preparing an adolescent for a lumbar puncture, which of the following actions should the nurse take?
- A. Place a cardiac monitor on the adolescent prior to the procedure
- B. Apply topical analgesic cream to the site one hour prior to the procedure
- C. Keep the adolescent in a semi-Fowler's position for 4 hours following the procedure
- D. Restrict fluids for 2 hours following the procedure
Correct answer: B
Rationale: The correct action for the nurse when preparing an adolescent for a lumbar puncture is to apply topical analgesic cream to the site one hour before the procedure. This helps reduce pain experienced during the lumbar puncture, making the procedure more comfortable for the adolescent. Placing a cardiac monitor on the adolescent is not necessary for a lumbar puncture. Keeping the adolescent in a semi-Fowler's position for 4 hours following the procedure is not a standard practice after a lumbar puncture. Restricting fluids for 2 hours following the procedure is not a requirement for a lumbar puncture preparation.
4. A school nurse is assessing a school-age child�s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child�s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct answer: C
Rationale: The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to the floor in a side-lying position immediately.
5. Which level nursery classifications are housed in institutions that can provide on-site surgical repair of serious congenital or acquired malformations?
- A. Level III
- B. Level I
- C. Level IV
- D. Level II
Correct answer: C
Rationale: The correct answer is C: Level IV. Level IV nurseries are equipped to provide the highest level of care, including complex surgical interventions for serious congenital or acquired malformations. These nurseries have the necessary resources and expertise to manage critical cases effectively. Choice A: Level III nurseries provide advanced care for moderately ill newborns but may not have the capacity for on-site surgical repair of serious malformations. Choice B: Level I nurseries offer basic care for healthy newborns and those with minor issues, lacking the resources for surgical interventions. Choice D: Level II nurseries can manage moderately ill newborns but may not have the capability for complex surgical interventions like Level IV nurseries.
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