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Pediatric ATI Proctored Test
1. A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?
- A. 5% dextrose infusion
- B. Normal saline infusion
- C. NPH insulin infusion
- D. Potassium infusion
Correct answer: B
Rationale: In the management of diabetic ketoacidosis (DKA), the initial intravenous (IV) fluid of choice is normal saline infusion. Normal saline helps to correct dehydration and electrolyte imbalances commonly seen in DKA patients. It does not contain glucose to prevent worsening hyperglycemia or ketoacidosis. NPH insulin infusion is not the initial treatment for DKA; it is typically used after fluid resuscitation. Potassium infusion may be required in DKA to address electrolyte imbalances, but normal saline is the priority for fluid resuscitation.
2. Fred, a 12-year-old boy, is diagnosed with pneumococcal pneumonia. Which of the following symptoms would Nurse Nica expect to assess?
- A. Mild cough
- B. Slight fever
- C. Chest pain
- D. Bulging fontanel
Correct answer: C
Rationale: Chest pain is a common symptom associated with pneumococcal pneumonia. It can occur due to inflammation of the pleura or irritation of the lung tissue, leading to sharp or stabbing pain that worsens with breathing or coughing. While cough and fever are also common with pneumonia, chest pain is particularly significant in this case.
3. A child of 3 years has been admitted to your pediatric ward. The doctor gave a provisional diagnosis of respiratory tract infection. After careful assessment and history, he gave a final diagnosis of lower respiratory infection. 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 specific sign of lower respiratory infection. This condition can cause discomfort or difficulty in breathing when lying flat, leading to a preference for an upright or semi-upright position. While cough and fever are common symptoms of respiratory infections, the inability to lie supine is more indicative of lower respiratory involvement.
4. A 7-year-old child named Kanjaga exhibits symptoms like fatigue, slow heart rate, dry skin, slower growth, and delayed puberty. Which of the following is the appropriate diagnosis for this deficiency that slows body processes?
- A. Diabetes
- B. Hypothyroidism
- C. Growth hormone deficiency
- D. Stunted growth
Correct answer: B
Rationale: The appropriate diagnosis for the symptoms described in Kanjaga, a 7-year-old child, is hypothyroidism. Hypothyroidism can lead to symptoms such as fatigue, slow heart rate, dry skin, slower growth, and delayed puberty in children.
5. The parents of a child hospitalized with asthma who is recovering and is being prepared for discharge are receiving home care instructions from the nurse. Which statement by a parent indicates a need for further instruction?
- A. Coughing spells may be triggered by dust or smoke
- B. Vomiting may occur when our child has coughing episodes
- C. We need to encourage our child to drink fluids
- D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks
Correct answer: D
Rationale: The statement 'We need to maintain droplet precautions and a quiet environment for at least 2 weeks' indicates a need for further instruction. Asthma management does not typically require maintaining droplet precautions. The focus should be on environmental control, medication adherence, and monitoring symptoms rather than droplet precautions, which are more relevant for contagious respiratory infections.
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