ATI RN
ATI Pediatrics Proctored Exam 2023
1. The healthcare provider is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?
- A. Vital signs and neurologic checks hourly
- B. Small, frequent formula feedings
- C. Elevate the head of the bed
- D. Daily head circumference measurements
Correct answer: C
Rationale: Elevating the head of the bed in a child with hydrocephalus can potentially increase intracranial pressure. This can be counterproductive and may lead to complications after shunt placement surgery. Keeping the head of the bed flat or slightly elevated is often recommended to optimize cerebral perfusion and reduce the risk of increased intracranial pressure.
2. A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?
- A. You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing.
- B. You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy.
- C. Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy.
- D. When using the peak expiratory flow meter, record your child's average of three readings.
Correct answer: C
Rationale: The nurse should inform the parent that the child will need pulmonary function tests every 12 to 24 months to assess lung function and response to treatment. These tests help evaluate the presence of lung disease, monitor disease progression, and assess the effectiveness of the current therapeutic regimen in managing asthma. Choice A is incorrect as salmeterol is not used for acute wheezing episodes but rather for long-term maintenance. Choice B is incorrect because weight monitoring is not directly related to inhaled corticosteroid therapy for asthma. Choice D is incorrect as peak expiratory flow meter readings should be recorded as instructed, not averaged.
3. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?
- A. I will make sure he gets his measles vaccine as soon as he gets home.
- B. He can stop taking his medication next week.
- C. I should check his urine for protein when he goes to the bathroom.
- D. He should eat a low-protein diet for the next few weeks.
Correct answer: C
Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.
4. Which type of play involves actions such as looking and touching the mother's face, putting hands in one's mouth, and responding to familiar people?
- A. Exploratory
- B. Functional or relational
- C. Pretend
- D. Symbolic or imaginary
Correct answer: A
Rationale: Exploratory play is characterized by exploring sensory experiences and learning about the environment. In this type of play, infants engage in activities like looking, touching, and responding to familiar stimuli to understand the world around them.
5. A young child admitted to the pediatric unit has fever, irritability, and vomiting with suspected bacterial meningitis. Which cerebrospinal fluid (CSF) result should the nurse anticipate based on these data?
- A. Decreased protein count
- B. Clear, straw-colored fluid
- C. Positive for red blood cells (RBCs)
- D. Decreased glucose level
Correct answer: D
Rationale: In bacterial meningitis, the glucose level in the cerebrospinal fluid (CSF) is typically decreased due to the increased utilization of glucose by the infecting bacteria. This metabolic change leads to a decrease in CSF glucose levels, making choice D the correct answer in this scenario. Choices A, B, and C are incorrect because bacterial meningitis usually results in an increased protein count, cloudy appearance of the CSF due to the presence of bacteria, and absence of red blood cells (RBCs) in the CSF unless there is a traumatic tap, respectively.
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