ATI LPN
ATI Pediatrics Proctored Test
1. Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. Initial treatment for this condition should include:
- A. Clamping and cutting the umbilical cord.
- B. Gently pulling on the cord to facilitate removal.
- C. Trying to remove the cord from around the neck.
- D. Keeping the cord moist and providing rapid transport.
Correct answer: C
Rationale: When encountering a situation where the umbilical cord is wrapped around a baby's neck upon delivery, the initial treatment should involve trying to remove the cord from around the neck gently. It is crucial to handle this situation delicately to avoid causing harm to the baby. Attempting to ease the cord over the baby's head without pulling or tightening can help prevent potential complications associated with cord compression. Choice A, clamping and cutting the umbilical cord, is not recommended as it can lead to abrupt deprivation of oxygen to the baby. Choice B, gently pulling on the cord, can worsen the situation by tightening the cord around the baby's neck. Choice D, keeping the cord moist and providing rapid transport, is not the immediate concern and does not address the potential risks of cord compression during delivery. Therefore, the priority is to carefully attempt to remove the cord from around the baby's neck to ensure a safe delivery.
2. Based on the complaints provided by Madam KK, is the child exhibiting danger signs?
- A. Yes
- B. No
- C. I don't know
- D. Yes
Correct answer: A
Rationale: Yes, the child is displaying danger signs with symptoms such as fever and rapid breathing, indicating a potential serious health issue that requires immediate attention. The correct answer is 'Yes' because the symptoms described in Madam KK's complaints align with danger signs that suggest a severe health problem. Choices B and C are incorrect because the symptoms mentioned clearly indicate the presence of danger signs. Choice D is a duplicate of choice A and does not provide a valid alternative.
3. Beta-adrenergic agonists such as Salbutamol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following?
- A. Dilate the bronchioles
- B. Reduce secondary infections
- C. Decrease postnasal drip
- D. Reduce airway inflammation
Correct answer: A
Rationale: Beta-adrenergic agonists like Salbutamol are used to dilate the bronchioles in asthma patients. This action helps in relieving bronchospasms and improving airflow to the lungs, making breathing easier for the individual. While reducing inflammation is an essential part of asthma management, beta-adrenergic agonists primarily work by relaxing the smooth muscles around the airways, leading to bronchodilation. Choices B, C, and D are incorrect because beta-adrenergic agonists are not primarily used to reduce secondary infections, decrease postnasal drip, or directly reduce airway inflammation in asthma patients.
4. The parents of a child hospitalized with asthma who is recovering and is being prepared for discharge are receiving home care instructions from the nurse. Which statement by a parent indicates a need for further instruction?
- A. Coughing spells may be triggered by dust or smoke
- B. Vomiting may occur when our child has coughing episodes
- C. We need to encourage our child to drink fluids
- D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks
Correct answer: D
Rationale: The statement 'We need to maintain droplet precautions and a quiet environment for at least 2 weeks' indicates a need for further instruction. Asthma management does not typically require maintaining droplet precautions. The focus should be on environmental control, medication adherence, and monitoring symptoms rather than droplet precautions, which are more relevant for contagious respiratory infections.
5. Which of the following injuries is MOST indicative of child abuse?
- A. Multiple bruises to the shins
- B. Burned hand with splash marks
- C. Small laceration to the chin
- D. Bruising to the upper back
Correct answer: D
Rationale: Bruising to the upper back is more suspicious for child abuse compared to the other listed injuries. In young children, injuries like bruises to the upper back are less likely to be accidental and may raise concerns about physical abuse. The upper back is an area less prone to accidental injuries during play or falls. Multiple bruises to the shins are common in active children. A burned hand with splash marks may suggest accidental burns. A small laceration to the chin is also a common injury from falls in children. Therefore, the bruising on the upper back is more concerning for possible child abuse.
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