ATI RN
ATI Pediatric Proctored Exam
1. A patient with Parkinson�s disease who takes levodopa/carbidopa (Sinemet) comes to the clinic for a semi-annual physical examination. Which question is the most important for that nurse to ask?
- A. Have you noticed any swelling in your feet?
- B. Are you having vivid dreams or hallucination?
- C. Have you noticed any changes in your stool?
- D. Have you had your flu vaccine?
Correct answer: B
Rationale: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug.
2. A male patient is receiving androgen therapy for hypogonadism. What adverse effect should the nurse monitor for during this therapy?
- A. Increased risk of bone fractures
- B. Increased risk of cardiovascular events
- C. Increased risk of liver dysfunction
- D. Increased risk of prostate cancer
Correct answer: B
Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is essential during this therapy. Choices A, C, and D are incorrect because androgen therapy is not typically associated with an increased risk of bone fractures, liver dysfunction, or prostate cancer.
3. A nurse is preparing to perform a routine abdominal assessment for a client. Which action should the nurse take?
- A. Palpate the abdomen before auscultation
- B. Inspect the abdomen after palpation
- C. Auscultate before palpation
- D. Start by percussing the abdomen
Correct answer: C
Rationale: The correct answer is to auscultate before palpation when performing an abdominal assessment. This sequence is crucial to prevent altering bowel sounds. Starting with palpation (Choice A) can lead to false interpretations of bowel sounds due to stimulation of the intestines. Inspecting the abdomen after palpation (Choice B) can also potentially alter the assessment findings. Starting with percussion (Choice D) is not recommended as it should come after auscultation to further assess underlying structures.
4. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.
- A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
- B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
- C. Lithium may help me lose the few extra pounds I tend to carry around.
- D. I take my lithium on an empty stomach to help with absorption.
Correct answer: C
Rationale: Proper hydration, discussing other medications, and taking lithium with or without food are important for effective and safe use of lithium. However, lithium is not prescribed for weight loss, and its usage should not be associated with losing extra pounds.
5. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?
- A. This is atypical behavior and should be addressed
- B. The infant should remain on high alert when awake
- C. This shows the infant is making neurological gains
- D. The family is disrupting the child's sleep patterns
Correct answer: C
Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.
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