ATI RN
ATI Pediatric Proctored Exam 2023
1. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?
- A. Position the newborn in a semi-Fowler position.
- B. Allow the newborn to stay in the nursery for observation.
- C. Offer the newborn pacifier for comfort.
- D. Wrap the newborn in blankets and place in an incubator.
Correct answer: A
Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.
2. A parent of a child with cystic fibrosis is being taught about dietary guidelines. Which statement by the parent indicates an understanding of the teaching?
- A. My child should eat a high-calorie, high-protein diet.
- B. My child should avoid eating eggs.
- C. My child should follow a low-fat, low-sodium diet.
- D. My child should follow a high-fiber, high-protein diet.
Correct answer: A
Rationale: The correct answer is A. For a child with cystic fibrosis, a high-calorie, high-protein diet is recommended to meet the increased metabolic needs associated with the condition. The protein helps with growth and repair, while the extra calories help compensate for malabsorption and increased energy requirements. Choice B is incorrect because eggs are a good source of protein and essential nutrients unless the child has a specific allergy. Choice C is incorrect as a low-fat, low-sodium diet is not typically recommended for children with cystic fibrosis who need higher calorie and fat intake. Choice D is incorrect because while a high-protein diet is beneficial, a high-fiber diet may not be suitable for a child with cystic fibrosis due to potential gastrointestinal issues.
3. A newborn's parents are being taught about ways to prevent sudden infant death syndrome (SIDS). Which of the following instructions should be included?
- A. Place the infant in a prone position to sleep.
- B. Allow the infant to sleep on a large pillow.
- C. Use a soft mattress in the infant's crib.
- D. Give the infant a pacifier at bedtime.
Correct answer: D
Rationale: The correct instruction to prevent SIDS is to give the infant a pacifier at bedtime. The use of a pacifier while the infant is sleeping is associated with a decreased risk of SIDS. Placing the infant on their back to sleep is recommended to prevent SIDS, not in a prone position (Choice A). Allowing the infant to sleep on a large pillow (Choice B) is dangerous and increases the risk of SIDS. Using a soft mattress in the infant's crib (Choice C) is also a risk factor for SIDS, so it should be avoided. Additionally, soft bedding or pillows should be avoided to reduce the risk of SIDS.
4. Which frame of reference emphasizes techniques to teach children movement that resemble coaching?
- A. Motor control/motor learning
- B. Rehabilitation
- C. Biomechanical
- D. Ayres' sensory integration
Correct answer: A
Rationale: The correct frame of reference that emphasizes techniques to teach children movement resembling coaching is Motor control/motor learning. This approach focuses on improving movement skills through techniques that are similar to coaching methods. It helps children develop and refine their motor skills in a structured and goal-oriented manner. Rehabilitation, Biomechanical, and Ayres' sensory integration have different emphases and objectives in therapy, making them incorrect choices for this question.
5. Marge is a 2-year-old girl who does not sit and eat at mealtimes but rather brings food to many rooms, eats a few bites, and drops it. Her parents report that she is a 'fussy eater.' Marge is significantly below weight for her age. She does not have any oral motor structure abnormalities, but eats only certain foods with the same texture. Which intervention strategy would be best to address the environmental context?
- A. Prolong mealtimes and eliminate all snacks
- B. Provide high-calorie snacks and meals at the table throughout the day
- C. Allow Marge to eat whenever and wherever she wants in the house
- D. Require Marge to eat everything on her plate and at snack
Correct answer: B
Rationale: In the case of Marge, who exhibits selective eating habits and struggles with weight gain, providing high-calorie snacks and meals at the table throughout the day can be an effective intervention. This strategy can help increase her food intake in a structured environment, promoting healthier eating habits and potentially addressing her below-average weight status. Choice A, prolonging mealtimes and eliminating all snacks, may not be the best approach as it could lead to more food refusal and stress during meals. Choice C, allowing Marge to eat whenever and wherever she wants in the house, may further enable her selective eating behavior and hinder progress. Choice D, requiring Marge to eat everything on her plate and at snack, can create a negative mealtime environment and may not address the underlying causes of her eating habits. Therefore, providing high-calorie snacks and meals at designated times offers a balanced approach to support Marge's nutritional needs and overall well-being.
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