ATI RN
ATI Pediatric Proctored Exam 2023
1. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?
- A. Continue screening and administer the vaccine if appropriate
- B. Note the contraindication but administer the vaccine regardless
- C. Note the contraindication and clarify the order with the healthcare provider
- D. Withhold the vaccine and inform the department of health
Correct answer: C
Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.
2. A client who is 48 hours postoperative following abdominal surgery is being assessed by a nurse. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 80/min
- B. Sanguineous drainage on the surgical dressing
- C. Temperature of 37.5°C (99.5°F)
- D. Serous drainage on the surgical dressing
Correct answer: B
Rationale: Sanguineous drainage from the surgical site 48 hours after surgery could indicate a complication such as hemorrhage or infection and should be reported. Sanguineous drainage is typically seen in the early postoperative period due to the presence of blood. Serous drainage, on the other hand, is normal in the later stages of wound healing. A heart rate of 80/min is within the normal range for an adult. A temperature of 37.5°C (99.5°F) is slightly elevated but not a concerning finding in the absence of other symptoms.
3. An older adult man has moved to a long-term care facility, and the nurse is performing medication reconciliation. The resident's current medication regimen includes alfuzosin (Uroxatral). After considering the most likely indication for this drug, what potential problem should the nurse include in the resident's interdisciplinary plan of care?
- A. Impaired urinary elimination
- B. Ineffective sexual pattern
- C. Sexual dysfunction
- D. Functional urinary incontinence
Correct answer: C
Rationale: The correct answer is C, 'Sexual dysfunction.' Alfuzosin is commonly prescribed for benign prostatic hyperplasia (BPH), a condition that can lead to sexual dysfunction in older men. It is important to include this potential problem in the interdisciplinary plan of care to address the impact of the medication on the resident's sexual health. Choices A, B, and D are incorrect because while alfuzosin can affect urinary function, the primary concern related to this medication in this scenario is sexual dysfunction due to its indication for BPH.
4. What is the priority intervention when continuous bubbling is observed in the water seal chamber of a chest tube?
- A. Check for an air leak
- B. Continue monitoring as it is not normal
- C. Replace the chest tube system
- D. Tighten the tube connections
Correct answer: A
Rationale: The correct answer is to 'Check for an air leak.' Continuous bubbling in the water seal chamber of a chest tube indicates an air leak, which can compromise the effectiveness of the chest tube in re-expanding the lung. Checking for an air leak is crucial to prevent respiratory complications. Choice B is incorrect because continuous bubbling is not normal and requires immediate intervention to address the air leak. Choice C is incorrect as replacing the entire chest tube system is not the initial priority when an air leak is suspected. Choice D is incorrect because tightening tube connections may not address the underlying issue of an air leak and should not be the initial action taken in this situation.
5. A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?
- A. Apply warm compresses to the mouth
- B. Rinse mouth with alcohol-free mouthwash
- C. Increase fluid intake
- D. Clean the mouth gently with a soft toothbrush after meals
Correct answer: A
Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.
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