ATI RN
ATI Pediatrics Proctored Exam 2023
1. A school-age child has peripheral edema. Which of the following assessments should the nurse perform to confirm peripheral edema?
- A. Palpate the dorsum of the child's feet
- B. Weigh the child daily using the same scale
- C. Assess the child's skin turgor
- D. Observe the child for periorbital swelling
Correct answer: A
Rationale: To confirm peripheral edema in a child, the nurse should palpate the dorsum of the child's feet by pressing a fingertip against a bony prominence for 5 seconds. This assessment helps detect the presence of pitting edema, which is characterized by an indentation that remains after the pressure is released.
2. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?
- A. Applying a diaper to prevent contamination of the sac
- B. Positioning the newborn in a side-lying position
- C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
- D. Positioning the newborn in a prone position
Correct answer: D
Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.
3. Which model of practice emphasizes the child's subjective experience of their abilities?
- A. Occupational Adaptation
- B. Model of Human Occupation
- C. Person-Environment-Occupation-Performance Model
- D. Canadian Model of Occupational Performance and Engagement
Correct answer: B
Rationale: The Model of Human Occupation (MOHO) emphasizes the child's subjective experience of their abilities, focusing on their motivation, roles, habits, and routines. It considers how these factors influence their occupational performance. MOHO helps occupational therapists understand how a child's perceptions of their abilities impact their engagement in meaningful activities and occupations.
4. The healthcare provider is providing care to a child who was treated with aspirin during a viral infection. Which clinical manifestations should cause the healthcare provider concern?
- A. Nausea, vomiting, and confusion
- B. Headache, vomiting, and seizures
- C. Sore throat, moist respirations, and cough
- D. Fever, rash, and photophobia
Correct answer: A
Rationale: The symptoms of nausea, vomiting, and confusion are concerning as they are indicative of Reye's syndrome, a rare but serious condition associated with aspirin use in children during viral illnesses. Reye's syndrome can lead to severe complications, including brain and liver damage, hence prompt recognition and management are crucial.
5. A patient with Parkinson�s disease who takes levodopa/carbidopa (Sinemet) comes to the clinic for a semi-annual physical examination. Which question is the most important for that nurse to ask?
- A. Have you noticed any swelling in your feet?
- B. Are you having vivid dreams or hallucination?
- C. Have you noticed any changes in your stool?
- D. Have you had your flu vaccine?
Correct answer: B
Rationale: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug.
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