ATI RN
ATI Pediatric Proctored Exam 2023
1. During an assessment, an infant is suspected to have intussusception. Which of the following findings should the nurse expect?
- A. Currant jelly stools
- B. Projectile vomiting
- C. Scaphoid abdomen
- D. Frequent stools
Correct answer: A
Rationale: Intussusception is a condition where one segment of the intestine telescopes into another, causing obstruction. The classic presentation includes currant jelly stools, which are a mixture of blood and mucus due to the sloughing of the intestinal mucosa. This finding is a result of the compromised blood supply to the affected area and is a key characteristic associated with intussusception.
2. A 9-month-old infant who is not sitting independently has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestations would the nurse expect to see in the baby?
- A. Hypotonia and muscle instability
- B. Hypertonia and persistence of primitive reflexes
- C. Tremors and exaggerated posturing
- D. Hemiplegia and hypertonia
Correct answer: A
Rationale: In ataxic cerebral palsy, the characteristic features include hypotonia (low muscle tone) and muscle instability. These manifestations contribute to the infant's difficulty in achieving independent sitting. Hypertonia (increased muscle tone) and persistence of primitive reflexes, as mentioned in option B, are more commonly associated with other types of cerebral palsy like spastic CP. Tremors and exaggerated posturing (option C) are not typical features of ataxic CP. Hemiplegia (paralysis of one side of the body) and hypertonia (increased muscle tone) mentioned in option D are more commonly seen in other types of cerebral palsy, such as spastic CP.
3. A child with nephrotic syndrome has not experienced diuresis after a month on corticosteroids. What protocol can the nurse encourage to induce diuresis?
- A. Ibuprofen, an anti-inflammatory agent
- B. Furosemide (Lasix), a diuretic
- C. Ciprofloxacin (Cipro), an antibiotic
- D. Cyclophosphamide (Cytoxan), an immunosuppressant
Correct answer: B
Rationale: To induce diuresis in a child with nephrotic syndrome who has not responded to corticosteroids, a diuretic like Furosemide (Lasix) is appropriate. Furosemide helps increase urine production and reduce fluid retention. Ibuprofen is an anti-inflammatory agent and does not directly induce diuresis. Ciprofloxacin is an antibiotic and is not used to promote diuresis. Cyclophosphamide is an immunosuppressant, not an antisuppressant, and is not typically used to induce diuresis in nephrotic syndrome.
4. When preparing to insert an intravenous catheter for a 7-year-old child, which of the following actions should a healthcare professional take?
- A. Apply an anesthetic cream to the insertion site 1 hr before the procedure.
- B. Use a 16-gauge needle for the insertion.
- C. Insert the catheter into a vein of the child's dominant hand.
- D. Choose a site over the child's metacarpal veins.
Correct answer: A
Rationale: Applying an anesthetic cream to the insertion site 1 hr before the procedure is crucial when inserting an intravenous catheter in a child to minimize pain and discomfort during the procedure. This practice is especially important in pediatric patients to ensure a more comfortable experience and improve cooperation during the insertion process. Choice B is incorrect as a 16-gauge needle is too large for a child, and a smaller gauge needle is typically used. Choice C is incorrect as the catheter should be inserted into a suitable vein, not specifically the dominant hand vein. Choice D is incorrect as metacarpal veins are usually avoided due to their small size and the potential for complications.
5. How should professionals communicate with parents and family members?
- A. Share information with both parents to distribute the stress equally
- B. Share information with one parent to ensure accuracy
- C. Share information with all individuals who interact with the child, whether family or not
- D. Provide information in writing exclusively to ensure clear communication
Correct answer: C
Rationale: When professionals communicate with parents and family members, it is essential to share information with all individuals who interact with the child, whether they are family members or not. This inclusive approach ensures that everyone involved in the child's care and well-being is well-informed and can provide support as needed. It is important to consider the broader network of individuals who play a role in the child's life to promote comprehensive and effective communication.
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