ATI RN
ATI Pediatrics Proctored Exam 2023
1. The nurse is teaching a patient with cancer about a new prescription for a fentanyl patch, 25mcg/hr. for chronic back pain. Which statement is the most appropriate to include in the teaching plan.
- A. You will need to change this patch every day, regardless of your pain level.
- B. This type of pain medication is not as likely to cause breathing problems.
- C. With the first patch, it will take about 24hrs before you feel the full effects.
- D. Use your heating pad for the back pain. It will also improve the patch�s effectiveness.
Correct answer: C
Rationale: Full analgesic effects can take up to 24 hours to develop with fentanyl patches. Most patches are changed every 72 hours. Has the same adverse effects as other opioids, including respiratory depression. Should avoid exposing the patch to external heat sources, because this may increase toxicity.
2. 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.
3. Which menu choices for a child diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?
- A. Carrots and green, leafy vegetables
- B. Spaghetti and meat sauce with breadsticks
- C. Hamburger on a bun and cherry gelatin
- D. Chips, cold cuts, and canned foods
Correct answer: A
Rationale: Carrots and green, leafy vegetables are high in potassium, which should be avoided in hyperkalemia. Therefore, this choice requires further instruction by the nurse to prevent exacerbating the child's condition.
4. A patient is prescribed fluconazole (Diflucan) for a vaginal yeast infection. The nurse should be concerned if the patient is also taking which medication?
- A. Losartan (Cozaar)
- B. Simvastatin (Zocor)
- C. Lisinopril (Zestril)
- D. Hydrochlorothiazide (HCTZ)
Correct answer: B
Rationale: When fluconazole is taken with statins like simvastatin, it can increase the levels of the statin in the blood, potentially leading to adverse effects such as muscle pain and weakness. Therefore, the nurse should be concerned if the patient is taking simvastatin along with fluconazole.
5. The healthcare provider should question an order for glucocorticoids in the treatment of a patient with what condition?
- A. Systemic fungal infection
- B. Diabetes Mellitus
- C. Myasthenia Gravis
- D. Glaucoma
Correct answer: A
Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.
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