ATI RN
ATI Pediatric Proctored Exam 2023
1. Which principle does not follow neuromaturational theory?
- A. The sequence and rate of motor development are consistent among infants
- B. Movement emerges from an interaction and cooperation of many systems
- C. Movement progresses from primitive reflexes to voluntary control
- D. Low-level skills are prerequisites for certain high-level skills
Correct answer: B
Rationale: Neuromaturational theory emphasizes that motor development progresses in a predictable sequence and rate, starting from primitive reflexes to voluntary control. It also states that low-level skills are foundational for higher-level skills. However, the theory does not support the idea that movement solely emerges from an interaction and cooperation of many systems, as it focuses more on the hierarchical development of motor skills.
2. A patient is prescribed Lisinopril as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug?
- A. Weight gain of 5 pounds in 1 week
- B. Potassium level of 3.5mEq/L
- C. Crackles in the lungs are no longer heard
- D. Jugular vein distention
Correct answer: C
Rationale: The correct answer is C. Lisinopril, an ACE inhibitor, promotes venous dilation, which helps reduce pulmonary congestion and peripheral edema. The absence of previously heard crackles in the lungs indicates effectiveness in reducing pulmonary congestion. Edema and jugular vein distention are signs of heart failure and would not indicate the therapeutic effect of Lisinopril. A potassium level of 3.5mEq/L is within the normal range and not directly related to the therapeutic effect of Lisinopril.
3. For which patient diagnosis would a prescription for nifedipine be least appropriate?
- A. Angina Pectoris
- B. Essential HTN
- C. Atrial Fibrillation
- D. Vasospastic Angina
Correct answer: C
Rationale: Nifedipine primarily acts as a calcium channel blocker, exerting its effects on vascular smooth muscle. It is not effective for treating dysrhythmias like Atrial Fibrillation, which involve abnormalities in the heart's electrical system. Nifedipine is commonly prescribed for conditions such as angina pectoris, essential hypertension, and vasospastic angina due to its vasodilatory and anti-anginal properties. Choices A, B, and D are more appropriate as nifedipine can help in managing angina pectoris, hypertension, and vasospastic angina by reducing myocardial oxygen demand and dilating coronary arteries.
4. A toddler in the emergency department has partial thickness burns on his right arm. Which of the following actions should the nurse take?
- A. Insert a nasogastric tube
- B. Initiate prophylactic antibiotic therapy
- C. Cleanse the affected area with mild soap and water
- D. Apply a topical corticosteroid to the affected area
Correct answer: C
Rationale: When a toddler has partial thickness burns, the nurse should cleanse the affected area with mild soap and water. This action helps remove any loose tissue that could lead to infection and prepares the area for appropriate wound care. Inserting a nasogastric tube (Choice A) is not indicated for a toddler with burns. Initiating prophylactic antibiotic therapy (Choice B) is not necessary for partial thickness burns unless there are signs of infection. Applying a topical corticosteroid (Choice D) is not recommended for initial management of burns as it can delay wound healing.
5. The patient taking spironolactone (Aldactone) makes a statement indicating effective teaching. Which statement shows understanding of the teaching?
- A. I will use salt substitutes to lower my sodium intake
- B. I will increase my intake of foods that are high in potassium
- C. I will call my doctor if I begin having menstrual irregularities
- D. I will take this medication at bedtime each evening
Correct answer: C
Rationale: The correct answer is C because spironolactone is a potassium-sparing diuretic that can cause endocrine effects like menstrual irregularities. Therefore, the patient recognizing the need to report such changes indicates effective teaching. Choices A and B are incorrect as salt substitutes and high-potassium foods should be avoided with spironolactone. Choice D is also incorrect because diuretics, including spironolactone, are ideally taken in the morning to prevent disturbances in sleep due to nocturia.
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