ATI RN
ATI Pediatrics Proctored Exam 2023
1. The healthcare provider is explaining to a 17-year-old female the actions to prevent urinary tract infection. Which is the best beverage for the healthcare provider to recommend to keep urine acidic?
- A. Milk
- B. Grape juice
- C. Apple juice
- D. Orange juice
Correct answer: C
Rationale: To maintain the acidity of urine and potentially prevent urinary tract infections, juices such as apple or cranberry are recommended due to their ability to create an acidic environment in the urinary tract that may help inhibit bacterial growth.
2. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?
- A. Clay-colored stools and dark urine
- B. History of early passage of meconium in the newborn period
- C. History of chronic, progressive constipation and failure to gain weight
- D. Continual bouts of foul-smelling diarrhea
Correct answer: C
Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.
3. A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?
- A. Promethazine
- B. Epinephrine
- C. Diphenhydramine
- D. Hydroxyzine
Correct answer: B
Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.
4. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?
- A. My daughter should wash and wipe the perineal area from front to back.
- B. I am only going to have my daughter wear cotton underwear.
- C. It is acceptable to take frequent bubble baths.
- D. She needs to drink lots of fluids and void frequently.
Correct answer: C
Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.
5. 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).
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