ATI RN
ATI Pediatrics Proctored Exam 2023
1. A toddler has minimal change nephrotic syndrome (MCNS) and 3+ pitting edema. Which intervention should the nurse include in the plan of care?
- A. Encourage an increased fluid intake for the toddler
- B. Place the child in an Airborne infection isolation room
- C. Increase the toddler's dietary sodium intake
- D. Administer corticosteroids to the toddler
Correct answer: D
Rationale: In managing minimal change nephrotic syndrome (MCNS) in children with pitting edema, corticosteroids are the mainstay of treatment. Corticosteroids help reduce inflammation and decrease proteinuria, addressing the underlying cause of MCNS. Therefore, the nurse should prioritize administering the prescribed corticosteroids to the toddler as part of the plan of care.
2. A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?
- A. Administer antibiotics as prescribed.
- B. Maintain the child on NPO status.
- C. Monitor the child's intake and output.
- D. Implement seizure precautions.
Correct answer: D
Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety. Administering antibiotics as prescribed is essential in treating bacterial meningitis, but seizure precautions take precedence due to the immediate risk of injury. Maintaining NPO status and monitoring intake and output are important aspects of care but are not the priority when considering the risk of seizures.
3. Which question does not provide information regarding the family's cultural values?
- A. Who makes the decisions?
- B. What is the child's date of birth?
- C. What are the daily routines and rules of mealtime?
- D. What do the parents believe about disability?
Correct answer: B
Rationale: The correct answer is B. Asking for the child's date of birth is a factual question that does not directly relate to the family's cultural values. Choices A, C, and D delve into aspects that could offer insights into the family's cultural values and beliefs. Question A explores decision-making dynamics within the family, which can be influenced by cultural norms. Question C inquires about daily routines and mealtime rules, which often reflect cultural practices and values. Question D relates to the parents' beliefs about disability, which can be shaped by cultural, religious, or societal perspectives. Therefore, these questions are more likely to provide information about the family's cultural values compared to the child's date of birth.
4. How does an occupational therapist use clinical guidelines to inform practice with children and youth?
- A. Modify guidelines to fit the specific environment
- B. Establish systems to monitor outcomes
- C. Select the most recent guidelines without considering the client
- D. Consider guidelines that fit one's clientele and environment
Correct answer: C
Rationale: When using clinical guidelines to inform practice with children and youth, it is crucial for occupational therapists to not solely rely on the most recent guidelines but to consider the individual needs and contexts of each client. Selecting guidelines based solely on recency without considering the specific client can lead to ineffective or inappropriate interventions.
5. A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data?
- A. Hypernatremia
- B. Metabolic acidosis
- C. Hypotonic dehydration
- D. Isotonic dehydration
Correct answer: C
Rationale: The correct answer is hypotonic dehydration. The combination of high hemoglobin and hematocrit with low serum sodium indicates hypotonic dehydration. In this condition, there is an excess of solutes relative to water, leading to higher red blood cell concentration (elevated hemoglobin and hematocrit) and low serum sodium levels.
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