ATI RN
ATI Pediatric Proctored Exam 2023
1. The patient is receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding is most likely related to an adverse effect of heparin?
- A. HR of 60 bpm
- B. BP of 160/88
- C. Discolored urine
- D. Inspiratory wheezing
Correct answer: C
Rationale: The primary and most serious adverse effect of heparin is bleeding. However, discolored urine can indicate bleeding into the urinary tract, which is a potential adverse effect of heparin therapy. While changes in heart rate (HR) and blood pressure (BP) can occur due to various reasons, discolored urine specifically points towards a potential adverse effect related to heparin therapy.
2. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?
- A. This is atypical behavior and should be addressed
- B. The infant should remain on high alert when awake
- C. This shows the infant is making neurological gains
- D. The family is disrupting the child's sleep patterns
Correct answer: C
Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.
3. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?
- A. Inflamed throat with exudate
- B. Purulent eye drainage
- C. Dry, hacking cough
- D. Koplik spots on buccal mucosa
Correct answer: C
Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.
4. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?
- A. Applying a diaper to prevent contamination of the sac
- B. Positioning the newborn in a side-lying position
- C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
- D. Positioning the newborn in a prone position
Correct answer: D
Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.
5. The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?
- A. Can interfere with the treatment for nephrosis.
- B. Require that the child have antibiotic coverage.
- C. Can be given in smaller, divided doses.
- D. Should be delayed.
Correct answer: D
Rationale: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.
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