ATI RN
ATI Pediatric Proctored Exam
1. Which assessment finding for a 4-month-old infant would require further action by the nurse?
- A. The posterior fontanel is open.
- B. The infant has good head control when held upright.
- C. The infant is able to roll only from abdomen to back.
- D. The anterior fontanel is open and soft.
Correct answer: A
Rationale: The correct answer is A. The posterior fontanel should be closed by 4 months of age. An open posterior fontanel at this age may indicate a delay in normal closure, which could be a cause for concern and require further evaluation by the healthcare provider to ensure proper development and growth. Choices B, C, and D are typical developmental milestones for a 4-month-old infant and do not raise immediate concerns requiring further action by the nurse.
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. 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.
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. When caring for an infant with respiratory syncytial virus (RSV), which of the following actions should the nurse take?
- A. Administer antibiotics IM once per day.
- B. Initiate droplet precautions.
- C. Place the infant in a negative-pressure isolation room.
- D. Suction the nasopharynx as needed.
Correct answer: D
Rationale: When caring for an infant with respiratory syncytial virus (RSV), maintaining a patent airway is crucial. Suctioning the nasopharynx as needed helps clear secretions, prevent airway obstruction, and promote effective breathing. This intervention can aid in improving the infant's respiratory status and overall comfort. Administering antibiotics IM once per day (Choice A) is not indicated for RSV as it is caused by a virus, not bacteria. Initiating droplet precautions (Choice B) is important to prevent the spread of respiratory infections like RSV, but directly caring for the infant involves more specific interventions. Placing the infant in a negative-pressure isolation room (Choice C) is generally reserved for airborne infections, not RSV which spreads through respiratory droplets.
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