ATI RN
ATI Pediatric Proctored Exam 2023
1. 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.
2. A patient is prescribed fluconazole (Diflucan) for a vaginal yeast infection. The nurse should be concerned if the patient is also taking which medication?
- A. Losartan (Cozaar)
- B. Simvastatin (Zocor)
- C. Lisinopril (Zestril)
- D. Hydrochlorothiazide (HCTZ)
Correct answer: B
Rationale: When fluconazole is taken with statins like simvastatin, it can increase the levels of the statin in the blood, potentially leading to adverse effects such as muscle pain and weakness. Therefore, the nurse should be concerned if the patient is taking simvastatin along with fluconazole.
3. A healthcare professional is assessing a child who has a rotavirus infection. Which of the following is an expected manifestation?
- A. Constipation
- B. Vomiting
- C. Jaundice
- D. Abdominal pain
Correct answer: B
Rationale: Vomiting is a common manifestation of rotavirus infection in children. Rotavirus typically presents with symptoms such as watery diarrhea, vomiting, fever, and abdominal pain. Constipation, jaundice, and abdominal pain are less commonly associated with rotavirus infection in children.
4. What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid?
- A. Contact sports
- B. Horseback riding
- C. Alcohol
- D. Diuretic medications
Correct answer: A
Rationale: Children who have only one kidney should avoid contact sports to prevent injury to that remaining organ.
5. A child with a history of seizures arrives in the emergency department (ED) in status epilepticus. Which is the priority nursing action?
- A. Take vital signs.
- B. Establish an intravenous line.
- C. Perform rapid neurologic assessment.
- D. Maintain a patent airway.
Correct answer: D
Rationale: When a child with a history of seizures presents in status epilepticus, the priority nursing action is to maintain a patent airway. This is crucial to ensure proper oxygenation and ventilation. While taking vital signs, establishing an intravenous line, and performing rapid neurologic assessment are important, maintaining a patent airway takes precedence. Hypoxia can lead to serious complications, making airway management the top priority to ensure the child's safety and prevent further deterioration.
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