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ATI Pediatrics Proctored Exam 2023 with NGN
1. A 3-year-old child has been admitted to your pediatric ward. The doctor gave a provisional diagnosis of respiratory tract infection. After careful assessment and history, a final diagnosis of lower respiratory infection was made. Which of the following signs will confirm the diagnosis?
- A. Cough
- B. Fever
- C. Inability to lie supine
- D. Inability to eat
Correct answer: C
Rationale: Inability to lie supine is a characteristic sign of lower respiratory infection. This positioning preference is often seen in patients with lower respiratory infections due to discomfort or difficulty breathing when lying flat on their back. While cough and fever are common symptoms associated with respiratory infections, they are not specific to lower respiratory infections. Inability to eat may indicate general illness or discomfort but is not a specific indicator of lower respiratory infection.
2. A new parent reports to the nurse that the baby looks cross-eyed several times a day. The nurse teaches the parents that this finding should resolve in how long?
- A. 2 months
- B. 2 weeks
- C. 1 year
- D. 4 months
Correct answer: D
Rationale: Transient strabismus, causing the baby to look cross-eyed, is due to poor neuromuscular control of the eye muscles. This condition typically resolves on its own within 3 to 4 months as the infant's neuromuscular control improves. Parents should be reassured that this is a common and temporary issue in infants. Choice A is incorrect as it is too long for the resolution of transient strabismus. Choice B is incorrect as 2 weeks is too short for resolution. Choice C is incorrect as 1 year is too long for transient strabismus to resolve.
3. A postpartum client who delivered a healthy newborn is being assessed by a nurse. Which finding would indicate a complication during the early postpartum period?
- A. Moderate lochia rubra
- B. Bradycardia
- C. Elevated blood pressure
- D. Uterine contraction
Correct answer: C
Rationale: An elevated blood pressure in the postpartum period may indicate the onset of preeclampsia, a serious complication that requires immediate medical attention. Preeclampsia is characterized by high blood pressure, protein in the urine, and sometimes swelling in the hands and face. If left untreated, preeclampsia can lead to serious complications for both the mother and the baby. Therefore, it is crucial for healthcare providers to closely monitor blood pressure levels in postpartum clients to promptly address any signs of preeclampsia. Choices A, B, and D are not indicative of a complication during the early postpartum period. Moderate lochia rubra is a normal finding as it indicates the normal discharge of blood and tissue from the uterus after childbirth. Bradycardia, a slow heart rate, is not typically a concern in the absence of other symptoms or signs of distress. Uterine contractions are essential for involution and are expected in the postpartum period.
4. What characteristic indicates that a mass on a newborn's head is a cephalohematoma?
- A. The mass appears on the second day after birth.
- B. The mass grows larger when the newborn cries.
- C. The head appears asymmetrical.
- D. The mass is located on only one side of the head.
Correct answer: A
Rationale: A cephalohematoma typically appears between the first and second days after birth, making choice A the correct answer. It results from blood vessel rupture between a cranial bone and the periosteal membrane. Choices B, C, and D are incorrect because the growth of the mass when the newborn cries, asymmetrical head appearance, or the mass being located on only one side of the head are not specific indicators of a cephalohematoma.
5. Which of the following are clinical types of diarrhoea EXCEPT?
- A. Acute watery
- B. Bloody diarrhoea
- C. Persistent diarrhoea
- D. Secretory diarrhoea
Correct answer: D
Rationale: Secretory diarrhoea is not a clinical type but a distinct mechanism of diarrhoea characterized by increased electrolyte secretion. Acute watery, bloody, and persistent diarrhoea are recognized clinical types associated with different underlying causes and pathophysiologies. Acute watery diarrhoea is common in infectious gastroenteritis, bloody diarrhoea can be caused by inflammatory conditions or infections, and persistent diarrhoea typically lasts for more than 14 days due to various reasons like infections, malabsorption, or inflammatory bowel diseases.
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