ATI RN
ATI Pediatric Proctored Exam
1. A patient in the emergency department reports taking sildenafil (Viagra) and nitroglycerin 1 hr before sexual activity. Which finding should the nurse immediately report to the physician?
- A. WBC of 3200 cells/mm³
- B. RR of 26 breaths/min
- C. Temp of 38°C
- D. BP of 70/50
Correct answer: D
Rationale: The correct answer is D: BP of 70/50. When sildenafil (Viagra) is taken with nitroglycerin, it can cause severe hypotension that is unresponsive to treatment. The combination of these medications can lead to a dangerous drop in blood pressure. It is crucial to immediately report hypotension in this scenario as it poses a significant risk to the patient's life. It is recommended to allow at least 24 hours to elapse between the last dose of sildenafil and nitroglycerin to prevent such adverse effects. The other vital signs and lab values may be abnormal but do not have the immediate life-threatening implications that severe hypotension does in this context.
2. A school nurse is assessing a school-age child�s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child�s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct answer: C
Rationale: The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to the floor in a side-lying position immediately.
3. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?
- A. My daughter should wash and wipe the perineal area from front to back.
- B. I am only going to have my daughter wear cotton underwear.
- C. It is acceptable to take frequent bubble baths.
- D. She needs to drink lots of fluids and void frequently.
Correct answer: C
Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.
4. The patient taking warfarin for prevention of deep vein thrombosis has an INR of 1.2. Which action by the nurse is most appropriate?
- A. Administer IV push protamine sulfate
- B. Continue with the current prescription.
- C. Prepare to administer Vitamin K
- D. Call healthcare provider to increase the dose
Correct answer: D
Rationale: An INR level of 1.2 is below the therapeutic range (2-3) for warfarin therapy. Therefore, the nurse should contact the healthcare provider to discuss the need for an increased dose to achieve the desired therapeutic range and prevent deep vein thrombosis effectively. Administering IV push protamine sulfate is used to reverse the effects of heparin, not warfarin. Continuing with the current prescription without addressing the subtherapeutic INR level may not effectively prevent deep vein thrombosis. Administering Vitamin K is indicated for warfarin overdose leading to excessive anticoagulation, not for a subtherapeutic INR level that is below the target range.
5. Which assessment finding for a 4-month-old infant would require further action by the nurse?
- A. The posterior fontanel is open.
- B. The infant has good head control when held upright.
- C. The infant is able to roll only from abdomen to back.
- D. The anterior fontanel is open and soft.
Correct answer: A
Rationale: The correct answer is A. The posterior fontanel should be closed by 4 months of age. An open posterior fontanel at this age may indicate a delay in normal closure, which could be a cause for concern and require further evaluation by the healthcare provider to ensure proper development and growth. Choices B, C, and D are typical developmental milestones for a 4-month-old infant and do not raise immediate concerns requiring further action by the nurse.
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