ATI RN
ATI Pediatrics Proctored Exam 2023
1. Which clinical manifestation should a nurse monitor for when assessing a pediatric client diagnosed with a basilar skull fracture?
- A. Periorbital ecchymosis
- B. Subdural hematoma
- C. Protruding bone
- D. Epidural hematoma
Correct answer: A
Rationale: Periorbital ecchymosis, also known as raccoon eyes, is a classic sign of a basilar skull fracture. It presents as bruising around the eyes due to blood collecting in the tissues. Monitoring for periorbital ecchymosis is crucial in assessing a pediatric client with a basilar skull fracture because it can indicate the presence of this serious injury.
2. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?
- A. Massive proteinuria, hypoalbuminemia, and edema
- B. Hematuria, bacteriuria, and weight gain
- C. Decreased urine specific gravity and increased urinary output
- D. Gross hematuria, albuminuria, and fever
Correct answer: A
Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.
3. A nurse is planning care for a school-age child who has thrombocytopenia. Which of the following interventions should the nurse include in the plan?
- A. Administer aspirin as needed for fever.
- B. Avoid venipunctures whenever possible.
- C. Encourage the child to participate in contact sports.
- D. Administer ibuprofen for pain.
Correct answer: B
Rationale: The correct answer is B: 'Avoid venipunctures whenever possible.' Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. Venipunctures can cause bleeding in these patients; therefore, they should be avoided whenever possible. Choice A is incorrect because aspirin should be avoided in patients with thrombocytopenia as it can further increase the risk of bleeding due to its antiplatelet effects. Choice C is incorrect because participating in contact sports can also increase the risk of injury and bleeding in a child with thrombocytopenia. Choice D is incorrect as ibuprofen, like aspirin, can also increase the risk of bleeding and should be avoided in these patients.
4. For a 6-year-old child with hypokalemia, which menu choice should the nurse encourage?
- A. Pizza with a fruit plate
- B. Chicken strips with chips
- C. Fajita with rice
- D. Hamburger with French fries
Correct answer: A
Rationale: Pizza with a fruit plate is the most suitable choice for a 6-year-old child with hypokalemia due to its potassium content. Potassium-rich foods like fruits can help replenish potassium levels in the body, aiding in the treatment of hypokalemia.
5. Which statement is true regarding playful children?
- A. They exhibit flexible problem-solving.
- B. They have low intelligence scores.
- C. They need clear rules and directions to succeed.
- D. They do not perform well in school.
Correct answer: A
Rationale: The correct statement is that playful children exhibit flexible problem-solving. Playful children often engage in creative and imaginative thinking, allowing them to approach problems in unique ways. This fosters better problem-solving abilities compared to those who may be more rigid in their thinking. Choice B is incorrect as there is no direct correlation between being playful and having low intelligence scores. Choice C is incorrect as playful children may thrive in environments that encourage creativity rather than rigid rules. Choice D is incorrect as being playful does not necessarily equate to poor academic performance.
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