ATI RN
ATI Pediatrics Proctored Exam 2023
1. The healthcare provider is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?
- A. Vital signs and neurologic checks hourly
- B. Small, frequent formula feedings
- C. Elevate the head of the bed
- D. Daily head circumference measurements
Correct answer: C
Rationale: Elevating the head of the bed in a child with hydrocephalus can potentially increase intracranial pressure. This can be counterproductive and may lead to complications after shunt placement surgery. Keeping the head of the bed flat or slightly elevated is often recommended to optimize cerebral perfusion and reduce the risk of increased intracranial pressure.
2. Which type of parenting style is associated with children who rank higher on many measures of social and cognitive development?
- A. Warm, responsive, positive
- B. Neutral, rigid, critical
- C. Absent, unstructured, negative
- D. Cold, neglectful, negative
Correct answer: A
Rationale: Research has shown that a warm, responsive, and positive parenting style is associated with children who rank higher on many measures of social and cognitive development. This style promotes secure attachment, emotional regulation, and overall well-being in children. In contrast, parenting styles characterized by neutrality, rigidity, negativity, or neglect have been linked to poorer outcomes in children's development. Understanding different parenting styles can help professionals tailor interventions to support families effectively and respectfully.
3. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?
- A. Inflamed throat with exudate
- B. Purulent eye drainage
- C. Dry, hacking cough
- D. Koplik spots on buccal mucosa
Correct answer: C
Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.
4. The nurse is planning care for a school-age client who is postoperative for the surgical removal of the appendix. In addition to pharmacologic pain management, what should the nurse include in the plan of care to address pain?
- A. Applying a warm, moist pack every 4 hours
- B. Applying EMLA cream to the incision site prior to ambulation
- C. Applying a cold, moist pack every 2 hours
- D. Applying a pillow against the abdomen to splint the incision site when coughing
Correct answer: D
Rationale: After an appendectomy, applying a pillow against the abdomen to splint the incision site when coughing helps reduce pain by providing support and minimizing movement that could cause discomfort.
5. A 4-year-old client with intractable seizures has been on a ketogenic diet for the last 6 months, with a decrease in seizure activity. This child is now admitted to the pediatric unit with left-sided pain. Which possible complication to this diet does the nurse suspect?
- A. Appendicitis
- B. Bowel obstruction
- C. Urinary tract infection
- D. Kidney stones
Correct answer: D
Rationale: The ketogenic diet increases the risk of kidney stones.
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