the nurse should question an order for glucocorticoids in the treatment of a patient with what the nurse should question an order for glucocorticoids in the treatment of a patient with what
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Nursing Elites

ATI RN

ATI Pediatrics Proctored Exam 2023

1. The healthcare provider should question an order for glucocorticoids in the treatment of a patient with what condition?

Correct answer: A

Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.

2. The most rapid prenatal changes take place in the period of the __________.

Correct answer: C

Rationale: The correct answer is C: embryo. The most rapid prenatal changes occur during the embryo stage, which spans from approximately 2 to 8 weeks after conception. This period is crucial as major organs and systems of the body develop rapidly, laying the foundation for future growth and development. The zygote stage is the initial single-celled entity formed by the union of sperm and egg, while the blastocyst stage involves the cluster of cells resulting from the zygote dividing and growing. The fetus stage follows the embryo stage and focuses on refining and growing existing structures rather than rapid development. Therefore, the embryo stage is where the most significant and rapid changes take place in prenatal development.

3. A patient who is receiving methotrexate for severe rheumatoid arthritis develops a megaloblastic anemia. The nurse will anticipate teaching the patient about increasing oral intake of

Correct answer: C

Rationale: The correct answer is C: cobalamin (vitamin B12). Methotrexate can lead to a deficiency in cobalamin, resulting in megaloblastic anemia. Therefore, increasing the oral intake of cobalamin is essential to address this deficiency. Choice A, iron, is incorrect because megaloblastic anemia caused by methotrexate is not typically due to iron deficiency. Choice B, folic acid, is also incorrect as methotrexate does not directly cause folic acid deficiency. Choice D, ascorbic acid (vitamin C), is incorrect as it is not directly related to megaloblastic anemia caused by methotrexate; instead, cobalamin is the key vitamin that needs attention.

4. After receiving change-of-shift report, which patient should the nurse assess first?

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

5. A healthcare professional auscultates a harsh hollow sound over a client's trachea & larynx. Which action should the healthcare professional take first?

Correct answer: A

Rationale: The healthcare professional has identified bronchial breath sounds, which are normal findings over the trachea & larynx, characterized by harsh, hollow, tubular, and blowing sounds. The appropriate initial action for the healthcare professional is to document these normal findings. Oxygen therapy, administering albuterol, or repositioning the client is unnecessary as this finding does not indicate a need for intervention.

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