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ATI Pediatrics Proctored Test
1. Which of the following is an abnormal finding when assessing the abdomen of a newborn?
- A. The umbilical cord has two arteries and one vein.
- B. The presence of green vomit.
- C. The liver is palpable 1 to 2 cm below the costal margin.
- D. The abdomen is soft and nondistended.
Correct answer: B
Rationale: The correct answer is B. The presence of green vomit in a newborn is an abnormal finding and indicates a possible intestinal obstruction. This finding requires immediate attention and further investigation. Choices A, C, and D are normal findings in a newborn's abdomen assessment. A newborn typically has an umbilical cord with two arteries and one vein, a liver that may be palpable 1 to 2 cm below the costal margin due to its normal size in a neonate, and a soft, nondistended abdomen as expected in healthy newborns.
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. What is the proper depth of chest compressions for a 9-month-old infant?
- A. 1/3 the diameter of the chest or about 1 1/2 inches.
- B. 1/4 the diameter of the chest or about 1 inch.
- C. 1/2 the diameter of the chest or about 2 inches.
- D. 1/3 the diameter of the chest or about 3/4 inch.
Correct answer: A
Rationale: When performing chest compressions on a 9-month-old infant, the proper depth is 1/3 the diameter of the chest, which equates to approximately 1 1/2 inches. This depth is crucial for effective cardiopulmonary resuscitation (CPR) in infants. Choice B, which suggests 1/4 the diameter of the chest or about 1 inch, is incorrect as it does not provide the recommended depth for infants. Choice C, stating 1/2 the diameter of the chest or about 2 inches, is too deep and may cause harm to the infant. Choice D, mentioning 1/3 the diameter of the chest or about 3/4 inch, is also incorrect as it underestimates the required depth for effective chest compressions on a 9-month-old infant.
4. Which of the following statements regarding SIDS is correct?
- A. SIDS can occur in premature infants.
- B. It is most commonly a result of child abuse.
- C. Death usually occurs during sleep.
- D. SIDS can be prevented by placing the baby on its back to sleep.
Correct answer: C
Rationale: The correct statement regarding SIDS is that death usually occurs during sleep. Sudden Infant Death Syndrome (SIDS) is the unexpected death of a seemingly healthy infant, typically occurring during sleep. The exact cause of SIDS is not fully understood. While placing the baby on its back to sleep is a recommended preventive measure to reduce the risk of SIDS, it cannot guarantee prevention. Choice A is incorrect as SIDS is not limited to premature infants. Choice B is incorrect as SIDS is not primarily caused by child abuse.
5. Management for a woman presenting with a prolapsed umbilical cord includes all of the following, EXCEPT:
- A. lifting the baby's head off the umbilical cord.
- B. placing the mother in a position that elevates her hips.
- C. ensuring that the cord stays moist during transport.
- D. relieving pressure off the cord by gently pulling on it.
Correct answer: D
Rationale: In cases of prolapsed umbilical cord, it is crucial to manage the situation promptly. The correct steps include lifting the baby's head off the umbilical cord to reduce pressure, placing the mother in a position that elevates her hips to relieve pressure on the cord, and ensuring that the cord stays moist. Pulling on the cord is not recommended as it can further compromise fetal circulation and should be avoided. Therefore, relieving pressure off the cord by gently pulling on it is not a recommended management approach in cases of prolapsed umbilical cord.
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