ATI RN
ATI Pediatric Proctored Exam
1. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?
- A. Steatorrhea
- B. Projectile vomiting
- C. Sunken abdomen
- D. Weight gain
Correct answer: A
Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.
2. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?
- A. Massive proteinuria, hypoalbuminemia, and edema
- B. Hematuria, bacteriuria, and weight gain
- C. Decreased urine specific gravity and increased urinary output
- D. Gross hematuria, albuminuria, and fever
Correct answer: A
Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.
3. When teaching a parent of a child with contact dermatitis, which instruction should the nurse include?
- A. Apply a thick layer of antibiotic ointment to the affected area.
- B. Rub the skin vigorously with a towel to dry it.
- C. Keep the child's skin dry.
- D. Apply a thin layer of corticosteroid cream to the affected area.
Correct answer: D
Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.
4. During an assessment, a healthcare professional is evaluating an infant with pneumonia. Which of the following findings should be the priority for the healthcare professional to report to the provider?
- A. Nasal flaring
- B. WBC count of 11,300
- C. Diarrhea
- D. Abdominal distension
Correct answer: A
Rationale: When assessing an infant with pneumonia, the priority finding to report to the provider is nasal flaring. Nasal flaring indicates acute respiratory distress, which can be a life-threatening condition requiring immediate intervention. Monitoring and addressing respiratory distress take precedence over other symptoms or laboratory results in this situation.
5. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?
- A. Change the ostomy pouch every day.
- B. Use baby wipes to clean the stoma.
- C. Avoid using soap to clean the stoma.
- D. Apply barrier ointment to the skin around the stoma.
Correct answer: D
Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.
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