ATI RN
ATI Pediatric Proctored Exam
1. As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?
- A. Increased PCO2 and respiratory acidosis
- B. Decreased PCO2 and respiratory alkalosis
- C. Low pH and low PCO2
- D. High pH and high PCO2
Correct answer: A
Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood. Therefore, choice A, 'Increased PCO2 and respiratory acidosis,' is the correct answer. Choices B, C, and D are incorrect because slow and shallow respirations would not lead to decreased PCO2 or respiratory alkalosis (choice B), low pH and low PCO2 (choice C), or high pH and high PCO2 (choice D).
2. When educating a parent of an infant with a new prescription for digoxin, which instruction should the nurse provide?
- A. Repeat the dose if the infant vomits.
- B. Mix the medication with food.
- C. Give the medication with meals.
- D. Monitor the infant's heart rate prior to administering the medication.
Correct answer: D
Rationale: The correct answer is D: 'Monitor the infant's heart rate prior to administering the medication.' It is crucial for the nurse to monitor the infant's heart rate before giving digoxin to identify any signs of digoxin toxicity early. Heart rate assessment helps in detecting and preventing potential complications associated with digoxin use. Choices A, B, and C are incorrect. Repeating the dose if the infant vomits can lead to overdose, mixing the medication with food may alter its absorption, and giving the medication with meals can affect its effectiveness. Therefore, the priority is to monitor the infant's heart rate to ensure safe administration of digoxin.
3. While caring for four different pediatric clients, which child is at the highest risk for dehydration?
- A. 7-year-old child with migraine headaches
- B. 4-year-old child with a broken arm
- C. 2-year-old child with cellulitis of the left leg
- D. 18-month-old child with tachypnea
Correct answer: D
Rationale: The 18-month-old child with tachypnea is at the highest risk for dehydration due to increased insensible water loss associated with rapid breathing.
4. A healthcare professional is preparing to administer a measles, mumps, and rubella (MMR) vaccine to a 15-month-old child. Which of the following findings is a contraindication to the administration of this vaccine?
- A. Family history of egg allergy
- B. Currently taking antibiotics
- C. History of asthma
- D. Presence of rhinorrhea
Correct answer: B
Rationale: Taking antibiotics is a contraindication to receiving the MMR vaccine because antibiotics can potentially interfere with the effectiveness of the vaccine. It is essential to avoid administering the MMR vaccine while the child is on antibiotics to ensure the vaccine provides the intended protection.
5. Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa (Sinemet) for newly diagnosed Parkinson�s disease?
- A. Take medication on a full stomach
- B. Change positions slowly
- C. The drug may cause the urine to be very dilute
- D. Carbidopa has many adverse effects
Correct answer: B
Rationale: Postural hypotension is common early in treatment, so the patient should be instructed to change positions slowly. Administration with meals should be avoided, if possible, because food delays the absorption of the levodopa component. If the patient is experiencing side effects of nausea and vomiting, administration with food may be considered. The levodopa component may darken urine. Carbidopa has no adverse effects of its own.
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