ATI RN
ATI Pediatric Proctored Exam 2023
1. Which of the following is not considered a part of body language?
- A. Mannerisms
- B. Speech
- C. Posture
- D. Position
Correct answer: B
Rationale: Body language encompasses non-verbal communication cues such as mannerisms, posture, and position. Speech, although a form of communication, is not typically classified as part of body language. Body language mainly refers to gestures, facial expressions, and body movements, which convey messages non-verbally.
2. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?
- A. Administer meperidine for pain.
- B. Apply cold compresses to the child's joints.
- C. Limit the child's fluid intake.
- D. Maintain bed rest for the child.
Correct answer: D
Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.
3. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?
- A. Continue screening and administer the vaccine if appropriate
- B. Note the contraindication but administer the vaccine regardless
- C. Note the contraindication and clarify the order with the healthcare provider
- D. Withhold the vaccine and inform the department of health
Correct answer: C
Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.
4. A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight � 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours?
- A. 88 mL/hr
- B. 86 mL/hr
- C. 81 mL/hr
- D. 83 mL/hr
Correct answer: B
Rationale: For 13 kg, the maintenance fluid is 1150 mL (1000 mL for first 10 kg + 3*50 mL for the remaining 3 kg). Replacement fluid is 910 mL (0.07 * 13000 mL). Total fluid is 2060 mL, divided by 24 hours is 86 mL/hr.
5. 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.
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