ATI RN
ATI Pediatric Proctored Exam 2023
1. 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.
2. A client with a nasogastric tube receiving continuous enteral feedings is at risk for aspiration. Which of the following actions should the nurse take to prevent aspiration?
- A. Elevate the head of the bed to 15 degrees
- B. Check gastric residual volumes every 6 hours
- C. Monitor the pH of gastric aspirate
- D. Instill 10 mL of air into the tube before feeding
Correct answer: B
Rationale: Checking gastric residual volumes every 6 hours is essential in preventing aspiration in clients receiving continuous enteral feedings. This practice helps determine if the stomach is adequately emptying, reducing the risk of regurgitation and aspiration. Elevating the head of the bed to 30 degrees, not 15 degrees, is recommended to further prevent aspiration by reducing the risk of reflux. Monitoring the pH of gastric aspirate is important to assess tube placement but does not directly prevent aspiration. Instilling air into the tube before feeding is not a recommended practice and does not prevent aspiration.
3. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?
- A. Clopidogrel (Plavix)
- B. Morphine
- C. Aspirin (ASA)
- D. Metoprolol (Lopressor)
Correct answer: A
Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.
4. Your goal is to minimize David’s risk of complications after a heriorrhaphy. You instruct the patient to:
- A. Avoid the use of pain medication.
- B. Cough and deep breathe Q2H.
- C. Splint the incision if he can’t avoid sneezing or coughing.
- D. Apply heat to scrotal swelling.
Correct answer: C
Rationale: Instruct the patient to splint the incision if he can't avoid sneezing or coughing to minimize the risk of complications after heriorrhaphy.
5. What is the accumulation of fatty deposits along the walls of arteries, leading to reduced blood flow?
- A. Atherosclerosis
- B. Arteriosclerosis
- C. Aneurysm
- D. Thrombosis
Correct answer: A
Rationale: Atherosclerosis is the correct answer. It refers to the buildup of fatty deposits (plaque) along the inner walls of arteries, narrowing the blood vessels and reducing blood flow. This condition can lead to serious complications such as heart attacks or strokes. Arteriosclerosis (choice B) is a broader term that refers to the thickening and hardening of the arterial walls. While related, it is not as specific as atherosclerosis in describing the fatty deposit accumulation. Aneurysm (choice C) is the abnormal bulging of an artery wall that can rupture and cause internal bleeding, not specifically related to fatty deposits. Thrombosis (choice D) is the formation of a blood clot within a blood vessel, which can obstruct blood flow, but it is not directly related to the accumulation of fatty deposits.
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