ATI RN
ATI Pediatric Proctored Exam
1. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?
- A. I will make sure he gets his measles vaccine as soon as he gets home.
- B. He can stop taking his medication next week.
- C. I should check his urine for protein when he goes to the bathroom.
- D. He should eat a low-protein diet for the next few weeks.
Correct answer: C
Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.
2. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?
- A. The dialysate is clear upon return.
- B. The volume of drained dialysate is less than the volume infused.
- C. The child is restless and eager to play.
- D. The child's vital signs remain consistent with those noted during infusion.
Correct answer: B
Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.
3. The healthcare provider is caring for a child on bed rest who has severe edema in the left lower extremity due to blocked lymphatic drainage. Which nursing diagnosis would take priority?
- A. Risk for Impaired Skin Integrity
- B. Risk for Altered Body Image
- C. Risk for Imbalanced Nutrition: Less Than Body Requirements
- D. Risk for Activity Intolerance
Correct answer: A
Rationale: The priority nursing diagnosis in this scenario is 'Risk for Impaired Skin Integrity' because severe edema in the left lower extremity can lead to compromised circulation and pressure ulcers, increasing the risk of skin breakdown and infection. Addressing and preventing impaired skin integrity is crucial for the child's overall health and well-being.
4. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?
- A. Draw a stick figure with seven body parts
- B. Draw a circle
- C. Identify right from left hand
- D. Tie their shoelaces
Correct answer: B
Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.
5. A healthcare provider is assessing an infant who has hydrocephalus and is 6 hours postoperative following placement of a ventriculoperitoneal shunt. Which of the following findings should the provider report to the healthcare provider?
- A. Decreased urine output
- B. Temperature of 37.5 degrees C (99.5 degrees F)
- C. Heart rate 130/min
- D. Leakage of cerebrospinal fluid
Correct answer: D
Rationale: The provider should report the leakage of cerebrospinal fluid to the healthcare provider as it may indicate shunt malfunction or infection, requiring immediate attention to prevent complications. Decreased urine output, a temperature of 37.5 degrees C, and a heart rate of 130/min are common postoperative findings and may not be directly related to shunt function. While these findings should still be monitored, they do not require immediate reporting like cerebrospinal fluid leakage.
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