ATI RN
ATI Pediatrics Proctored Exam 2023
1. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?
- A. Inflamed throat with exudate
- B. Purulent eye drainage
- C. Dry, hacking cough
- D. Koplik spots on buccal mucosa
Correct answer: C
Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.
2. What is the appropriate site to administer an intramuscular (IM) vaccine to a newborn?
- A. The dorsal gluteal muscle
- B. The vastus lateralis muscle
- C. The ventral gluteal muscle
- D. The biceps muscle
Correct answer: B
Rationale: The correct site to administer an intramuscular (IM) vaccine to a newborn is the vastus lateralis muscle. For newborns, the vastus lateralis is preferred over the dorsogluteal site because the dorsogluteal site has been associated with low antibody seroconversion rates, indicating a reduced immune response. The vastus lateralis is also recommended for IM injections in newborns, while the deltoid muscle is preferred for older infants and children. The ventral gluteal muscle and the biceps muscle are not appropriate sites for IM injections. Therefore, choice B is the correct answer.
3. What is a condition where the walls of the arteries become thickened and stiff, often due to the buildup of plaque, leading to reduced blood flow?
- A. Atherosclerosis
- B. Angina
- C. Hypertension
- D. Arrhythmia
Correct answer: A
Rationale: Atherosclerosis is the correct answer. It is a condition characterized by the thickening and stiffening of artery walls due to plaque buildup, which restricts blood flow. Angina (choice B) is chest pain or discomfort caused by reduced blood flow to the heart. Hypertension (choice C) is high blood pressure, not directly related to arterial wall thickening. Arrhythmia (choice D) refers to irregular heart rhythms and is not specifically linked to artery wall changes like atherosclerosis.
4. Which of the following is a result of stimulation of the sympathetic nervous system?
- A. decreased blood flow to the skeletal muscles
- B. increased cardiac output
- C. decreased respiratory rate
- D. increased urinary output
Correct answer: increased cardiac output
Rationale: Stimulation of the sympathetic nervous system leads to an increase in cardiac output. When the sympathetic nervous system is activated, it causes the heart to beat faster and with more force, leading to an increased cardiac output. Choices A, C, and D are incorrect because the sympathetic nervous system does not cause decreased blood flow to the skeletal muscles, decreased respiratory rate, or increased urinary output.
5. A nurse is caring for a client with diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?
- A. 14 units
- B. 28 units
- C. 32 units
- D. 42 units
Correct answer: D
Rationale: The nurse should combine both orders of insulin in the same syringe. To prepare the correct dose, the nurse should withdraw the regular insulin first (14 units) and then the NPH insulin (28 units), totaling 42 units. This combination ensures the client receives the prescribed doses of both types of insulin. Choices A, B, and C are incorrect because the nurse needs to prepare and administer both types of insulin as prescribed, resulting in a total of 42 units in the syringe.
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