ATI LPN
ATI Pediatrics Proctored Exam 2023 with NGN
1. What assessment finding places a newborn at risk for developing physiologic jaundice?
- A. Cephalohematoma
- B. Mongolian spots
- C. Telangiectatic nevi
- D. Molding
Correct answer: A
Rationale: The correct answer is A, Cephalohematoma. Physiologic jaundice in newborns can occur due to the breakdown of excess red blood cells. A cephalohematoma, a collection of blood caused by ruptured blood vessels between a cranial bone's surface and periosteal membrane, can lead to increased red blood cell breakdown. This increased breakdown can contribute to the development of physiologic jaundice in newborns. Choices B, Mongolian spots, and C, Telangiectatic nevi, are both benign skin conditions and are not directly associated with increased red blood cell breakdown. Choice D, Molding, refers to the shaping of the fetal head during passage through the birth canal and is not related to the development of physiologic jaundice.
2. What advice should a school-age child with type 1 diabetes mellitus follow to prevent hypoglycemia during soccer practice?
- A. Drink a cup of orange juice before soccer practice
- B. Eat twice the amount normally eaten at lunchtime
- C. Take half the amount of prescribed insulin on practice days
- D. Take the prescribed insulin at noontime rather than in the morning
Correct answer: A
Rationale: Drinking orange juice before soccer practice is recommended to prevent hypoglycemia in children with type 1 diabetes. Orange juice contains fast-acting carbohydrates that can quickly raise blood sugar levels if they drop during physical activity. Eating twice the amount normally eaten at lunchtime can lead to hyperglycemia, which is high blood sugar, rather than preventing hypoglycemia. Adjusting insulin doses should only be done under the guidance of a healthcare provider. Taking insulin at noontime rather than in the morning does not directly address preventing hypoglycemia during afternoon soccer practice.
3. When does the onset of type 2 diabetes typically occur?
- A. Occurs after pubertal onset in the majority of cases
- B. Occurs due to parental financial status
- C. Occurs in childhood
- D. Occurs after giving birth
Correct answer: A
Rationale: The onset of type 2 diabetes typically occurs after pubertal onset. It is more commonly diagnosed in adulthood, although it can also develop in younger individuals. Factors such as genetics, lifestyle, and obesity play a significant role in the development of type 2 diabetes.
4. Nana Esi is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?
- A. If your blood glucose levels are controlled, you can switch to using pills.
- B. The pills correct fat and protein metabolism, not carbohydrate metabolism.
- C. Your body does not make insulin, so the insulin injections help to replace it.
- D. The pills work on the adult pancreas; you can switch when you are 18.
Correct answer: C
Rationale: The nurse's best reply to Nana Esi is option C: 'Your body does not make insulin, so the insulin injections help to replace it.' In type 1 diabetes, the body's immune system destroys the insulin-producing beta cells in the pancreas. As a result, individuals with type 1 diabetes do not produce insulin, necessitating insulin injections for survival. Option A is incorrect as type 1 diabetes always requires insulin therapy. Option B is inaccurate as pills do not replace the function of insulin. Option D is also incorrect as there is no age restriction on using insulin therapy for type 1 diabetes.
5. A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:
- A. gently restraining her and assisting with ventilations.
- B. ventilations with a flow-restricted, oxygen-powered device.
- C. a non-rebreathing mask with the flow rate set at 6 to 8 L/min.
- D. asking the mother to hold an oxygen mask near her face.
Correct answer: C
Rationale: In a pediatric patient with respiratory distress, a non-rebreathing mask with a flow rate set at 6 to 8 L/min is the most effective way to deliver oxygen. This method ensures a high concentration of oxygen is delivered to the child, aiding in improving oxygen saturation levels. In this scenario, the mother can assist in holding the mask to maintain comfort and cooperation in the child while ensuring proper oxygen delivery.
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