ATI RN
ATI Pediatrics Proctored Exam 2023
1. Which menu choices for a child diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?
- A. Carrots and green, leafy vegetables
- B. Spaghetti and meat sauce with breadsticks
- C. Hamburger on a bun and cherry gelatin
- D. Chips, cold cuts, and canned foods
Correct answer: A
Rationale: Carrots and green, leafy vegetables are high in potassium, which should be avoided in hyperkalemia. Therefore, this choice requires further instruction by the nurse to prevent exacerbating the child's condition.
2. The healthcare provider should question an order for glucocorticoids in the treatment of a patient with what condition?
- A. Systemic fungal infection
- B. Diabetes Mellitus
- C. Myasthenia Gravis
- D. Glaucoma
Correct answer: A
Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.
3. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?
- A. Inflamed throat with exudate
- B. Purulent eye drainage
- C. Dry, hacking cough
- D. Koplik spots on buccal mucosa
Correct answer: C
Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.
4. A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as?
- A. Cystometrogram
- B. Cystoscopy
- C. Voiding cystourethrogram
- D. Intravenous pyelogram
Correct answer: C
Rationale: The correct test for an x-ray examination of the bladder and urethra before and during micturition is a voiding cystourethrogram. This procedure allows visualization of the bladder and urethra while the patient is urinating to assess for any abnormalities in the anatomy or function of these structures.
5. A parent is receiving discharge teaching following their infant's hypospadias repair. Which instruction should the parent follow?
- A. Apply a warm compress to the infant's surgical site twice daily.
- B. Avoid giving the infant a tub bath for 1 week.
- C. Apply an antibiotic ointment to the infant's penis daily.
- D. Clamp the infant's catheter for 30 minutes every 4 hours.
Correct answer: B
Rationale: After hypospadias repair, it is essential to avoid giving the infant a tub bath for 1 week to prevent infection and promote proper healing. Submerging the surgical site in water too soon can increase the risk of infection and compromise the healing process.
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