ATI RN
ATI Pediatric Proctored Exam 2023
1. Why is the specific gravity for infants lower than for older children?
- A. Infants have a greater body surface area.
- B. Infants have a higher basal metabolic rate.
- C. Infants have a greater percentage of body weight that is water.
- D. Infants' kidneys are less able to concentrate urine.
Correct answer: D
Rationale: The correct answer is D because infants' kidneys are less developed compared to older children, making them less efficient at concentrating urine. This results in a lower specific gravity in infants. The other choices do not directly explain why the specific gravity is lower in infants.
2. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?
- A. Bag-valve-mask system
- B. Sterile gauze and saline
- C. Soft arm restraints
- D. Endotracheal tube
Correct answer: D
Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.
3. The healthcare professional is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: 4 oz of Pedialyte, One-half of an 8-oz cup of clear orange Jell-O, Two graham crackers, 200 mL of D5 1/2 sodium chloride IV. Output: 345 mL of urine, 50 mL of loose stool. How many milliliters should the healthcare professional document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.
- A. 440
- B. 400
- C. 410
- D. 450
Correct answer: A
Rationale: The total intake is 440 mL (4 oz of Pedialyte = 120 mL, half of an 8 oz cup of Jell-O = 120 mL, and 200 mL of IV fluids). The graham crackers are not counted as intake. Therefore, the correct answer is 440. Choice B (400) is incorrect because it does not account for the intake of Jell-O. Choice C (410) is incorrect as it does not include the Pedialyte intake. Choice D (450) is incorrect because it overestimates the total intake by including the graham crackers.
4. 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.
5. When developing a home program for self-care, which approach is the most effective?
- A. Require the parent to practice the steps regularly and track progress.
- B. Introduce new home programs weekly with clear instructions for the parent to follow.
- C. List all the steps and have the parent teach them to the child without practicing.
- D. Practice the new steps until the child is ready to independently perform them at home.
Correct answer: D
Rationale: The most effective approach when developing a home program for self-care is to practice the new steps with the child until they are capable of independently carrying them out at home. This method ensures that the child has mastered the skills before transitioning to independent implementation. It is essential for the child's success in self-care activities and promotes their autonomy and confidence. Requiring the parent to practice the steps regularly and track progress, introducing new programs weekly, or having the parent teach the steps without practice may not be as beneficial in fostering the child's independence and skill acquisition.
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