ATI RN
ATI Pediatric Proctored Exam
1. When the home health nurse visits the home of a 10-month-old child, she observes the environment for risks of injury to the child. Which observation will the nurse discuss with the mother?
- A. The mother leaves the filled mop bucket on the floor while in another room.
- B. The mother turns all pan handles to the back of the stove.
- C. The mother fills the bathtub before bringing the baby into the bathroom.
- D. When riding in a car, the child is in a car seat in the middle of the back seat.
Correct answer: A
Rationale: The correct answer is A because leaving a filled mop bucket on the floor poses a drowning hazard for a 10-month-old child. Water in the bucket can be a potential drowning risk if the child falls into it. Pan handles turned to the back of the stove prevent accidental spills or burns, which is a safety measure in the kitchen. Filling the bathtub before bringing the baby into the bathroom helps in preventing burns from hot water. Placing the child in a car seat in the middle of the back seat provides safety by minimizing the risk of injury during a car ride, but it is not the most immediate risk to address in the scenario provided.
2. Which clinical manifestation should a nurse monitor for when assessing a pediatric client diagnosed with a basilar skull fracture?
- A. Periorbital ecchymosis
- B. Subdural hematoma
- C. Protruding bone
- D. Epidural hematoma
Correct answer: A
Rationale: Periorbital ecchymosis, also known as raccoon eyes, is a classic sign of a basilar skull fracture. It presents as bruising around the eyes due to blood collecting in the tissues. Monitoring for periorbital ecchymosis is crucial in assessing a pediatric client with a basilar skull fracture because it can indicate the presence of this serious injury.
3. 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.
4. A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate based on the current data?
- A. Placing the newborn on a radiant warmer
- B. Placing the newborn in an open crib
- C. Preparing the newborn for phototherapy
- D. Preparing the newborn for bottle-feeding
Correct answer: A
Rationale: Placing the newborn on a radiant warmer is appropriate as it helps maintain the body temperature and prevent hypothermia in a newborn with an omphalocele defect. This is crucial for the infant's well-being and supports their physiological stability.
5. Which assessment finding for a 4-month-old infant would require further action by the nurse?
- A. The posterior fontanel is open.
- B. The infant has good head control when held upright.
- C. The infant is able to roll only from abdomen to back.
- D. The anterior fontanel is open and soft.
Correct answer: A
Rationale: The correct answer is A. The posterior fontanel should be closed by 4 months of age. An open posterior fontanel at this age may indicate a delay in normal closure, which could be a cause for concern and require further evaluation by the healthcare provider to ensure proper development and growth. Choices B, C, and D are typical developmental milestones for a 4-month-old infant and do not raise immediate concerns requiring further action by the nurse.
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