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ATI Pediatrics Proctored Exam 2023 with NGN
1. During the initial assessment of the newborn, which of the following data would be considered normal?
- A. Chest circumference 31.5 cm, head circumference 33.5 cm
- B. Chest circumference 30 cm, head circumference 29 cm
- C. Chest circumference 38 cm, head circumference 31.5 cm
- D. Chest circumference 32.5 cm, head circumference 36 cm
Correct answer: A
Rationale: The correct answer is A. During the initial assessment of a newborn, the average head circumference at birth is 32 to 37 cm, while the average chest circumference ranges from 30 to 35 cm. Normally, the head's circumference is about 2 cm greater than the chest circumference at birth. Choice A provides measurements of chest circumference 31.5 cm and head circumference 33.5 cm, both falling within the normal range in terms of actual size and relative size. Choices B, C, and D do not align with the typical measurements seen in a healthy newborn. Choice B has both circumferences below the average range, choice C has the chest circumference above the average, and choice D has the head circumference notably higher than the chest circumference, which is not typical for a newborn.
2. A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
- A. Always store insulin vials in the refrigerator
- B. Adjust insulin dosage before exercise
- C. Presence of ketones in urine indicates a need for less insulin
- D. Systematically rotate injection sites
Correct answer: D
Rationale: Systematically rotating injection sites is crucial to prevent tissue damage and ensure optimal insulin absorption. This practice helps in preventing lipohypertrophy, a condition characterized by fat accumulation at injection sites, which can affect insulin absorption and lead to inconsistent blood glucose control. By rotating injection sites, the risk of skin and tissue damage is minimized, and insulin's effectiveness is maintained over time.
3. The caregiver is teaching a new mother about infant safety. Which statement indicates that further teaching is needed?
- A. I will place my baby on their back to sleep.
- B. I will keep soft toys and pillows out of the crib.
- C. I will use a car seat for every car ride.
- D. I will allow my baby to sleep in my bed.
Correct answer: D
Rationale: Allowing a baby to sleep in an adult bed increases the risk of suffocation and Sudden Infant Death Syndrome (SIDS). It is safer for infants to sleep on a firm, flat surface in their own crib or bassinet to reduce the risk of accidental suffocation or strangulation. Therefore, the caregiver should be advised against co-sleeping with the infant to ensure the baby's safety.
4. When performing CPR on an infant with suspected sudden infant death syndrome (SIDS), an important aspect to consider is:
- A. Focusing all of your attention on the infant, with minimal parental interaction.
- B. Carefully inspecting the environment in which the infant was found.
- C. Understanding that most infants with SIDS can be successfully resuscitated.
- D. Encouraging the presence of the parents during your resuscitation attempt.
Correct answer: B
Rationale: When dealing with a suspected case of SIDS, it is crucial to carefully inspect the environment in which the infant was found. This inspection can provide valuable information that may help determine the cause and support further investigation into the incident. By examining the surroundings, potential hazards or clues related to the sudden event may be identified, aiding in understanding the circumstances and potentially preventing similar incidents in the future.
5. Which of the following statements regarding febrile seizures in children is correct?
- A. They can occur even after a child has had a fever for longer than 24 hours.
- B. They can be caused by viral or bacterial meningitis.
- C. They do not typically occur on the first day of a fever.
- D. They typically last less than 15 minutes and often do not have a postictal phase.
Correct answer: D
Rationale: The correct answer is D. Febrile seizures in children typically last less than 15 minutes and often do not have a postictal phase, meaning there is usually no prolonged recovery period or confusion after the seizure. They are commonly associated with the rapid rise in body temperature at the onset of a fever, rather than the duration of the fever itself. Choices A, B, and C are incorrect because febrile seizures can occur even after a child has had a fever for longer than 24 hours, they can be caused by viral or bacterial meningitis, and they do not have a typical pattern of occurring on the first day of a fever.
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