ATI RN
ATI Pediatrics Proctored Exam 2023
1. 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.
2. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?
- A. Pain with urination
- B. New onset disorientation to time and place
- C. HR changes from a baseline of 70-80bpm to 110-120bpm
- D. #ERROR!
Correct answer: B
Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.
3. After administering Gardasil, the HPV vaccine, to an 11-year-old girl, the healthcare provider informs the parent that routine screening with which diagnostic test is needed?
- A. Beta hCG
- B. Chlamydia test
- C. PAP test
- D. Mammogram
Correct answer: C
Rationale: Following the administration of Gardasil, the HPV vaccine, routine screening with a PAP test is necessary. While Gardasil protects against certain types of HPV, it does not cover all strains that could lead to cervical cancer. Therefore, individuals who have received the vaccine should still undergo regular PAP tests to screen for cervical abnormalities caused by other HPV strains.
4. 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.
5. 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.
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