ATI RN
ATI Pediatric Proctored Exam
1. What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?
- A. Restrict intake of oral fluids and high-fiber foods
- B. Take an apical pulse for 30 seconds before administration
- C. Notify the healthcare provider of nausea, vomiting, and visual changes
- D. Hold the medications if the heart rate is greater than 110 bpm
Correct answer: C
Rationale: When a patient is prescribed verapamil and digoxin, it is crucial to monitor for signs of digoxin toxicity due to the potential interaction between these medications. Verapamil can elevate digoxin blood serum levels, increasing the risk of toxicity. Symptoms of digoxin toxicity include nausea, vomiting, and visual changes. Therefore, the most appropriate nursing consideration is to notify the healthcare provider of these symptoms. Restricting intake of oral fluids and high-fiber foods is not a specific consideration related to this medication combination. Before administering digoxin, it is essential to take an apical pulse for a full minute, not just 30 seconds, to ensure accuracy. Additionally, holding the medications if the heart rate exceeds 110 bpm is not a typical response to the combination of verapamil and digoxin, which can cause bradycardia rather than tachycardia.
2. The healthcare provider is providing dietary teaching to the parent of a school-age child who has celiac disease. The healthcare provider should recommend that the parent offer which of the following foods to the child?
- A. Wheat bread
- B. Vanilla malt
- C. Barley soup
- D. Rice pudding
Correct answer: D
Rationale: Celiac disease requires a lifelong gluten-free diet. Foods containing gluten such as wheat, barley, and rye should be avoided. Rice pudding is a safe option as it does not contain gluten, making it a suitable choice for a child with celiac disease.
3. Which strategy is most likely to promote positive behavior in children?
- A. Providing flexible instructions with no consequences
- B. Limiting opportunities until the child performs adequately
- C. Improving the child's competence and creating a positive environment
- D. Setting strict rules with punishments for misbehavior
Correct answer: C
Rationale: Improving the child's competence and creating a positive environment is the most effective strategy to promote positive behavior in children. This approach focuses on enhancing the child's skills and abilities while fostering a supportive and encouraging atmosphere. By empowering the child and surrounding them with positivity, they are more likely to exhibit positive behaviors as they feel competent, valued, and motivated. This strategy emphasizes support and reinforcement over punitive measures, leading to long-lasting behavioral improvements.
4. A parent of a preschooler is being taught by a nurse about administering ear drops. Which of the following statements by the parent indicates an understanding of the teaching?
- A. I will straighten my child's ear canal by pulling it upward and backward.
- B. I will administer the ear drops immediately after removing them from the refrigerator.
- C. I will pull the ear lobe down and back before administering the ear drops.
- D. I will massage my child's ear after administering the ear drops.
Correct answer: D
Rationale: Correct administration of ear drops includes massaging the child's ear after administering the drops to facilitate proper absorption of the medication. This action helps ensure the effectiveness of the treatment. Choices A, B, and C are incorrect. Choice A describes incorrect positioning of the ear canal, choice B mentions incorrect storage of the ear drops, and choice C describes an incorrect technique for administering ear drops.
5. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?
- A. Blood pressure 90/50
- B. Respiratory rate 45/min
- C. Weight 14.5 kg or 32 lb
- D. Heart rate 110/min
Correct answer: B
Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.
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