ATI RN
ATI Pediatrics Proctored Exam 2023
1. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?
- A. Clay-colored stools and dark urine
- B. History of early passage of meconium in the newborn period
- C. History of chronic, progressive constipation and failure to gain weight
- D. Continual bouts of foul-smelling diarrhea
Correct answer: C
Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.
2. A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?
- A. WBC of 3200 cells/mm³
- B. RR of 26 breaths/min
- C. Temp of 38°C
- D. BP of 70/50
Correct answer: D
Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario as it poses a significant risk to the patient's life. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.
3. The healthcare provider is preparing medication instructions for a child who has undergone a kidney transplant and is prescribed cyclosporine. The parents ask the provider about the reason for the cyclosporine. Which rationale for this medication should the healthcare provider include in the response?
- A. Suppress rejection
- B. Decrease pain
- C. Improve circulation
- D. Boost immunity
Correct answer: A
Rationale: Cyclosporine is used to suppress the immune system and prevent rejection of the transplanted kidney. It helps to reduce the risk of the body attacking and rejecting the new organ. This medication is crucial in ensuring the success of the kidney transplant by keeping the immune system in check.
4. Which question provides information regarding a child's community mobility?
- A. What is the level of supervision provided?
- B. Can the child leave the house and play with friends?
- C. Is the child being bullied?
- D. Is there equipment available so the child can play with peers?
Correct answer: B
Rationale: Choice B directly assesses the child's community mobility by inquiring about their ability to leave the house and engage in play activities with friends. Community mobility involves the child's independence in social and recreational activities outside the home, making this question crucial for understanding their daily functioning and autonomy.
5. Why is it important to assess for in a child receiving prednisone to treat nephrotic syndrome?
- A. Infection
- B. Urinary retention
- C. Easy bruising
- D. Hypoglycemia
Correct answer: A
Rationale: When a child is receiving prednisone to treat nephrotic syndrome, it is crucial to assess for infection. Prednisone suppresses the immune system, making the child more vulnerable to infections. Since steroids can mask typical signs of infection, it is essential to look for subtle symptoms to ensure prompt treatment and prevent complications. Therefore, choices B, C, and D are incorrect as they are not directly related to the impact of prednisone therapy in nephrotic syndrome.
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