ATI RN
ATI Pediatrics Proctored Exam 2023
1. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?
- A. Draw a stick figure with seven body parts
- B. Draw a circle
- C. Identify right from left hand
- D. Tie their shoelaces
Correct answer: B
Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.
2. 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.
3. 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.
4. 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.
5. A school-age child is 4 hours postoperative following perforated appendicitis repair. Which of the following actions should the nurse take?
- A. Maintain the child on a clear liquid diet for 48 hours.
- B. Administer antibiotics for 7 days.
- C. Apply warm compresses to the surgical site every 4 hours.
- D. Keep the child on NPO status for 24 hours.
Correct answer: B
Rationale: Administering antibiotics for 7 days is essential postoperatively to prevent infections and complications in a child who underwent perforated appendicitis repair. This helps in reducing the risk of secondary infections and promoting healing. Clear liquid diets, warm compresses, and prolonged fasting are not the primary interventions indicated in this scenario.
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