ATI RN
ATI Pediatric Proctored Exam 2023
1. A healthcare provider is preparing to administer ibuprofen 5 mg per kg every 6 hours PRN for temperatures above 38.0 degrees Celsius or 100.5 degrees Fahrenheit to an infant who weighs 17.6 lb. The infant has a temperature of 38.4 degrees Celsius or 101.2 degrees Fahrenheit. Available is ibuprofen liquid 100 mg/5 ml. How many milliliters should the healthcare provider administer to the infant?
- A. 12 ml
- B. 6 ml
- C. 2 ml
- D. 1 ml
Correct answer: C
Rationale: To calculate the correct dosage, first convert the infant's weight to kilograms: 17.6 lb = 8 kg. The prescribed dose is 5 mg/kg, so for an 8 kg infant, the total dose required is 40 mg. Since the available ibuprofen liquid is 100 mg/5 ml, to find out how many milliliters to administer, divide the total dose (40 mg) by the concentration of the liquid (100 mg/5 ml), which equals 2 ml. Therefore, the healthcare provider should administer 2 ml of ibuprofen to the infant.
2. When receiving change-of-shift report for children, which child should the nurse assess first?
- A. A toddler who has a concussion and an episode of forceful vomiting
- B. An adolescent with infective endocarditis who reports having a headache
- C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
- D. A school-age child with acute glomerulonephritis and brown-colored urine
Correct answer: A
Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.
3. A preschool-age child is admitted to the hospital with acute postinfectious glomerulonephritis (APIGN). Which is the priority nursing diagnosis for this child?
- A. Risk for Injury related to hypertension.
- B. Altered Growth and Development related to chronic disease.
- C. Risk for Infection related to hypertension.
- D. Fluid Volume Excess related to decreased plasma filtration.
Correct answer: A
Rationale: The priority nursing diagnosis for a preschool-age child with acute postinfectious glomerulonephritis (APIGN) is 'Risk for Injury related to hypertension' due to the potential complications such as hypertensive encephalopathy. Hypertension poses an immediate threat to the child's well-being, making it crucial to address the risk for injury associated with elevated blood pressure as the top priority.
4. During the oliguric phase of acute kidney injury, what intervention should be included in the plan of care for a child?
- A. Administer a loop diuretic.
- B. Provide a low-sodium diet.
- C. Weigh the child weekly.
- D. Provide a high-protein diet.
Correct answer: A
Rationale: During the oliguric phase of acute kidney injury, the priority is managing fluid balance. Administering a loop diuretic is crucial to promote diuresis and reduce fluid retention, aiding in managing the condition effectively. Providing a low-sodium diet may be beneficial but is not the priority intervention during this phase. Weighing the child weekly is important for monitoring overall health but does not directly address the oliguric phase. Providing a high-protein diet is not typically recommended in acute kidney injury, especially during the oliguric phase, as it can put additional stress on the kidneys.
5. When teaching a parent of a 2-month-old infant with acute gastroenteritis who is bottle feeding, which of the following statements should the nurse include?
- A. Offer Pedialyte between formula feedings.
- B. Feed the infant every 6 hours.
- C. Give diluted apple juice if the infant becomes dehydrated.
- D. Switch to soy-based formula permanently.
Correct answer: A
Rationale: In the case of acute gastroenteritis in a 2-month-old infant who is bottle feeding, the nurse should recommend offering Pedialyte between formula feedings. This helps prevent dehydration and ensures that the infant receives essential electrolytes and fluids to aid in recovery. Pedialyte is specifically formulated to help replace lost fluids and electrolytes due to vomiting and diarrhea, making it a suitable choice for infants with gastroenteritis. Choice B is incorrect because infants with acute gastroenteritis should be fed more frequently to prevent dehydration. Choice C is incorrect as apple juice is not recommended for infants with gastroenteritis; Pedialyte or oral rehydration solutions are preferred. Choice D is incorrect because switching to soy-based formula permanently is not necessary for managing acute gastroenteritis; Pedialyte and continuing with the current formula are more appropriate.
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