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. A healthcare professional is preparing to administer a measles, mumps, and rubella (MMR) vaccine to a 15-month-old child. Which of the following findings is a contraindication to the administration of this vaccine?
- A. Family history of egg allergy
- B. Currently taking antibiotics
- C. History of asthma
- D. Presence of rhinorrhea
Correct answer: B
Rationale: Taking antibiotics is a contraindication to receiving the MMR vaccine because antibiotics can potentially interfere with the effectiveness of the vaccine. It is essential to avoid administering the MMR vaccine while the child is on antibiotics to ensure the vaccine provides the intended protection.
3. 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.
4. 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.
5. What is an initial sign of nephrosis that the nurse might note in a child?
- A. Raspberry-like rash
- B. Periorbital edema
- C. Temperature elevation
- D. Abdominal pain
Correct answer: B
Rationale: In nephrotic syndrome, edema is a common symptom that is generalized and not easily noticeable, even by parents. However, an early sign that can be assessed by the nurse is periorbital edema, which refers to swelling around the eyes. This can be an initial indicator of nephrosis and may prompt further evaluation and intervention.
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