ATI RN
ATI Pediatric Proctored Exam
1. What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?
- A. 3 months
- B. 2 weeks
- C. 2.6 months
- D. 4 weeks
Correct answer: B
Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks. Choice A is incorrect because 3 months is not the correct adjustment for the given scenario. Choice C is incorrect as it provides a fractional value for age, which is not practical in this context. Choice D is incorrect as 4 weeks does not account for the weeks of prematurity.
2. A nasogastric tube for suction is ordered for a neonate diagnosed with a diaphragmatic hernia. Which complication related to gastric drainage is the priority when planning care for this neonate?
- A. Weight loss
- B. Metabolic alkalosis
- C. Dehydration
- D. Hyperbilirubinemia
Correct answer: B
Rationale: Metabolic alkalosis is the priority complication to consider when a neonate with a diaphragmatic hernia is placed on gastric suction. Prolonged gastric drainage can lead to the loss of stomach acids, resulting in metabolic alkalosis, which can have serious consequences for the neonate's health.
3. A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate based on the current data?
- A. Placing the newborn on a radiant warmer
- B. Placing the newborn in an open crib
- C. Preparing the newborn for phototherapy
- D. Preparing the newborn for bottle-feeding
Correct answer: A
Rationale: Placing the newborn on a radiant warmer is appropriate as it helps maintain the body temperature and prevent hypothermia in a newborn with an omphalocele defect. This is crucial for the infant's well-being and supports their physiological stability.
4. A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?
- A. Hypernatremia
- B. Metabolic acidosis
- C. Hypotonic dehydration
- D. Isotonic dehydration
Correct answer: C
Rationale: The correct answer is hypotonic dehydration. The combination of high hemoglobin and hematocrit with low serum sodium indicates hypotonic dehydration. In this condition, there is an excess of solutes relative to water, leading to higher red blood cell concentration (elevated hemoglobin and hematocrit) and low serum sodium levels.
5. When receiving change-of-shift report for children, which child should the nurse assess first?
- A. A toddler who has a concussion and an episode of forceful vomiting
- B. An adolescent with infective endocarditis who reports having a headache
- C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
- D. A school-age child with acute glomerulonephritis and brown-colored urine
Correct answer: A
Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.
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