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. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?
- A. Potassium level
- B. Lithium level
- C. Creatinine level
- D. Blood pressure
Correct answer: B
Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.
3. When discussing the correction of hypospadias in a newborn, what does the nurse explain about this condition?
- A. No intervention is required as the defect will correct itself over time.
- B. Surgical repair of hypospadias is typically performed before 18 months of age.
- C. Corrective surgery is commonly postponed until preschool age.
- D. Repairing the defect does not increase the risk of testicular cancer.
Correct answer: B
Rationale: Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis. Surgical repair is the primary treatment for hypospadias and is usually recommended to be done before 18 months of age. This timing is preferred for optimal cosmetic and functional outcomes. Waiting until preschool age for corrective surgery may increase the complexity of the procedure and potential complications. Correcting hypospadias does not impact the risk of testicular cancer.
4. 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.
5. What is it called when the therapist adjusts the difficulty level of an activity to match the child's abilities by bringing a toy closer for them to successfully reach and grasp during therapy?
- A. Compensating
- B. Adapting
- C. Grading
- D. Modifying
Correct answer: C
Rationale: The correct answer is C: Grading. Grading involves adjusting the difficulty level of an activity to match the child's abilities. Bringing a toy closer for easier reach is an example of grading in therapy, helping the child succeed in reaching and grasping the toy within their current capabilities. Choice A, Compensating, implies making up for a deficit, which is not the case here. Choice B, Adapting, suggests changing the activity itself, not just the difficulty level. Choice D, Modifying, indicates altering the toy or the task itself, rather than adjusting the task's difficulty level.
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