ATI RN
ATI Pediatric Proctored Exam
1. When a patient is taking glucocorticoids and digoxin, which electrolyte should the nurse prioritize monitoring?
- A. Calcium
- B. Magnesium
- C. Sodium
- D. Potassium
Correct answer: D
Rationale: The nurse should primarily monitor potassium levels in a patient taking glucocorticoids and digoxin. Glucocorticoids can lead to potassium loss, potentially increasing the risk of digoxin toxicity. Additionally, glucocorticoids may worsen hypokalemia induced by diuretics like thiazides and loops. While calcium, magnesium, and sodium are important electrolytes to monitor in various clinical situations, they are not the priority in this specific scenario of a patient on glucocorticoids and digoxin.
2. When evaluating infants and young children in early intervention services, which of the following is recommended?
- A. Gain information from family, caregivers, professionals, and the child to create a total picture of the child's strengths and challenges
- B. Report test scores and therapist observations rather than parent reports
- C. Identify the areas of concern, weaknesses, and deficits to best address the child's and family's needs
- D. Observe the child in one setting with objective data from professionals
Correct answer: A
Rationale: When evaluating infants and young children in early intervention services, it is crucial to gather information from multiple sources, including family, caregivers, professionals, and the child. This holistic approach helps create a comprehensive understanding of the child's strengths and challenges, leading to a more effective intervention plan.
3. 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.
4. Which parental statement indicates correct understanding of preventive techniques for heat-related illnesses when children exercise?
- A. Wearing dark clothing during exercise is not recommended.
- B. Water is the preferred fluid for fluid replenishment.
- C. During activity, stopping for fluids every 15 to 20 minutes is essential.
- D. Hydration should be maintained throughout the exercise session.
Correct answer: C
Rationale: The correct preventive technique for heat-related illnesses during exercise is to stop for fluids every 15 to 20 minutes to prevent dehydration and maintain hydration levels. This practice helps regulate body temperature and prevent heat-related complications. Choice A is incorrect as wearing light-colored, loose-fitting clothing is recommended to reflect sunlight and allow better air circulation. Choice B is incorrect as while water is important, a sports drink containing electrolytes may be more beneficial for longer exercise sessions. Choice D is incorrect as it does not emphasize the importance of regular fluid intake during exercise to prevent dehydration.
5. Which assessment finding for a 4-month-old infant would require further action by the nurse?
- A. The posterior fontanel is open.
- B. The infant has good head control when held upright.
- C. The infant is able to roll only from abdomen to back.
- D. The anterior fontanel is open and soft.
Correct answer: A
Rationale: The correct answer is A. The posterior fontanel should be closed by 4 months of age. An open posterior fontanel at this age may indicate a delay in normal closure, which could be a cause for concern and require further evaluation by the healthcare provider to ensure proper development and growth. Choices B, C, and D are typical developmental milestones for a 4-month-old infant and do not raise immediate concerns requiring further action by the nurse.
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