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ATI Pediatrics Proctored Test
1. You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before but had a miscarriage at 19 weeks. You should document her obstetric history as:
- A. gravida 2, para 1.
- B. gravida 2, para 0.
- C. gravida 1, para 1.
- D. gravida 0, para 2.
Correct answer: B
Rationale: In obstetrics, gravida indicates the number of pregnancies, including the current one. Para indicates the number of pregnancies carried to viability (20 weeks or more). Since the patient has been pregnant twice but only carried one pregnancy past 20 weeks, her obstetric history should be documented as gravida 2, para 0. The miscarriage at 19 weeks does not contribute to the para count. Choice A (gravida 2, para 1) would indicate that she has had two pregnancies with one resulting in a live birth, which is incorrect. Choice C (gravida 1, para 1) would indicate that she has had one pregnancy with one live birth, which does not reflect her obstetric history. Choice D (gravida 0, para 2) would indicate that she has never been pregnant past 20 weeks, which is also inaccurate.
2. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?
- A. Give the child honey (simple sugar)
- B. Give the child milk (complex sugar)
- C. Contact the healthcare provider before doing anything
- D. Give the child nothing by mouth
Correct answer: A
Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.
3. During transport of a woman in labor, the patient tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What should you do?
- A. Ask the mother to take short, quick breaths until you arrive at the hospital.
- B. Allow the head to deliver and check for the location of the cord.
- C. Apply gentle pressure to the baby's head and notify the hospital immediately.
- D. Advise your partner to stop the ambulance and assist with the delivery.
Correct answer: D
Rationale: When the top of the baby's head is visible (crowning) during transport, it indicates imminent delivery. In this situation, it is crucial to stop the ambulance and assist with the delivery. This ensures a safe delivery process for the mother and the baby. Waiting to arrive at the hospital or attempting to apply pressure to the baby's head can lead to complications. Allowing the head to deliver and checking for the cord's location is a necessary step during the delivery process, but the immediate priority is to assist in the safe delivery of the baby.
4. What is the reason for Asthma in 4-year-old Mabele, as Mrs. Joyce Thomson inquires? How would you explain it?
- A. Asthma occurs due to inflammation of the respiratory tract triggered by infections.
- B. An asthmatic attack can occur when the child is exposed to certain allergens, triggering an allergic reaction in the bronchioles that causes bronchial constriction.
- C. An asthmatic attack is a response to the release of inflammatory mediators to epithelial cells, affecting the autonomic neural control of the airway.
- D. Asthma is not an inborn problem; it involves abnormal growth of the bronchial tree causing restriction.
Correct answer: B
Rationale: Asthma in children like Mabele can be triggered by exposure to allergens, leading to an allergic reaction in the bronchioles. This reaction causes constriction of the bronchial tree, resulting in an asthmatic attack. It is essential for caregivers to identify and minimize exposure to these triggers to manage and prevent asthma episodes effectively.
5. A mother of a 2-year-old child complains that her child has a fever, sore mouth, and red eye. What will be the possible diagnosis?
- A. TB
- B. Meningitis
- C. Measles
- D. Pertussis
Correct answer: C
Rationale: The correct answer is C, Measles. Measles commonly presents with symptoms such as fever, sore mouth, and red eyes. These characteristic symptoms help differentiate measles from the other conditions listed. Tuberculosis (Choice A) typically presents with respiratory symptoms, Meningitis (Choice B) commonly presents with symptoms like headache, neck stiffness, and altered mental status, while Pertussis (Choice D) is characterized by severe coughing spells. Therefore, in this case, the symptoms described align more closely with measles.
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