ATI LPN
Pediatric ATI Proctored Test
1. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?
- A. The child should be allowed to play because doing so can foster healthy self-esteem
- B. The risk for fractures is increased because GH deficiency results in fragile bones
- C. Activity could aggravate insulin sensitivity, causing hyperglycemia
- D. Activity would aggravate the child's joints, already overtasked by obesity
Correct answer: A
Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.
2. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:
- A. placing the child supine and palpating the abdomen.
- B. separating the child from the parent to ensure a reliable examination.
- C. examining the child in the parent's arms.
- D. palpating the painful area of the abdomen first.
Correct answer: C
Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.
3. Which of the following statements regarding 2-rescuer child CPR is correct?
- A. The chest should be compressed with one hand, and a compression-to-ventilation ratio of 30:2 should be used.
- B. The chest should not be allowed to fully recoil in between compressions.
- C. A compression-to-ventilation ratio of 15:2 should be used if an advanced airway is in place.
- D. Compress the chest with one or two hands to a depth equal to one-third the diameter of the chest.
Correct answer: D
Rationale: During 2-rescuer child CPR, it is important to compress the chest with one or two hands to a depth equal to one-third the diameter of the chest. This technique ensures effective chest compressions are being delivered to help circulate blood and oxygenate the child's body. Choice A is incorrect because both hands should be used for chest compressions in 2-rescuer CPR. Choice B is incorrect as allowing the chest to fully recoil between compressions is essential to create negative pressure and facilitate blood flow back to the heart. Choice C is incorrect as the standard compression-to-ventilation ratio for child CPR is 30:2, regardless of whether an advanced airway is in place.
4. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:
- A. allowing the parents to transport the child.
- B. offering oxygen and providing transport.
- C. rapidly cooling the child in cold water.
- D. keeping the child warm and providing transport.
Correct answer: B
Rationale: After a febrile seizure, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.
5. When assisting ventilations in a 4-year-old child with a bag-valve mask, what should the EMT do?
- A. Deliver each breath over 2 to 3 seconds.
- B. Ensure the appropriate mask size is used.
- C. Block the pop-off valve if needed to achieve adequate chest rise.
- D. Reassess the pulse rate after 60 seconds.
Correct answer: C
Rationale: When assisting ventilations in a 4-year-old child with a bag-valve mask, the EMT should block the pop-off valve if needed to achieve adequate chest rise. This action helps ensure effective ventilation and adequate oxygenation in the child. Blocking the pop-off valve allows for better control over the volume of air delivered and can help maintain positive pressure in the airway, assisting in improving oxygenation and ventilation in the child. Choices A, B, and D are incorrect because delivering each breath over 2 to 3 seconds is a general guideline but may need adjustment based on patient response, ensuring the appropriate mask size is important but not the primary concern in this scenario, and reassessing the pulse rate is not directly related to the ventilation technique being discussed.
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