LPN LPN
ATI Pediatrics Proctored Test
1. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:
- A. allowing the parents to transport the child.
- B. offering oxygen and providing transport.
- C. rapidly cooling the child in cold water.
- D. keeping the child warm and providing transport.
Correct answer: B
Rationale: After a febrile seizure, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.
2. Which of the following is a more reliable indicator of perfusion in children than in adults?
- A. Blood pressure
- B. Heart rate
- C. Respiratory rate
- D. Capillary refill
Correct answer: D
Rationale: Capillary refill is a more reliable indicator of perfusion in children than in adults. This is because children have more compliant vessels, making capillary refill a more sensitive indicator of perfusion status in this population. In contrast, while blood pressure, heart rate, and respiratory rate are important indicators, they may not be as reliable in children as capillary refill. Blood pressure can be affected by various factors such as anxiety or pain, heart rate can be influenced by emotions or temperature, and respiratory rate may vary with activity levels. Therefore, capillary refill is preferred in children for a more accurate assessment of perfusion.
3. A 30-year-old woman has severe lower abdominal pain and light vaginal bleeding. She tells you that her last menstrual period was 2 months ago. On the basis of these findings, you should suspect:
- A. a normal pregnancy.
- B. a ruptured ovarian cyst.
- C. an ectopic pregnancy.
- D. a spontaneous abortion.
Correct answer: C
Rationale: Severe lower abdominal pain, light vaginal bleeding, and a history of missed periods are concerning for an ectopic pregnancy. The absence of a normal menstrual period along with these symptoms raises suspicion for an ectopic pregnancy, which requires immediate medical attention due to the risk of rupture and life-threatening complications. A normal pregnancy would typically present with different symptoms such as a positive pregnancy test and typical signs of early pregnancy. A ruptured ovarian cyst may present with similar symptoms but typically lacks the history of missed periods. A spontaneous abortion usually involves heavier bleeding and tissue passage, which is not described in this scenario.
4. Which of the following clinical signs would MOST suggest acute respiratory distress in a 2-month-old infant?
- A. Heart rate of 130 beats/min
- B. Respiratory rate of 30 breaths/min
- C. Abdominal breathing
- D. Grunting respirations
Correct answer: D
Rationale: Grunting respirations are a key clinical sign of acute respiratory distress in infants. Grunting is a protective mechanism where the infant exhales against a partially closed glottis to increase functional residual capacity and oxygenation. This is often seen in conditions such as respiratory distress syndrome, pneumonia, or other causes of respiratory compromise in infants. Monitoring respiratory patterns like grunting is crucial for early recognition and intervention in infants with respiratory distress. Choices A, B, and C are less specific to acute respiratory distress in infants. While an elevated heart rate and respiratory rate can be present in respiratory distress, grunting respirations are a more direct indicator of significant respiratory compromise in infants.
5. What are the MOST important initial steps in assessing and managing a newborn?
- A. Drying and warming the infant, obtaining an APGAR score.
- B. Clearing the airway, keeping the infant warm.
- C. Suctioning the airway, obtaining a heart rate.
- D. Keeping the infant warm, counting respirations.
Correct answer: B
Rationale: The most crucial initial steps in assessing and managing a newborn involve clearing the airway to ensure proper breathing and keeping the infant warm to maintain body temperature. Airway clearance helps prevent respiratory distress, while warmth is essential to prevent hypothermia, a common issue in newborns. These steps are vital in the immediate care of a newborn to support their transition to extrauterine life and ensure their well-being. Choice A is incorrect because obtaining an APGAR score is important but not as critical as clearing the airway. Choice C is incorrect as suctioning the airway is not always necessary and obtaining a heart rate is secondary to ensuring a clear airway and warmth. Choice D is incorrect because counting respirations is not as immediate and crucial as clearing the airway.
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