ATI LPN
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. The nurse is preparing to administer erythromycin eye ointment to a newborn. The mother asks why this is necessary. What is the nurse's best response?
- A. It helps to prevent eye infections caused by bacteria in the birth canal.
- B. It protects the baby's eyes from bright lights in the delivery room.
- C. It prevents the development of jaundice.
- D. It helps the baby see more clearly after birth.
Correct answer: A
Rationale: Erythromycin eye ointment is administered to newborns to prevent eye infections caused by bacteria present in the birth canal. This ointment does not have a direct correlation with protecting the baby's eyes from bright lights, preventing jaundice, or improving the baby's vision clarity post-birth.
3. You are dispatched to a residence where an 8-year-old boy was pulled from a swimming pool. When you arrive, a neighbor is performing rescue breathing on the child. After confirming that the child is not breathing, you should:
- A. begin chest compressions and reassess in 2 minutes.
- B. assess for a carotid pulse for no more than 10 seconds.
- C. tell the neighbor to continue rescue breathing as you apply the AED.
- D. ask the neighbor how long the child was submerged under the water.
Correct answer: B
Rationale: In cases of drowning, it is crucial to assess for a carotid pulse for no more than 10 seconds to determine if chest compressions are needed. This quick assessment helps determine the next steps in providing appropriate care to the patient. Performing chest compressions without confirming the need may not be beneficial and could potentially harm the patient if unnecessary.
4. Which of the following injuries is MOST indicative of child abuse?
- A. Multiple bruises to the shins
- B. Burned hand with splash marks
- C. Small laceration to the chin
- D. Bruising to the upper back
Correct answer: D
Rationale: Bruising to the upper back is more suspicious for child abuse compared to the other listed injuries. In young children, injuries like bruises to the upper back are less likely to be accidental and may raise concerns about physical abuse. The upper back is an area less prone to accidental injuries during play or falls. Multiple bruises to the shins are common in active children. A burned hand with splash marks may suggest accidental burns. A small laceration to the chin is also a common injury from falls in children. Therefore, the bruising on the upper back is more concerning for possible child abuse.
5. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn?
- A. Assess the newborn's skin condition and color.
- B. Initiate positive-pressure ventilations.
- C. Start chest compressions and contact medical control.
- D. Provide blow-by oxygen with oxygen tubing.
Correct answer: B
Rationale: In a newborn with a heart rate below 100 beats/min, the most appropriate initial management is to initiate positive-pressure ventilations. This helps support the newborn's respiratory effort and oxygenation in the setting of a low heart rate, ensuring adequate oxygen supply to vital organs. Assessing the skin condition and color, starting chest compressions, or providing blow-by oxygen are not the priority in this scenario where respiratory support is crucial.
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