ATI RN
ATI Pediatrics Proctored Exam 2023
1. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?
- A. Hypoalbuminemia
- B. Hyperkalemia
- C. Polyuria
- D. Hyperglycemia
Correct answer: A
Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.
2. A child receives a vaccine for MMR. Six hours after the injection, the child�s parent reports local soreness, erythema, lethargy, and a fever of 101�F to a nurse. Which action should the nurse take?
- A. Give instructions on relieving symptoms with acetaminophen
- B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
- C. Tell the parent that a live vaccine will cause a mild case of measles
- D. Obtain and fill out a Vaccine Adverse Event Report form
Correct answer: A
Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.
3. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?
- A. Elevate the head of the child's bed
- B. Insert a large-bore IV catheter for the child
- C. Determine the allergen that caused the child's reaction
- D. Administer IM epinephrine to the child
Correct answer: D
Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.
4. What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?
- A. Restrict intake of oral fluids and high-fiber foods
- B. Take an apical pulse for 30 seconds before administration
- C. Notify the healthcare provider of nausea, vomiting, and visual changes
- D. Hold the medications if the heart rate is greater than 110 bpm
Correct answer: C
Rationale: When a patient is prescribed verapamil and digoxin, it is crucial to monitor for signs of digoxin toxicity due to the potential interaction between these medications. Verapamil can elevate digoxin blood serum levels, increasing the risk of toxicity. Symptoms of digoxin toxicity include nausea, vomiting, and visual changes. Therefore, the most appropriate nursing consideration is to notify the healthcare provider of these symptoms. Restricting intake of oral fluids and high-fiber foods is not a specific consideration related to this medication combination. Before administering digoxin, it is essential to take an apical pulse for a full minute, not just 30 seconds, to ensure accuracy. Additionally, holding the medications if the heart rate exceeds 110 bpm is not a typical response to the combination of verapamil and digoxin, which can cause bradycardia rather than tachycardia.
5. Which is the priority nursing assessment when providing care for an infant at risk for dehydration?
- A. Urine output
- B. Urine specific gravity
- C. Vital signs
- D. Daily weight
Correct answer: D
Rationale: The correct answer is Daily weight. Daily weight is a crucial assessment in infants at risk for dehydration because changes in weight can indicate fluid balance and dehydration status. It is essential to monitor daily weight to promptly identify and manage dehydration in infants.
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