ATI RN
ATI Pediatrics Proctored Exam 2023
1. A parent of a child with celiac disease is receiving teaching from a nurse. Which of the following statements should the nurse make?
- A. You should give your child vitamin supplements that contain iron.
- B. Your child will need a gluten-free diet.
- C. Your child should consume large amounts of dietary fiber.
- D. Your child can resume eating whole wheat bread.
Correct answer: B
Rationale: The correct answer is B. Celiac disease requires a strict gluten-free diet to manage the condition effectively. Gluten-containing foods like wheat, barley, and rye must be avoided to prevent intestinal damage and symptoms in individuals with celiac disease. Therefore, the nurse should emphasize the importance of a gluten-free diet to the parent of the child with celiac disease.
2. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?
- A. Pain with urination
- B. New onset disorientation to time and place
- C. HR changes from a baseline of 70-80bpm to 110-120bpm
- D. #ERROR!
Correct answer: B
Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.
3. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?
- A. Administer aspirin for pain.
- B. Avoid administering NSAIDs.
- C. Restrict physical activities.
- D. Apply heat to joints.
Correct answer: B
Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.
4. A nasogastric tube for suction is ordered for a neonate diagnosed with a diaphragmatic hernia. Which complication related to gastric drainage is the priority when planning care for this neonate?
- A. Weight loss
- B. Metabolic alkalosis
- C. Dehydration
- D. Hyperbilirubinemia
Correct answer: B
Rationale: Metabolic alkalosis is the priority complication to consider when a neonate with a diaphragmatic hernia is placed on gastric suction. Prolonged gastric drainage can lead to the loss of stomach acids, resulting in metabolic alkalosis, which can have serious consequences for the neonate's health.
5. For which patient diagnosis would a prescription for nifedipine be least appropriate?
- A. Angina Pectoris
- B. Essential HTN
- C. Atrial Fibrillation
- D. Vasospastic Angina
Correct answer: C
Rationale: Nifedipine primarily acts as a calcium channel blocker, exerting its effects on vascular smooth muscle. It is not effective for treating dysrhythmias like Atrial Fibrillation, which involve abnormalities in the heart's electrical system. Nifedipine is commonly prescribed for conditions such as angina pectoris, essential hypertension, and vasospastic angina due to its vasodilatory and anti-anginal properties. Choices A, B, and D are more appropriate as nifedipine can help in managing angina pectoris, hypertension, and vasospastic angina by reducing myocardial oxygen demand and dilating coronary arteries.
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