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 patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?
- A. Promethazine
- B. Epinephrine
- C. Diphenhydramine
- D. Hydroxyzine
Correct answer: B
Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.
3. 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.
4. Which is the appropriate intervention when providing care to a child diagnosed with nephrotic syndrome, who is edematous and on bed rest?
- A. Monitor blood pressure every 30 minutes.
- B. Reposition every 2 hours.
- C. Limit visitors.
- D. Encourage fluids.
Correct answer: B
Rationale: Repositioning every 2 hours is crucial in preventing skin breakdown in an edematous child on bed rest. This intervention helps redistribute pressure and maintain skin integrity, reducing the risk of pressure ulcers. It is an essential part of care for patients with limited mobility to ensure their comfort and prevent complications related to immobility.
5. The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?
- A. Hypertension
- B. Edema
- C. Diabetes insipidus
- D. Protection against postmenopausal osteoporosis
Correct answer: A
Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.
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