ATI RN
ATI Pediatrics Proctored Exam 2023
1. 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.
2. What does a Z-score of -3.00 indicate?
- A. The child's score indicates he is ahead of his peers and performing well
- B. The child's score places him within normal limits on this test item
- C. The test is inconclusive
- D. The child's score falls below the majority of his peers on this test
Correct answer: D
Rationale: A Z-score of -3.00 indicates that the child's performance is significantly below the average of their peers. It represents an extreme low score, indicating a substantial deviation from the mean performance of the group.
3. 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.
4. 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.
5. 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.
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