ATI RN
ATI Pediatric Proctored Exam
1. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?
- A. Administer aspirin for pain.
- B. Avoid administering NSAIDs.
- C. Restrict physical activities.
- D. Apply heat to joints.
Correct answer: B
Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.
2. Which level nursery classifications are housed in institutions that can provide on-site surgical repair of serious congenital or acquired malformations?
- A. Level III
- B. Level I
- C. Level IV
- D. Level II
Correct answer: C
Rationale: The correct answer is C: Level IV. Level IV nurseries are equipped to provide the highest level of care, including complex surgical interventions for serious congenital or acquired malformations. These nurseries have the necessary resources and expertise to manage critical cases effectively. Choice A: Level III nurseries provide advanced care for moderately ill newborns but may not have the capacity for on-site surgical repair of serious malformations. Choice B: Level I nurseries offer basic care for healthy newborns and those with minor issues, lacking the resources for surgical interventions. Choice D: Level II nurseries can manage moderately ill newborns but may not have the capability for complex surgical interventions like Level IV nurseries.
3. When the home health nurse visits the home of a 10-month-old child, she observes the environment for risks of injury to the child. Which observation will the nurse discuss with the mother?
- A. The mother leaves the filled mop bucket on the floor while in another room.
- B. The mother turns all pan handles to the back of the stove.
- C. The mother fills the bathtub before bringing the baby into the bathroom.
- D. When riding in a car, the child is in a car seat in the middle of the back seat.
Correct answer: A
Rationale: The correct answer is A because leaving a filled mop bucket on the floor poses a drowning hazard for a 10-month-old child. Water in the bucket can be a potential drowning risk if the child falls into it. Pan handles turned to the back of the stove prevent accidental spills or burns, which is a safety measure in the kitchen. Filling the bathtub before bringing the baby into the bathroom helps in preventing burns from hot water. Placing the child in a car seat in the middle of the back seat provides safety by minimizing the risk of injury during a car ride, but it is not the most immediate risk to address in the scenario provided.
4. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?
- A. 0.9% normal saline (NS)
- B. D5 0.2% (�) normal saline
- C. D5W
- D. Albumin
Correct answer: A
Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.
5. As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?
- A. Increased PCO2 and respiratory acidosis
- B. Decreased PCO2 and respiratory alkalosis
- C. Low pH and low PCO2
- D. High pH and high PCO2
Correct answer: A
Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood. Therefore, choice A, 'Increased PCO2 and respiratory acidosis,' is the correct answer. Choices B, C, and D are incorrect because slow and shallow respirations would not lead to decreased PCO2 or respiratory alkalosis (choice B), low pH and low PCO2 (choice C), or high pH and high PCO2 (choice D).
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