ATI RN
ATI Pediatrics Proctored Exam 2023
1. Which clean-catch urinalysis finding should raise the most concern for a child admitted to an urgent care center to rule out a urinary tract infection?
- A. 2+ white blood cells
- B. 1+ red blood cells
- C. Urine appearance: cloudy
- D. Specific gravity: 1.009
Correct answer: D
Rationale: A specific gravity of 1.009 is low, indicating diluted urine, which can be concerning in the context of a urinary tract infection. Diluted urine may suggest inadequate concentration due to increased fluid intake or impaired kidney function, which are important considerations in the assessment of a possible UTI.
2. The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?
- A. Can interfere with the treatment for nephrosis.
- B. Require that the child have antibiotic coverage.
- C. Can be given in smaller, divided doses.
- D. Should be delayed.
Correct answer: D
Rationale: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.
3. The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising blood pressure?
- A. Angiotensin I
- B. Angiotensin II
- C. Angiotensin III
- D. Renin
Correct answer: B
Rationale: Angiotensin II is the most potent compound in the renin-angiotensin-aldosterone system for raising blood pressure. It acts as a powerful vasoconstrictor, leading to increased systemic vascular resistance. Angiotensin II is formed from angiotensin I through the action of the angiotensin-converting enzyme. While renin initiates the cascade by converting angiotensinogen to angiotensin I, it is angiotensin II that exerts the strongest pressor effect.
4. Which is the appropriate intervention when providing care to a child diagnosed with nephrotic syndrome, who is edematous and on bed rest?
- A. Monitor blood pressure every 30 minutes.
- B. Reposition every 2 hours.
- C. Limit visitors.
- D. Encourage fluids.
Correct answer: B
Rationale: Repositioning every 2 hours is crucial in preventing skin breakdown in an edematous child on bed rest. This intervention helps redistribute pressure and maintain skin integrity, reducing the risk of pressure ulcers. It is an essential part of care for patients with limited mobility to ensure their comfort and prevent complications related to immobility.
5. A school-age child has peripheral edema. Which of the following assessments should the nurse perform to confirm peripheral edema?
- A. Palpate the dorsum of the child's feet
- B. Weigh the child daily using the same scale
- C. Assess the child's skin turgor
- D. Observe the child for periorbital swelling
Correct answer: A
Rationale: To confirm peripheral edema in a child, the nurse should palpate the dorsum of the child's feet by pressing a fingertip against a bony prominence for 5 seconds. This assessment helps detect the presence of pitting edema, which is characterized by an indentation that remains after the pressure is released.
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