ATI RN
ATI Pediatric Proctored Exam 2023
1. A child is being assessed for Kawasaki disease. Which of the following findings should be expected?
- A. Decreased heart rate
- B. Dry, scaly skin
- C. Fever unresponsive to antipyretics
- D. Nontender cervical lymphadenopathy
Correct answer: C
Rationale: In Kawasaki disease, a child typically presents with a fever that is unresponsive to antipyretics because the disease is characterized by systemic inflammation. The persistent fever is a hallmark feature of the disease and can last for more than five days despite treatment with antipyretics.
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 child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight � 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours?
- A. 88 mL/hr
- B. 86 mL/hr
- C. 81 mL/hr
- D. 83 mL/hr
Correct answer: B
Rationale: For 13 kg, the maintenance fluid is 1150 mL (1000 mL for first 10 kg + 3*50 mL for the remaining 3 kg). Replacement fluid is 910 mL (0.07 * 13000 mL). Total fluid is 2060 mL, divided by 24 hours is 86 mL/hr.
4. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?
- A. Allow the child to bathe 6 hours after the procedure.
- B. Keep the child on bed rest for 12 hours.
- C. Maintain a pressure dressing on the site for 8 hours.
- D. Resume regular activities the day after the procedure.
Correct answer: B
Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.
5. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?
- A. 0.9% normal saline (NS)
- B. D5 0.2% (�) normal saline
- C. D5W
- D. Albumin
Correct answer: A
Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.
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