ATI RN
ATI Pediatric Proctored Exam
1. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?
- A. My daughter should wash and wipe the perineal area from front to back.
- B. I am only going to have my daughter wear cotton underwear.
- C. It is acceptable to take frequent bubble baths.
- D. She needs to drink lots of fluids and void frequently.
Correct answer: C
Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.
2. A school-age child is 2 hours postoperative following a tonsillectomy. Which of the following actions should the nurse include in the plan of care?
- A. Place a heating pad at the surgical site.
- B. Encourage the child to cough every 2 hours.
- C. Administer analgesics to the child on a regular schedule.
- D. Apply an ice collar to the child's neck.
Correct answer: D
Rationale: After a tonsillectomy, applying an ice collar to the child's neck helps decrease pain and swelling. Heat should be avoided as it can increase bleeding. Encouraging coughing may increase the risk of bleeding. Administering analgesics on a regular schedule is essential for pain management, but the immediate postoperative period may require additional interventions like ice collar application.
3. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?
- A. Allow the child to bathe 6 hours after the procedure.
- B. Keep the child on bed rest for 12 hours.
- C. Maintain a pressure dressing on the site for 8 hours.
- D. Resume regular activities the day after the procedure.
Correct answer: B
Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.
4. The healthcare provider is caring for a child on bed rest who has severe edema in the left lower extremity due to blocked lymphatic drainage. Which nursing diagnosis would take priority?
- A. Risk for Impaired Skin Integrity
- B. Risk for Altered Body Image
- C. Risk for Imbalanced Nutrition: Less Than Body Requirements
- D. Risk for Activity Intolerance
Correct answer: A
Rationale: The priority nursing diagnosis in this scenario is 'Risk for Impaired Skin Integrity' because severe edema in the left lower extremity can lead to compromised circulation and pressure ulcers, increasing the risk of skin breakdown and infection. Addressing and preventing impaired skin integrity is crucial for the child's overall health and well-being.
5. A child is being assessed for possible appendicitis with perforation. Which of the following findings should the nurse expect?
- A. Hyperactive bowel sounds
- B. Abdominal distension
- C. Hypoactive bowel sounds
- D. Bradycardia
Correct answer: D
Rationale: In a child with appendicitis and possible perforation, the nurse should expect bradycardia due to peritoneal irritation. Bradycardia is a common response to peritoneal inflammation or infection, indicating a possible serious complication. Hyperactive bowel sounds, abdominal distension, and hypoactive bowel sounds are more commonly associated with other gastrointestinal conditions and are less likely to be present in a child with appendicitis and perforation. Therefore, the correct answer is bradycardia (D) as it aligns with the expected physiological response in this scenario.
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