ATI RN
ATI Pediatric Proctored Exam 2023
1. When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?
- A. Store the insulin in the refrigerator after each use.
- B. Rotate injection sites each time you give the injection.
- C. You should give the insulin at room temperature.
- D. Administer the insulin within 30 minutes of each meal.
Correct answer: C
Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.
2. A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?
- A. Hypernatremia
- B. Metabolic acidosis
- C. Hypotonic dehydration
- D. Isotonic dehydration
Correct answer: C
Rationale: The correct answer is hypotonic dehydration. The combination of high hemoglobin and hematocrit with low serum sodium indicates hypotonic dehydration. In this condition, there is an excess of solutes relative to water, leading to higher red blood cell concentration (elevated hemoglobin and hematocrit) and low serum sodium levels.
3. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?
- A. Impaired Gas Exchange
- B. Risk for Infection
- C. Anxiety (parental)
- D. Acute Pain
Correct answer: A
Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.
4. The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?
- A. Hypertension
- B. Edema
- C. Diabetes insipidus
- D. Protection against postmenopausal osteoporosis
Correct answer: A
Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.
5. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?
- A. Hypoalbuminemia
- B. Hyperkalemia
- C. Polyuria
- D. Hyperglycemia
Correct answer: A
Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.
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