ATI RN
ATI Pediatric Proctored Exam 2023
1. A nurse administers naloxone (Narcan) to a post-op patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication?
- A. Drowsiness
- B. Tics and tremors
- C. Increased Pain
- D. Nausea and vomiting
Correct answer: C
Rationale: Naloxone reverses the effects of narcotics. Although the patient�s respiratory status will improve after administration of naloxone, the pain will be more acute.
2. A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?
- A. Administer antibiotics as prescribed.
- B. Maintain the child on NPO status.
- C. Monitor the child's intake and output.
- D. Implement seizure precautions.
Correct answer: D
Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety. Administering antibiotics as prescribed is essential in treating bacterial meningitis, but seizure precautions take precedence due to the immediate risk of injury. Maintaining NPO status and monitoring intake and output are important aspects of care but are not the priority when considering the risk of seizures.
3. Which assessment finding for a 4-month-old infant would require further action by the nurse?
- A. The posterior fontanel is open.
- B. The infant has good head control when held upright.
- C. The infant is able to roll only from abdomen to back.
- D. The anterior fontanel is open and soft.
Correct answer: A
Rationale: The correct answer is A. The posterior fontanel should be closed by 4 months of age. An open posterior fontanel at this age may indicate a delay in normal closure, which could be a cause for concern and require further evaluation by the healthcare provider to ensure proper development and growth. Choices B, C, and D are typical developmental milestones for a 4-month-old infant and do not raise immediate concerns requiring further action by the nurse.
4. A child is being cared for following a head injury. Which of the following findings should indicate to the healthcare provider that the child is developing diabetes insipidus?
- A. Urine specific gravity of 1.045
- B. Sodium level of 155
- C. Blood glucose level of 45
- D. Urine output of 35 ml per hour
Correct answer: B
Rationale: In a child with a head injury, the development of diabetes insipidus can occur due to pituitary hypofunction, leading to a deficiency of antidiuretic hormone. An elevated sodium level (hypernatremia) is a key finding in diabetes insipidus due to the excessive loss of free water in the urine, resulting in increased sodium concentration in the blood.
5. Why is the specific gravity for infants lower than for older children?
- A. Infants have a greater body surface area.
- B. Infants have a higher basal metabolic rate.
- C. Infants have a greater percentage of body weight that is water.
- D. Infants' kidneys are less able to concentrate urine.
Correct answer: D
Rationale: The correct answer is D because infants' kidneys are less developed compared to older children, making them less efficient at concentrating urine. This results in a lower specific gravity in infants. The other choices do not directly explain why the specific gravity is lower in infants.
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