ATI RN
ATI Pediatric Proctored Exam 2023
1. The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?
- A. Passive range-of-motion exercises to promote hip flexion
- B. Oxygen at 2 L nasal cannula to maintain saturation above 95%
- C. Hourly vital signs and neurologic checks
- D. Elevate head of bed 30 degrees
Correct answer: A
Rationale: In a pediatric client with increased intracranial pressure (ICP) and decreased level of consciousness (LOC), passive range-of-motion exercises to promote hip flexion should be questioned as they can potentially increase intracranial pressure. This action may not be safe for the client's condition. The other options are appropriate interventions for managing a pediatric client with increased ICP and decreased LOC.
2. Janice is waiting for discharge instructions after her herniorrhaphy. Which of the following instructions do you include?
- A. Eat a low-fiber diet.
- B. Resume heavy lifting in 2 weeks.
- C. Lose weight, if obese.
- D. Resume sexual activity once discomfort is gone.
Correct answer: C
Rationale: Advise the patient to lose weight if obese to reduce the risk of complications after herniorrhaphy.
3. George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage?
- A. If there is any drainage, notify the surgeon immediately.
- B. The drainage will decrease daily until the bile duct heals.
- C. First, the drainage is dark green; then it becomes dark yellow.
- D. If the drainage stops, milk the tube toward the puncture wound.
Correct answer: B
Rationale: Before discharge, inform the patient that the drainage will decrease daily until the bile duct heals.
4. What are the expected ECG changes in hypokalemia?
- A. Flattened T waves
- B. ST elevation
- C. Wide QRS complex
- D. Tall T waves
Correct answer: A
Rationale: Flattened T waves are the most common ECG change seen in patients with hypokalemia. Hypokalemia leads to a decrease in serum potassium levels, affecting the repolarization phase of the cardiac action potential. This results in T wave flattening or inversion. ST elevation is typically seen in conditions like myocardial infarction, not in hypokalemia. Wide QRS complex is more associated with hyperkalemia than hypokalemia. Tall T waves are often seen in hyperkalemia, not hypokalemia.
5. Which disorder is caused by a Staphylococcus aureus organism producing a toxin leading to exfoliation and large blister formation?
- A. Herpes simplex I virus
- B. Bullous impetigo
- C. Necrotizing fasciitis
- D. Cellulitis
Correct answer: B
Rationale: Bullous impetigo is the correct answer because it is caused by a Staphylococcus aureus toxin that leads to exfoliation and the formation of large blisters. Herpes simplex I virus (Choice A) causes cold sores and is not associated with exfoliation and blister formation. Necrotizing fasciitis (Choice C) is a severe skin infection involving the deeper layers of skin and subcutaneous tissues, typically caused by bacteria such as Streptococcus or Clostridium species, not Staphylococcus aureus. Cellulitis (Choice D) is a common bacterial skin infection, but it does not involve exfoliation and blister formation as seen in bullous impetigo.
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