ATI RN
ATI Pediatric Proctored Exam
1. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?
- A. I will make sure he gets his measles vaccine as soon as he gets home.
- B. He can stop taking his medication next week.
- C. I should check his urine for protein when he goes to the bathroom.
- D. He should eat a low-protein diet for the next few weeks.
Correct answer: C
Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.
2. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?
- A. Forcibly push the foreskin down over the head of the penis.
- B. Place a warm compress on the penis.
- C. Notify the healthcare provider in charge.
- D. Wait a few hours and try again.
Correct answer: C
Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.
3. At what age may an infant close their eyes to bright lights and show improved head control?
- A. 30-33 weeks after conception
- B. 34-36 weeks after conception
- C. Less than 30 weeks after conception
- D. 37-40 weeks after conception
Correct answer: A
Rationale: Around 30-33 weeks after conception, infants usually start closing their eyes in response to bright lights and exhibit enhanced head control. This developmental milestone indicates progress in their visual and motor abilities, reflecting the maturation of their neurological system. As preterm infants continue to grow and develop, they gradually acquire these skills, showcasing the natural progression of their sensory and motor functions.
4. A patient is 1 hour postoperative following an open reduction internal fixation of the left tibia. Which of the following actions should the nurse take?
- A. Assess neurovascular status of the extremities every 4 hours
- B. Monitor the patient's pain level every 8 hours
- C. Assist the patient to the bathroom every 2 hours
- D. Keep the patient's left leg elevated on two pillows
Correct answer: A
Rationale: The correct action for the nurse to take 1 hour postoperative following an open reduction internal fixation of the left tibia is to assess neurovascular status of the extremities every 4 hours. This frequent assessment is crucial to monitor for any signs of complications such as impaired circulation or nerve damage. Monitoring every 4 hours allows for early detection of any issues, enabling timely intervention and prevention of potential complications. Monitoring the patient's pain level every 8 hours (choice B) is not as immediate or essential for postoperative care. Assisting the patient to the bathroom every 2 hours (choice C) may not be necessary if the patient is not ambulatory yet. Keeping the patient's left leg elevated on two pillows (choice D) can be beneficial but is not the priority in the immediate postoperative period compared to assessing neurovascular status.
5. A child is being assessed for Kawasaki disease. Which of the following findings should be expected?
- A. Decreased heart rate
- B. Dry, scaly skin
- C. Fever unresponsive to antipyretics
- D. Nontender cervical lymphadenopathy
Correct answer: C
Rationale: In Kawasaki disease, a child typically presents with a fever that is unresponsive to antipyretics because the disease is characterized by systemic inflammation. The persistent fever is a hallmark feature of the disease and can last for more than five days despite treatment with antipyretics.
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