LPN LPN
ATI Pediatrics Proctored Test
1. Which of the following findings is abnormal?
- A. Rapid, irregular breathing in a newly born infant
- B. Heart rate of 80 beats/min in a 3-month-old infant
- C. Respiratory rate of 26 breaths/min in a 2-year-old child
- D. Systolic BP of 100 mm Hg in a 10-year-old child
Correct answer: B
Rationale: A heart rate of 80 beats per minute in a 3-month-old infant is abnormally low for that age group and could indicate underlying health issues. The normal heart rate for a 3-month-old infant is typically higher, around 100-150 beats per minute. Therefore, this finding stands out as abnormal and warrants further evaluation. Choice A is not necessarily abnormal in a newly born infant as irregular breathing patterns can be common during the neonatal period. Choice C falls within the normal respiratory rate range for a 2-year-old child, which is around 20-30 breaths per minute. Choice D reflects a systolic blood pressure value within the normal range for a 10-year-old child, which is typically around 90-110 mm Hg.
2. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:
- A. placing the child supine and palpating the abdomen.
- B. separating the child from the parent to ensure a reliable examination.
- C. examining the child in the parent's arms.
- D. palpating the painful area of the abdomen first.
Correct answer: C
Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.
3. After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should:
- A. assess for a carotid pulse.
- B. open the airway and ventilate.
- C. immediately perform CPR.
- D. reanalyze the cardiac rhythm.
Correct answer: C
Rationale: After delivering a shock, it is crucial to immediately resume CPR. CPR helps circulate oxygenated blood to vital organs until the AED prompts you to stop for further rhythm analysis. This continuous cycle of CPR and defibrillation maximizes the chances of restoring a normal cardiac rhythm and improving the child's chances of survival. Assessing for a carotid pulse is not necessary after a shock as pulse checks are often unreliable during resuscitation. Opening the airway and ventilating is not the immediate step after delivering a shock as CPR takes precedence. Reanalyzing the cardiac rhythm should be done only when prompted by the AED after a set period of CPR.
4. Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?
- A. Dry the infant briskly.
- B. Suction the mouth.
- C. Begin artificial ventilations.
- D. Begin chest compressions.
Correct answer: C
Rationale: In a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min, the priority action is to begin artificial ventilations. A heart rate below 100 beats/min with cyanosis indicates a need for immediate respiratory support to improve oxygenation. Drying the infant briskly or suctioning the mouth may be necessary later but are not the initial priority. Chest compressions are not indicated as the heart rate is above 60 beats/min.
5. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?
- A. begin ventilations with a bag-mask device.
- B. gently flick the soles of their feet for up to 60 seconds.
- C. immediately suction their mouth and nose.
- D. start CPR if the heart rate is less than 80 beats/min.
Correct answer: A
Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.
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