ATI RN
ATI Pediatric Proctored Exam 2023
1. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?
- A. Impaired Gas Exchange
- B. Risk for Infection
- C. Anxiety (parental)
- D. Acute Pain
Correct answer: A
Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.
2. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?
- A. Change the ostomy pouch every day.
- B. Use baby wipes to clean the stoma.
- C. Avoid using soap to clean the stoma.
- D. Apply barrier ointment to the skin around the stoma.
Correct answer: D
Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.
3. 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.
4. 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.
5. Why is it important to assess for in a child receiving prednisone to treat nephrotic syndrome?
- A. Infection
- B. Urinary retention
- C. Easy bruising
- D. Hypoglycemia
Correct answer: A
Rationale: When a child is receiving prednisone to treat nephrotic syndrome, it is crucial to assess for infection. Prednisone suppresses the immune system, making the child more vulnerable to infections. Since steroids can mask typical signs of infection, it is essential to look for subtle symptoms to ensure prompt treatment and prevent complications. Therefore, choices B, C, and D are incorrect as they are not directly related to the impact of prednisone therapy in nephrotic syndrome.
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