ATI RN
ATI Pediatric Proctored Exam
1. A nurse is providing teaching to the guardian of an infant about home safety. Which of the following statements by the guardian indicates an understanding of the teaching?
- A. I will place my baby on her stomach to sleep
- B. I will put a small pillow in my baby's crib
- C. I will keep my baby's crib away from the radiator
- D. I will use a drop-side crib for my baby
Correct answer: C
Rationale: The nurse should instruct the guardian to keep the baby�s crib away from the radiator to prevent burns.
2. What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?
- A. 3 months
- B. 2 weeks
- C. 2.6 months
- D. 4 weeks
Correct answer: B
Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks. Choice A is incorrect because 3 months is not the correct adjustment for the given scenario. Choice C is incorrect as it provides a fractional value for age, which is not practical in this context. Choice D is incorrect as 4 weeks does not account for the weeks of prematurity.
3. A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?
- A. You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing.
- B. You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy.
- C. Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy.
- D. When using the peak expiratory flow meter, record your child's average of three readings.
Correct answer: C
Rationale: The nurse should inform the parent that the child will need pulmonary function tests every 12 to 24 months to assess lung function and response to treatment. These tests help evaluate the presence of lung disease, monitor disease progression, and assess the effectiveness of the current therapeutic regimen in managing asthma. Choice A is incorrect as salmeterol is not used for acute wheezing episodes but rather for long-term maintenance. Choice B is incorrect because weight monitoring is not directly related to inhaled corticosteroid therapy for asthma. Choice D is incorrect as peak expiratory flow meter readings should be recorded as instructed, not averaged.
4. A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient�s history should the nurse recognize as a contributing factor?
- A. Amoxicillin (Amoxil)
- B. Cimetidine (Tagamet)
- C. Metronidazole (Flagyl)
- D. Omeprazole (Prilosec)
Correct answer: B
Rationale: Cimetidine binds to androgen receptors, producing receptor blockade, which can cause enlarged breast tissue, reduced libido, and impotence. All these effects reverse when dosing stops. Amoxicillin, metronidazole, and omeprazole are not associated with gynecomastia.
5. A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?
- A. WBC of 3200 cells/mm³
- B. RR of 26 breaths/min
- C. Temp of 38°C
- D. BP of 70/50
Correct answer: D
Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario as it poses a significant risk to the patient's life. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.
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