ATI RN
ATI Pediatric Proctored Exam
1. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?
- A. 0.9% normal saline (NS)
- B. D5 0.2% (�) normal saline
- C. D5W
- D. Albumin
Correct answer: A
Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.
2. Which clean-catch urinalysis finding should raise the most concern for a child admitted to an urgent care center to rule out a urinary tract infection?
- A. 2+ white blood cells
- B. 1+ red blood cells
- C. Urine appearance: cloudy
- D. Specific gravity: 1.009
Correct answer: D
Rationale: A specific gravity of 1.009 is low, indicating diluted urine, which can be concerning in the context of a urinary tract infection. Diluted urine may suggest inadequate concentration due to increased fluid intake or impaired kidney function, which are important considerations in the assessment of a possible UTI.
3. The caregiver is teaching a parent of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?
- A. I will not use carbonated beverages to dilute his medication.
- B. I will give his medication with food to minimize gastrointestinal upset.
- C. I will not let him chew his tablet.
- D. I will bring him to the physician's office for regular blood work to check his blood levels.
Correct answer: B
Rationale: The correct answer is B. Valproic acid should be administered with food to reduce the risk of gastrointestinal upset. Giving it on an empty stomach may increase the likelihood of adverse effects. The other statements are correct: A - Carbonated beverages should not be used to dilute the medication, C - The tablet should not be chewed, and D - Regular blood work is necessary to monitor valproic acid levels and potential side effects.
4. What is it called when the therapist adjusts the difficulty level of an activity to match the child's abilities by bringing a toy closer for them to successfully reach and grasp during therapy?
- A. Compensating
- B. Adapting
- C. Grading
- D. Modifying
Correct answer: C
Rationale: The correct answer is C: Grading. Grading involves adjusting the difficulty level of an activity to match the child's abilities. Bringing a toy closer for easier reach is an example of grading in therapy, helping the child succeed in reaching and grasping the toy within their current capabilities. Choice A, Compensating, implies making up for a deficit, which is not the case here. Choice B, Adapting, suggests changing the activity itself, not just the difficulty level. Choice D, Modifying, indicates altering the toy or the task itself, rather than adjusting the task's difficulty level.
5. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?
- A. Applying a diaper to prevent contamination of the sac
- B. Positioning the newborn in a side-lying position
- C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
- D. Positioning the newborn in a prone position
Correct answer: D
Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.
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