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ATI Pediatrics Proctored Exam 2023 with NGN
1. The healthcare provider is assessing a postpartum client who is 1 day post-delivery. Which finding would require immediate intervention?
- A. Lochia rubra with a few small clots
- B. Fundus firm and midline
- C. Temperature of 100.4°F (38°C)
- D. Saturated perineal pad in 15 minutes
Correct answer: D
Rationale: A saturated perineal pad in 15 minutes indicates excessive bleeding, known as postpartum hemorrhage, which is a critical condition requiring immediate intervention to prevent further complications like hypovolemic shock. Monitoring and managing postpartum bleeding are crucial in the early postpartum period to ensure the client's safety and well-being. The other options are normal postpartum findings: lochia rubra with a few small clots is expected in the early postpartum period, a firm and midline fundus indicates proper uterine contraction, and a temperature of 100.4°F (38°C) is within the normal range for the postpartum period.
2. April, a 10-year-old admitted to inpatient pediatric care, has been becoming increasingly agitated and losing control in the day room. Time-out has proven to be ineffective for April to engage in self-reflection. April’s mother mentions using time-out up to 20 times a day. The nurse acknowledges that:
- A. Time-out is a crucial aspect of April’s baseline discipline.
- B. Time-out is no longer an effective intervention.
- C. April finds enjoyment in time-out and misbehaves to seek solitude.
- D. Time-out will have to be replaced with seclusion and restraint.
Correct answer: B
Rationale: The scenario describes how April's behavior is not improving with the frequent use of time-out, indicating that it is no longer an effective intervention. When a strategy such as time-out loses its effectiveness due to overuse, it is crucial to explore alternative therapeutic measures to address the underlying issues effectively.
3. A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?
- A. A client who received a burn on the arm while using a hot iron at home
- B. A client who requests a change of antipsychotic medication due to new adverse effects
- C. A client who reports hearing a voice saying that life is not worth living anymore
- D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview
Correct answer: C
Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.
4. Which assessment finding best supports dissociative fugue?
- A. The patient states that he cannot remember important information about himself.
- B. The patient is found to be wandering in a park and cannot remember his name or where he lives.
- C. The patient reports feeling as if she is outside her body and observing herself from a distance.
- D. The patient has a sudden onset of symptoms after experiencing a traumatic event.
Correct answer: B
Rationale: The key feature of dissociative fugue is sudden, unexpected travel away from home during which the individual may not be able to recall their identity or past events. Choice B best reflects this by describing a scenario where the patient is found wandering in a park and unable to remember their name or residence, which aligns with the characteristic dissociative amnesia seen in dissociative fugue. Choices A, C, and D do not directly support dissociative fugue. Choice A refers more to general dissociative amnesia, Choice C describes depersonalization/derealization disorder, and Choice D suggests acute stress reaction rather than dissociative fugue.
5. A client with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?
- A. Hypoglycemia
- B. Infection
- C. Hypotension
- D. Weight loss
Correct answer: B
Rationale: The correct answer is B: Infection. Prednisone is an immunosuppressant medication commonly used in COPD to reduce inflammation. Due to its immunosuppressive effects, clients are at an increased risk of developing infections. Therefore, nurses should closely monitor clients receiving prednisone for signs and symptoms of infections to provide timely interventions.
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