ATI RN
ATI Pediatric Proctored Exam
1. A healthcare professional is assessing an infant who has heart failure. Which of the following findings should the healthcare professional expect?
- A. Weight gain
- B. Bounding pulses
- C. Hyperactivity
- D. Increased urine output
Correct answer: A
Rationale: In infants with heart failure, one of the key manifestations is weight gain due to fluid retention. The heart's inability to pump effectively can lead to fluid buildup in the body, causing weight gain. Bounding pulses, hyperactivity, and increased urine output are not typically associated with heart failure in infants. Bounding pulses are associated with conditions like aortic regurgitation, hyperactivity can be a sign of other issues, and increased urine output is not a common finding in heart failure.
2. The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?
- A. Analyze HR and rhythm
- B. Assess for Homan�s sign
- C. Check BP
- D. Palpate the pedal pulses
Correct answer: A
Rationale: Before giving digoxin, the nurse will assess the HR and rhythm. The dosage will be held and the prescriber notified if the HR is below 60 bpm or if the cardiac rhythm has changes. Digoxin can cause bradycardia and electrical changes in the heart.
3. Which physical assessment technique should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor?
- A. Performing range-of-motion exercises on lower extremities
- B. Palpating the abdomen
- C. Assessing for bowel sounds
- D. Percussing ankle and knee reflexes
Correct answer: B
Rationale: Palpating the abdomen should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor because it could disturb the tumor and potentially cause the malignancy to spread. The other assessment techniques are safe to perform and provide valuable information about the child's condition. Range-of-motion exercises help assess mobility and joint health, assessing for bowel sounds is important to monitor gastrointestinal function, and percussing ankle and knee reflexes can help evaluate neurological responses.
4. 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.
5. 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.
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