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. 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.
3. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?
- A. Administer aspirin for pain.
- B. Avoid administering NSAIDs.
- C. Restrict physical activities.
- D. Apply heat to joints.
Correct answer: B
Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.
4. A parent of a child with celiac disease is receiving teaching from a nurse. Which of the following statements should the nurse make?
- A. You should give your child vitamin supplements that contain iron.
- B. Your child will need a gluten-free diet.
- C. Your child should consume large amounts of dietary fiber.
- D. Your child can resume eating whole wheat bread.
Correct answer: B
Rationale: The correct answer is B. Celiac disease requires a strict gluten-free diet to manage the condition effectively. Gluten-containing foods like wheat, barley, and rye must be avoided to prevent intestinal damage and symptoms in individuals with celiac disease. Therefore, the nurse should emphasize the importance of a gluten-free diet to the parent of the child with celiac disease.
5. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?
- A. Steatorrhea
- B. Projectile vomiting
- C. Sunken abdomen
- D. Weight gain
Correct answer: A
Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.
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