ATI RN
ATI Pediatric Proctored Exam
1. 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.
2. What type of characteristic is described in this scenario?
- A. Mode Change
- B. Social
- C. Enduring
- D. Situational
Correct answer: D
Rationale: The scenario describes a temporary change in Ava's emotional state due to a specific event - the fight with her friend. This aligns with the definition of a situational characteristic, which is influenced by specific circumstances or events. Ava's sadness and tearfulness in this situation are not reflective of a permanent trait but rather a response to a particular situation. Choices A, B, and C are incorrect. 'Mode Change' does not accurately describe the situation; 'Social' is too broad and does not specifically address Ava's emotional state change; 'Enduring' implies a long-lasting trait, which is not the case in this scenario.
3. When educating a patient about sildenafil (Viagra), which adverse effect should be a priority for the patient to report to his prescriber?
- A. Flushing
- B. Diarrhea
- C. Hearing loss
- D. Dyspepsia
Correct answer: C
Rationale: The correct answer is 'C: Hearing loss.' In rare cases, Viagra has been associated with sudden hearing loss, typically in one ear, which can be partial or complete. Any onset of hearing problems while using Viagra should be reported promptly to the prescriber. It is recommended to discontinue the medication if it is used for erectile dysfunction. 'Flushing,' 'Diarrhea,' and 'Dyspepsia' are known adverse effects of Viagra but are generally less serious compared to hearing loss.
4. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?
- A. Draw a stick figure with seven body parts
- B. Draw a circle
- C. Identify right from left hand
- D. Tie their shoelaces
Correct answer: B
Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.
5. A healthcare professional is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The professional should identify which of the following laboratory values indicates effectiveness of the current treatment?
- A. Potassium 2.9 mEq/L
- B. Sodium 140 mEq/L
- C. Urine specific gravity 1.035
- D. BUN 25 mg/dL
Correct answer: B
Rationale: A sodium level of 140 mEq/L within the expected reference range indicates effective treatment for dehydration. In dehydration, sodium levels are often elevated, so a normal sodium level suggests that the treatment is helping to restore the electrolyte balance in the infant's body.
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