ATI RN
ATI Pediatric Proctored Exam
1. A patient taking isotretinoin (Accutane) for acne vulgaris. Which statement indicates that the patient teaching has been effective?
- A. I should use a reliable form of birth control.
- B. I will stop taking the drug if my skin is dry.
- C. It is important to increase intake of vitamin A.
- D. I do not need to use sunblock while taking Accutane.
Correct answer: A
Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin. Choice B is incorrect because discontinuing isotretinoin abruptly can lead to a flare-up of acne. Choice C is incorrect because increasing vitamin A intake can be harmful due to the risk of hypervitaminosis A. Choice D is incorrect because isotretinoin makes the skin more sensitive to sunlight, so sunblock is essential to prevent sunburn and skin damage.
2. A child receives a vaccine for MMR. Six hours after the injection, the child�s parent reports local soreness, erythema, lethargy, and a fever of 101�F to a nurse. Which action should the nurse take?
- A. Give instructions on relieving symptoms with acetaminophen
- B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
- C. Tell the parent that a live vaccine will cause a mild case of measles
- D. Obtain and fill out a Vaccine Adverse Event Report form
Correct answer: A
Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.
3. An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?
- A. Necrotizing enterocolitis (NEC)
- B. Ulcerative colitis (UC)
- C. Crohn's disease
- D. Appendicitis
Correct answer: B
Rationale: Ulcerative colitis is a type of inflammatory bowel disease characterized by recurrent abdominal pain, diarrhea, and bloody stools. The symptoms described align with the clinical presentation of ulcerative colitis, making it the most likely diagnosis in this scenario. Necrotizing enterocolitis primarily affects premature infants, Crohn's disease typically presents with non-bloody diarrhea, and appendicitis is characterized by right lower quadrant abdominal pain. Therefore, based on the symptoms provided, ulcerative colitis is the most appropriate suspicion.
4. The healthcare provider is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?
- A. Vital signs and neurologic checks hourly
- B. Small, frequent formula feedings
- C. Elevate the head of the bed
- D. Daily head circumference measurements
Correct answer: C
Rationale: Elevating the head of the bed in a child with hydrocephalus can potentially increase intracranial pressure. This can be counterproductive and may lead to complications after shunt placement surgery. Keeping the head of the bed flat or slightly elevated is often recommended to optimize cerebral perfusion and reduce the risk of increased intracranial pressure.
5. Which physical assessment technique should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor?
- A. Performing range-of-motion exercises on lower extremities
- B. Palpating the abdomen
- C. Assessing for bowel sounds
- D. Percussing ankle and knee reflexes
Correct answer: B
Rationale: Palpating the abdomen should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor because it could disturb the tumor and potentially cause the malignancy to spread. The other assessment techniques are safe to perform and provide valuable information about the child's condition. Range-of-motion exercises help assess mobility and joint health, assessing for bowel sounds is important to monitor gastrointestinal function, and percussing ankle and knee reflexes can help evaluate neurological responses.
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