ATI LPN
ATI Pediatrics Proctored Exam 2023 with NGN
1. In the treatment of an infected hematoma, which of the following is NOT recommended?
- A. Incision and drainage
- B. Systemic antibiotics
- C. A and B
- D. Vitamin E
Correct answer: D
Rationale: Vitamin E is not a standard treatment for infected hematomas. The primary interventions for infected hematomas typically involve incision and drainage to remove infected fluid and debris, along with the administration of systemic antibiotics to combat the infection. Vitamin E does not play a significant role in the treatment of infected hematomas and is therefore not recommended as a primary treatment option. Choice A (Incision and drainage) and Choice B (Systemic antibiotics) are recommended treatments for infected hematomas as they help in removing infected fluid and combating the infection, respectively. Therefore, the correct answer is D, Vitamin E.
2. A nurse is planning to irrigate and dress a clean, granulating wound for a client. Which of the following actions should the nurse take?
- A. Irrigate the wound with normal saline.
- B. Apply a wet-to-dry gauze dressing.
- C. Use a cotton ball to cleanse the wound.
- D. Administer an analgesic after the dressing change.
Correct answer: A
Rationale: The correct answer is to irrigate the wound with normal saline. Normal saline is the preferred solution for wound irrigation as it is isotonic and gentle, promoting healing in granulating wounds. Choice B, applying a wet-to-dry gauze dressing, is not appropriate for clean, granulating wounds as it can cause trauma to the wound bed upon removal. Choice C, using a cotton ball to cleanse the wound, is not ideal as cotton fibers can adhere to the wound and cause contamination. Choice D, administering an analgesic after the dressing change, is important for pain management but is not directly related to irrigating and dressing the wound.
3. A 28-year-old woman at 34 weeks of gestation presents with elevated liver enzymes and pruritus. Labs reveal total bilirubin to be 4.2 mg/dL, AST 480 U/L, ALT 640 U/L, and alkaline phosphatase 232 U/L. Viral hepatitis serologies and ANA are negative. On physical examination, she is jaundiced, but has a normal blood pressure, no edema, and a soft abdomen. The fetus is in no distress. Which of the following is true?
- A. The baby should be delivered immediately
- B. Symptoms will resolve promptly after delivery
- C. There is little risk of recurrence with subsequent pregnancies
- D. The mother should be screened for long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency
Correct answer: B
Rationale: The patient's presentation is consistent with intrahepatic cholestasis of pregnancy (ICP), a condition characterized by elevated liver enzymes, pruritus, and jaundice in the absence of other liver disease causes. ICP typically resolves promptly after delivery. Immediate delivery is indicated only for fetal distress, not maternal symptoms. ICP does have a significant risk of recurrence in subsequent pregnancies. Treatment options for ICP include cholestyramine and ursodeoxycholic acid. Screening for long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency is not indicated in this context as it is associated with acute fatty liver of pregnancy and HELLP syndrome, not ICP.
4. The client has atrial fibrillation and is receiving warfarin (Coumadin) therapy. Which laboratory test should be monitored to evaluate the effectiveness of the warfarin therapy?
- A. Prothrombin time (PT) and international normalized ratio (INR)
- B. Activated partial thromboplastin time (aPTT)
- C. Complete blood count (CBC)
- D. Fibrinogen levels
Correct answer: A
Rationale: Monitoring the Prothrombin time (PT) and international normalized ratio (INR) is crucial for assessing the effectiveness of warfarin therapy. These tests help determine the clotting ability of the blood and ensure that the client is within the desired therapeutic range to prevent clotting events or bleeding complications. Activated partial thromboplastin time (aPTT) (Choice B) is more commonly used to monitor heparin therapy, not warfarin. Complete blood count (CBC) (Choice C) and fibrinogen levels (Choice D) do not directly assess the effectiveness of warfarin therapy in the same way that PT and INR do.
5. What is the primary focus of community health nursing?
- A. Individual patient care
- B. Hospital-based care
- C. Community-wide health promotion and disease prevention
- D. Specialized medical treatment
Correct answer: C
Rationale: Community health nursing primarily concentrates on promoting health and preventing diseases within the community. It involves working with the community as a whole to improve health outcomes and prevent illnesses through education, interventions, and collaborations. This approach differs from individual patient care, hospital-based services, or specialized medical treatments, as it aims to enhance the well-being of the entire community by addressing broader health issues and promoting preventive measures.
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