ATI RN
ATI Pediatrics Proctored Exam 2023
1. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?
- A. Hypoalbuminemia
- B. Hyperkalemia
- C. Polyuria
- D. Hyperglycemia
Correct answer: A
Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.
2. 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.
3. 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.
4. In the management of heart failure, which diuretic is preferred due to its demonstrated significant mortality reduction in patients with heart failure?
- A. Furosemide (Lasix)
- B. Hydrochlorothiazide (HydroDIURIL)
- C. Spironolactone (Aldactone)
- D. Mannitol (Osmitrol)
Correct answer: C
Rationale: Spironolactone, a potassium-sparing diuretic, is the preferred choice in heart failure due to its cardio-protective effect, leading to reduced mortality in patients with heart failure. It is used to manage both hypertension and edema, making it a valuable option in heart failure treatment.
5. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?
- A. Seizures
- B. Respiratory distress
- C. Hyperthermia
- D. Bradycardia
Correct answer: A
Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.
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