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. 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.
3. 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.
4. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?
- A. The dialysate is clear upon return.
- B. The volume of drained dialysate is less than the volume infused.
- C. The child is restless and eager to play.
- D. The child's vital signs remain consistent with those noted during infusion.
Correct answer: B
Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.
5. Which factor will not promote play and playfulness in children?
- A. Novel toys
- B. Familiar peers
- C. Comfortable atmosphere
- D. Directive adults
Correct answer: D
Rationale: Directive adults can inhibit spontaneous play and creativity, which are essential for fostering playfulness in children. When adults are too directive, children may feel constrained and less likely to engage in imaginative and free play. Encouraging independence and allowing children to explore and create their play scenarios can enhance playfulness and creativity.
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