ATI RN
ATI Pediatrics Proctored Exam 2023
1. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?
- A. Pain with urination
- B. New onset disorientation to time and place
- C. HR changes from a baseline of 70-80bpm to 110-120bpm
- D. #ERROR!
Correct answer: B
Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.
2. During an assessment, an infant is suspected to have intussusception. Which of the following findings should the nurse expect?
- A. Currant jelly stools
- B. Projectile vomiting
- C. Scaphoid abdomen
- D. Frequent stools
Correct answer: A
Rationale: Intussusception is a condition where one segment of the intestine telescopes into another, causing obstruction. The classic presentation includes currant jelly stools, which are a mixture of blood and mucus due to the sloughing of the intestinal mucosa. This finding is a result of the compromised blood supply to the affected area and is a key characteristic associated with intussusception.
3. When teaching a parent of a 2-month-old infant with acute gastroenteritis who is bottle feeding, which of the following statements should the nurse include?
- A. Offer Pedialyte between formula feedings.
- B. Feed the infant every 6 hours.
- C. Give diluted apple juice if the infant becomes dehydrated.
- D. Switch to soy-based formula permanently.
Correct answer: A
Rationale: In the case of acute gastroenteritis in a 2-month-old infant who is bottle feeding, the nurse should recommend offering Pedialyte between formula feedings. This helps prevent dehydration and ensures that the infant receives essential electrolytes and fluids to aid in recovery. Pedialyte is specifically formulated to help replace lost fluids and electrolytes due to vomiting and diarrhea, making it a suitable choice for infants with gastroenteritis. Choice B is incorrect because infants with acute gastroenteritis should be fed more frequently to prevent dehydration. Choice C is incorrect as apple juice is not recommended for infants with gastroenteritis; Pedialyte or oral rehydration solutions are preferred. Choice D is incorrect because switching to soy-based formula permanently is not necessary for managing acute gastroenteritis; Pedialyte and continuing with the current formula are more appropriate.
4. A child has Wilms' tumor and is scheduled for surgery. Which of the following actions should the nurse include in the plan of care?
- A. Palpate the child's abdomen daily for tumor size.
- B. Reposition the child frequently.
- C. Prepare the child for chemotherapy.
- D. Avoid palpating the abdomen.
Correct answer: D
Rationale: Palpating the abdomen of a child with Wilms' tumor should be avoided to prevent the risk of rupturing the tumor and spreading cancer cells. This action is crucial to maintain the child's safety and prevent potential complications before surgery.
5. Why should a healthcare professional take time to get to know the things a family does together, their weekly routine, and an explanation of family dynamics?
- A. Involvement in the family is central to best practice
- B. It is not necessary, but it is beneficial
- C. To gather demographic information for documentation purposes
- D. To assess if they have values that align with the practitioner's
Correct answer: A
Rationale: Understanding the activities, routines, and dynamics of a family is crucial for a healthcare professional to provide holistic care. By gaining insight into the family's lifestyle and relationships, the professional can tailor interventions that are better integrated into the family's daily life, fostering more effective therapy outcomes and enhancing the overall quality of care provided. Choice A is the correct answer because involvement in the family is indeed central to best practice in healthcare. Choices B, C, and D are incorrect because simply gathering demographic information, assessing values alignment, or considering it as optional fails to recognize the importance of understanding the family dynamics for effective care delivery.
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