ATI RN
ATI Pediatrics Proctored Exam 2023
1. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?
- A. Pain with urination
- B. New onset disorientation to time and place
- C. HR changes from a baseline of 70-80bpm to 110-120bpm
- D. #ERROR!
Correct answer: B
Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.
2. Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?
- A. Headache, hematuria, and vertigo
- B. Foul-smelling urine, elevated blood pressure (BP), and hematuria
- C. Urgency, dysuria, and fever
- D. Severe flank pain, nausea, and headache
Correct answer: C
Rationale: Preschool-age children with a urinary tract infection commonly present with urgency (feeling the need to urinate urgently), dysuria (painful urination), and fever. These symptoms are indicative of a UTI in this age group and should prompt further assessment and intervention by the nurse. Choice A is incorrect because headache and vertigo are not typical symptoms of UTI in preschool-age children. Choice B is incorrect because while foul-smelling urine and hematuria can be present in UTI, elevated blood pressure is not a common finding in this condition. Choice D is incorrect as severe flank pain and nausea are not typical manifestations of UTI in preschool-age children.
3. Which of the following is a common issue experienced by families of children with ASD?
- A. Financial limitations
- B. Social isolation
- C. Difficulty accessing needed services
- D. Difficulty obtaining early diagnosis
Correct answer: C
Rationale: Families of children with ASD commonly experience challenges in accessing needed services. This can include difficulties in obtaining appropriate therapies, educational support, and specialized interventions. While financial limitations and social isolation are also significant issues faced by these families, the primary concern often revolves around the challenges in accessing essential services for their children.
4. A patient who has PUD and is receiving magnesium hydroxide (MOM) is experiencing an increased number of BM. Which is the nurse�s priority action?
- A. Ask the HCP for a reduction in dose
- B. Encourage the patient to increase dietary fiber
- C. Administer the drug with an aluminum hydroxide antacid
- D. Instruct patient to keep an accurate stool count
Correct answer: C
Rationale: MOM is a rapid-acting antacid with a prominent adverse effect of diarrhea. To compensate, it usually is administered in combo with aluminum hydroxide which promotes constipation. A reduction in dose might be necessary if the diarrhea is severe, but this is not a priority action. Increasing dietary fiber and keeping a stool count are appropriate actions to implement after adding an antacid to counteract the diarrhea effect.
5. A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer?
- A. Aspirin
- B. Acetaminophen
- C. Ibuprofen
- D. Naproxen Sodium (Aleve)
Correct answer: B
Rationale: When a patient is already receiving glucocorticoids for rheumatoid arthritis and complains of a headache, it is essential to consider the potential interactions and side effects of additional medications. Aspirin and NSAIDs like ibuprofen and naproxen sodium can increase the risk of gastrointestinal irritation and ulceration when used concurrently with glucocorticoids. Acetaminophen is a safer choice in this scenario for managing the patient's headache without exacerbating the gastrointestinal issues associated with the use of glucocorticoids. Acetaminophen does not have the same gastrointestinal side effects as aspirin, ibuprofen, or naproxen sodium, making it the most appropriate option for headache relief in this case.
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