ATI RN
ATI Pediatric Proctored Exam
1. When planning care for a newborn with esophageal atresia and tracheoesophageal fistula, which is the priority nursing diagnosis?
- A. Ineffective Tissue Perfusion
- B. Ineffective Infant Feeding Pattern
- C. Acute Pain
- D. Risk for Aspiration
Correct answer: D
Rationale: The priority nursing diagnosis for a newborn with esophageal atresia and tracheoesophageal fistula is 'Risk for Aspiration' because of the potential respiratory complications associated with these conditions. The newborn is at a higher risk of aspirating oral or gastric contents due to the abnormal connections between the esophagus and trachea, posing a serious threat to the airway and lungs. Addressing this risk is crucial to prevent respiratory distress and maintain the airway's patency, making it the priority nursing diagnosis in this scenario. 'Ineffective Tissue Perfusion' is not the priority as respiratory compromise takes precedence over perfusion concerns. 'Ineffective Infant Feeding Pattern' may be relevant but addressing the risk of aspiration is more critical. 'Acute Pain' is not the priority compared to the life-threatening risk of aspiration.
2. Although stress exposure initiates integrated responses by multiple systems, which system first activates the most important changes?
- A. Pulmonary
- B. Gastrointestinal
- C. Neuroendocrine
- D. Cardiovascular
Correct answer: C
Rationale: The correct answer is C, the Neuroendocrine system. When the body is exposed to stress, the neuroendocrine system plays a crucial role in initiating the body's response. This system, particularly through the hypothalamic-pituitary-adrenal axis, triggers a cascade of physiological responses to stress. Choices A, B, and D are incorrect because while other systems like the cardiovascular and gastrointestinal systems also respond to stress, the neuroendocrine system is primarily responsible for the initial and significant changes in the body's stress response.
3. A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?
- A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
- B. By increasing estrogen levels, which induce uterine contractions.
- C. By altering the uterine lining, preventing implantation.
- D. By stimulating uterine contractions, which expel the embryo.
Correct answer: A
Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.
4. A client has a new prescription for furosemide. Which of the following instructions should the nurse include?
- A. Avoid foods high in potassium while taking this medication.
- B. This medication may cause your blood pressure to increase.
- C. This medication can cause you to retain fluids.
- D. Take this medication with meals.
Correct answer: D
Rationale: The correct instruction for a client taking furosemide is to take the medication with meals. This helps prevent gastrointestinal upset and improves medication tolerance. Option A is incorrect because furosemide is a loop diuretic that can cause potassium depletion, so avoiding foods high in potassium is not necessary. Option B is incorrect as furosemide typically lowers blood pressure. Option C is incorrect because furosemide is a diuretic that promotes fluid loss rather than retention.
5. The client is on a nitrate for angina. What is the most common side effect the nurse should monitor for?
- A. Headache
- B. Flushing
- C. Dizziness
- D. Nausea
Correct answer: A
Rationale: The correct answer is A, Headache. Nitrates commonly cause headaches as a side effect due to vasodilation. Flushing, dizziness, and nausea are less common side effects associated with nitrates. Flushing is more related to the dilation of blood vessels closer to the skin's surface, dizziness could occur but is not as common as headaches, and nausea is a less typical side effect of nitrates.
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