ATI LPN
Pediatric ATI Proctored Test
1. 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.
2. Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?
- A. Supine with legs elevated
- B. Supine with hips elevated
- C. Left lateral recumbent
- D. Left side with legs elevated
Correct answer: B
Rationale: The most appropriate position for a mother in labor with a prolapsed umbilical cord is supine with hips elevated. This position helps reduce pressure on the cord, preventing further complications and ensuring optimal blood flow to the fetus.
3. How will a ventricular septal defect affect blood flow?
- A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
- B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
- C. No shunting occurs due to high pressure in the left ventricle.
- D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.
Correct answer: A
Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.
4. A mother reported to you that her 6-year-old child is suffering from diarrhea. Which of the following advice will you give to the mother?
- A. Breastfeeding should be continued day and night
- B. Formula milk should be stopped for 6 hours
- C. Breast milk can be given together with oral rehydration salts
- D. A and C
Correct answer: D
Rationale: When a child is suffering from diarrhea, it is essential to continue breastfeeding day and night to maintain hydration and provide necessary nutrients. Stopping formula milk for 6 hours (choice B) is not the recommended approach as it may lead to a lack of essential nutrients during this critical time. Giving breast milk together with oral rehydration salts (choice C) can help replenish lost fluids and electrolytes, making it a suitable recommendation. Therefore, advising the mother to follow both options A and C is the most appropriate approach to manage the child's condition effectively.
5. Which of the following signs is MOST indicative of inadequate breathing in an infant?
- A. Sunken fontanelles
- B. Heart rate of 130 beats/min
- C. Expiratory grunting
- D. Abdominal breathing
Correct answer: C
Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.
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