ATI RN
ATI Pediatric Proctored Exam 2023
1. Which urinary diversion procedure is the least damaging to the body image of the adolescent?
- A. Urostomy
- B. Ileal conduit
- C. Nephrostomy
- D. Suprapubic placement
Correct answer: B
Rationale: The correct answer is B: Ileal conduit. The ileal conduit diverts urine to the colon, and the urine is excreted with the feces. Unlike urostomy, nephrostomy, and suprapubic placement, the ileal conduit does not require an external appliance, which can be less damaging to an adolescent's body image.
2. Mary is excited to work with the family of a friend with whom she has lost contact. Mary hopes the family will be able to connect her with her friend and is looking forward to hearing about her friend. At the next session, she asks the mother many questions about her friend and they spend a lot of time discussing their home town, etc. Which statement describes this scenario?
- A. It is not therapeutic: The relationship serves no purpose
- B. It is therapeutic: Therapist, child, and family have a reciprocal caring relationship
- C. It is not therapeutic: Mary is benefiting, but not the child and family
- D. It is therapeutic: Both parties are benefiting in the relationship
Correct answer: C
Rationale: In this scenario, Mary's focus on her own needs and interests by asking the mother about her lost friend and hometown indicates a lack of therapeutic benefit for the child and family. Effective therapy should prioritize the needs and goals of the child and family, not the therapist's personal desires or connections. Therefore, this interaction is not therapeutic as it fails to address the primary purpose of the therapy, which is to benefit the child and family. Choice A is incorrect because while the relationship may not be therapeutic, it does serve a purpose for Mary. Choice B is incorrect as there is no indication of a reciprocal caring relationship in this scenario. Choice D is incorrect as the focus is primarily on Mary's personal interests, rather than mutual benefit in the therapeutic relationship.
3. When preparing to insert an intravenous catheter for a 7-year-old child, which of the following actions should a healthcare professional take?
- A. Apply an anesthetic cream to the insertion site 1 hr before the procedure.
- B. Use a 16-gauge needle for the insertion.
- C. Insert the catheter into a vein of the child's dominant hand.
- D. Choose a site over the child's metacarpal veins.
Correct answer: A
Rationale: Applying an anesthetic cream to the insertion site 1 hr before the procedure is crucial when inserting an intravenous catheter in a child to minimize pain and discomfort during the procedure. This practice is especially important in pediatric patients to ensure a more comfortable experience and improve cooperation during the insertion process. Choice B is incorrect as a 16-gauge needle is too large for a child, and a smaller gauge needle is typically used. Choice C is incorrect as the catheter should be inserted into a suitable vein, not specifically the dominant hand vein. Choice D is incorrect as metacarpal veins are usually avoided due to their small size and the potential for complications.
4. What is the priority nursing intervention when caring for a neonate born with bladder exstrophy?
- A. Measuring intake and output
- B. Inserting a Foley catheter
- C. Covering the defect with sterile plastic wrap
- D. Palpating the bladder mass to ensure urine is expelled
Correct answer: C
Rationale: The priority nursing intervention when caring for a neonate born with bladder exstrophy is to cover the defect with sterile plastic wrap. This intervention helps prevent infection and maintains a moist environment, promoting optimal healing and reducing the risk of complications.
5. A healthcare professional is preparing to collect a sample from a toddler for a sickle turbidity test. Which of the following actions should the healthcare professional plan to take?
- A. Obtain a sputum specimen
- B. Perform an Allen test
- C. Perform a finger stick
- D. Obtain a stool specimen
Correct answer: C
Rationale: The healthcare professional should perform a finger stick on a toddler as a component of the sickle turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait and children who have the disease. Finger stick is a common method used to collect blood samples, especially in pediatric patients, for various tests.
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