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. At what age may an infant close their eyes to bright lights and show improved head control?
- A. 30-33 weeks after conception
- B. 34-36 weeks after conception
- C. Less than 30 weeks after conception
- D. 37-40 weeks after conception
Correct answer: A
Rationale: Around 30-33 weeks after conception, infants usually start closing their eyes in response to bright lights and exhibit enhanced head control. This developmental milestone indicates progress in their visual and motor abilities, reflecting the maturation of their neurological system. As preterm infants continue to grow and develop, they gradually acquire these skills, showcasing the natural progression of their sensory and motor functions.
3. A toddler has minimal change nephrotic syndrome (MCNS) and 3+ pitting edema. Which intervention should the nurse include in the plan of care?
- A. Encourage an increased fluid intake for the toddler
- B. Place the child in an Airborne infection isolation room
- C. Increase the toddler's dietary sodium intake
- D. Administer corticosteroids to the toddler
Correct answer: D
Rationale: In managing minimal change nephrotic syndrome (MCNS) in children with pitting edema, corticosteroids are the mainstay of treatment. Corticosteroids help reduce inflammation and decrease proteinuria, addressing the underlying cause of MCNS. Therefore, the nurse should prioritize administering the prescribed corticosteroids to the toddler as part of the plan of care.
4. A school nurse is assessing a school-age child�s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child�s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct answer: C
Rationale: The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to the floor in a side-lying position immediately.
5. When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?
- A. Store the insulin in the refrigerator after each use.
- B. Rotate injection sites each time you give the injection.
- C. You should give the insulin at room temperature.
- D. Administer the insulin within 30 minutes of each meal.
Correct answer: C
Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.
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