ATI RN
ATI Pediatric Proctored Exam
1. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?
- A. The dialysate is clear upon return.
- B. The volume of drained dialysate is less than the volume infused.
- C. The child is restless and eager to play.
- D. The child's vital signs remain consistent with those noted during infusion.
Correct answer: B
Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.
2. An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?
- A. Necrotizing enterocolitis (NEC)
- B. Ulcerative colitis (UC)
- C. Crohn's disease
- D. Appendicitis
Correct answer: B
Rationale: Ulcerative colitis is a type of inflammatory bowel disease characterized by recurrent abdominal pain, diarrhea, and bloody stools. The symptoms described align with the clinical presentation of ulcerative colitis, making it the most likely diagnosis in this scenario. Necrotizing enterocolitis primarily affects premature infants, Crohn's disease typically presents with non-bloody diarrhea, and appendicitis is characterized by right lower quadrant abdominal pain. Therefore, based on the symptoms provided, ulcerative colitis is the most appropriate suspicion.
3. When providing teaching to the family of a school-age child with juvenile idiopathic arthritis, which instruction should the nurse include?
- A. Limit the child's movement of the large joints.
- B. Encourage the child to perform independent self-care.
- C. Provide the child with a soft mattress for sleeping.
- D. Schedule a 2-hour daily nap for the child in the afternoon.
Correct answer: B
Rationale: Encouraging the child to perform independent self-care is essential when managing juvenile idiopathic arthritis. This instruction helps minimize pain and stiffness in the child's joints while promoting mobility and independence. It is crucial for the child to learn self-management skills early to cope better with the condition in the long term.
4. A school nurse is assessing a school-age child�s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child�s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct answer: C
Rationale: The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to the floor in a side-lying position immediately.
5. A nurse is planning care to address nutritional needs for a preschooler with cystic fibrosis. Which interventions should the nurse include in plans?
- A. Administer pancreatic enzymes 2 hours after meals.
- B. Monitor and adjust the use of pancreatic enzymes if steatorrhea develops.
- C. Encourage adequate fluid intake based on the child's needs.
- D. Increase fat content in the child's diet to 40% of total calories.
Correct answer: D
Rationale: Increasing fat content in the diet is essential for meeting the high energy needs of a child with cystic fibrosis. Cystic fibrosis impairs the absorption of nutrients, particularly fats, so increasing the fat content in the child's diet to 40% of total calories helps ensure adequate caloric intake. This intervention can help maintain the child's nutritional status and support growth and development.
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