ATI RN
ATI Pediatric Proctored Exam
1. When preparing to insert an intravenous catheter for a 7-year-old child, which of the following actions should a healthcare professional take?
- A. Apply an anesthetic cream to the insertion site 1 hr before the procedure.
- B. Use a 16-gauge needle for the insertion.
- C. Insert the catheter into a vein of the child's dominant hand.
- D. Choose a site over the child's metacarpal veins.
Correct answer: A
Rationale: Applying an anesthetic cream to the insertion site 1 hr before the procedure is crucial when inserting an intravenous catheter in a child to minimize pain and discomfort during the procedure. This practice is especially important in pediatric patients to ensure a more comfortable experience and improve cooperation during the insertion process. Choice B is incorrect as a 16-gauge needle is too large for a child, and a smaller gauge needle is typically used. Choice C is incorrect as the catheter should be inserted into a suitable vein, not specifically the dominant hand vein. Choice D is incorrect as metacarpal veins are usually avoided due to their small size and the potential for complications.
2. A patient is 1 hour postoperative following an open reduction internal fixation of the left tibia. Which of the following actions should the nurse take?
- A. Assess neurovascular status of the extremities every 4 hours
- B. Monitor the patient's pain level every 8 hours
- C. Assist the patient to the bathroom every 2 hours
- D. Keep the patient's left leg elevated on two pillows
Correct answer: A
Rationale: The correct action for the nurse to take 1 hour postoperative following an open reduction internal fixation of the left tibia is to assess neurovascular status of the extremities every 4 hours. This frequent assessment is crucial to monitor for any signs of complications such as impaired circulation or nerve damage. Monitoring every 4 hours allows for early detection of any issues, enabling timely intervention and prevention of potential complications. Monitoring the patient's pain level every 8 hours (choice B) is not as immediate or essential for postoperative care. Assisting the patient to the bathroom every 2 hours (choice C) may not be necessary if the patient is not ambulatory yet. Keeping the patient's left leg elevated on two pillows (choice D) can be beneficial but is not the priority in the immediate postoperative period compared to assessing neurovascular status.
3. A child receives a vaccine for MMR. Six hours after the injection, the child�s parent reports local soreness, erythema, lethargy, and a fever of 101�F to a nurse. Which action should the nurse take?
- A. Give instructions on relieving symptoms with acetaminophen
- B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
- C. Tell the parent that a live vaccine will cause a mild case of measles
- D. Obtain and fill out a Vaccine Adverse Event Report form
Correct answer: A
Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.
4. When discussing the correction of hypospadias in a newborn, what does the nurse explain about this condition?
- A. No intervention is required as the defect will correct itself over time.
- B. Surgical repair of hypospadias is typically performed before 18 months of age.
- C. Corrective surgery is commonly postponed until preschool age.
- D. Repairing the defect does not increase the risk of testicular cancer.
Correct answer: B
Rationale: Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis. Surgical repair is the primary treatment for hypospadias and is usually recommended to be done before 18 months of age. This timing is preferred for optimal cosmetic and functional outcomes. Waiting until preschool age for corrective surgery may increase the complexity of the procedure and potential complications. Correcting hypospadias does not impact the risk of testicular cancer.
5. Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?
- A. An undescended testicle can reduce fertility.
- B. The testicle usually descends spontaneously during the first month of life.
- C. Surgical correction reduces the risk for testicular tumors.
- D. The optimal time to surgically correct the condition is at diagnosis.
Correct answer: A
Rationale: The correct answer is A because an undescended testicle can reduce fertility. Even after surgical correction (orchiopexy), fertility rates may be reduced, especially when one testis remains undescended. The statement in choice B is incorrect as the testicle should have descended into the scrotum by the time the infant is 4-6 months old. While choice C is true that surgical correction can reduce the risk of testicular tumors, the question focuses on the father's understanding of the information presented, which is better reflected in choice A. Choice D is incorrect because the optimal time for surgical correction of an undescended testicle is typically around 6-18 months of age, not necessarily at the time of diagnosis.
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