ATI RN
ATI Pediatric Proctored Exam
1. 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.
2. 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.
3. What is it called when the therapist adjusts the difficulty level of an activity to match the child's abilities by bringing a toy closer for them to successfully reach and grasp during therapy?
- A. Compensating
- B. Adapting
- C. Grading
- D. Modifying
Correct answer: C
Rationale: The correct answer is C: Grading. Grading involves adjusting the difficulty level of an activity to match the child's abilities. Bringing a toy closer for easier reach is an example of grading in therapy, helping the child succeed in reaching and grasping the toy within their current capabilities. Choice A, Compensating, implies making up for a deficit, which is not the case here. Choice B, Adapting, suggests changing the activity itself, not just the difficulty level. Choice D, Modifying, indicates altering the toy or the task itself, rather than adjusting the task's difficulty level.
4. The healthcare professional is preparing to administer an immunization to a four-year-old child. Which of the following actions should the professional plan to take?
- A. Place the child in a prone position for the immunization
- B. Request that the child's caregiver stay in the room during the immunization
- C. Administer the immunization using a 24-gauge needle
- D. Inject the immunization slowly without aspirating
Correct answer: C
Rationale: When administering an immunization to a four-year-old child, it is important to use a 24-gauge needle to minimize pain and discomfort for the child. Thicker needles can cause more pain and tissue trauma. Using a thinner needle like a 24-gauge is appropriate for pediatric immunizations. Placing the child in a prone position for immunization is not recommended as it can be uncomfortable and may not allow for proper access to the injection site. Having the caregiver stay in the room during the immunization is beneficial for support and comfort for the child. Injecting the immunization slowly without aspirating is correct, as aspirating before administering the immunization is not required for intramuscular injections in current practice.
5. What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?
- A. 3 months
- B. 2 weeks
- C. 2.6 months
- D. 4 weeks
Correct answer: B
Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks. Choice A is incorrect because 3 months is not the correct adjustment for the given scenario. Choice C is incorrect as it provides a fractional value for age, which is not practical in this context. Choice D is incorrect as 4 weeks does not account for the weeks of prematurity.
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