ATI RN
ATI Pediatrics Proctored Exam 2023
1. A school-age child has peripheral edema. Which of the following assessments should the nurse perform to confirm peripheral edema?
- A. Palpate the dorsum of the child's feet
- B. Weigh the child daily using the same scale
- C. Assess the child's skin turgor
- D. Observe the child for periorbital swelling
Correct answer: A
Rationale: To confirm peripheral edema in a child, the nurse should palpate the dorsum of the child's feet by pressing a fingertip against a bony prominence for 5 seconds. This assessment helps detect the presence of pitting edema, which is characterized by an indentation that remains after the pressure is released.
2. 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.
3. 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.
4. When teaching parents of a school-aged child with a new diagnosis of osteomyelitis of the tibia, which statement by the parents indicates an understanding of the teaching?
- A. My child will have a cast until healing is complete.
- B. My child will receive antibiotics for several weeks.
- C. My child can return to playing sports once he is discharged.
- D. My child needs to be in contact isolation.
Correct answer: B
Rationale: The correct answer is B. Osteomyelitis of the tibia typically requires antibiotic therapy for at least 4 weeks. Surgery may be necessary if the infection does not respond to antibiotics. Weight-bearing should be avoided with osteomyelitis to prevent complications. Choices A, C, and D are incorrect because a cast until healing, returning to sports immediately, and contact isolation are not primary management strategies for osteomyelitis.
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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