ATI LPN
ATI Pediatrics Proctored Test
1. You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:
- A. hyperventilate her due to severe hypoxia.
- B. attach the AED pads after 5 minutes of high-quality CPR.
- C. perform compressions and ventilations at a ratio of 30:2.
- D. allow the chest to fully recoil between compressions.
Correct answer: D
Rationale: Allowing the chest to fully recoil between compressions is crucial during CPR to ensure proper blood flow. This action allows the heart to refill with blood, enhancing the effectiveness of compressions and circulation. Hyperventilating the patient can lead to decreased cardiac output and is not recommended. Attaching AED pads should be done as soon as possible in a pediatric cardiac arrest situation, ideally within 2 minutes. The correct compression-to-ventilation ratio for pediatric CPR is 30:2, focusing on high-quality compressions to provide adequate perfusion to vital organs.
2. Which of the following statements regarding the length-based resuscitation tape measure is correct?
- A. The resuscitation tape estimates a child's weight based on his or her height.
- B. It is a reliable tool in children who are less than 5 years of age.
- C. The red end of the tape measure is placed at the top of the child's head.
- D. The tape measure can be used in children who weigh up to 75 pounds.
Correct answer: D
Rationale: The length-based resuscitation tape measure is designed to estimate a child's weight based on their length and can be used for children weighing up to 75 pounds. It is a reliable tool for pediatric weight estimation in emergency situations.
3. A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?
- A. 5% dextrose infusion
- B. Normal saline infusion
- C. NPH insulin infusion
- D. Potassium infusion
Correct answer: B
Rationale: In the management of diabetic ketoacidosis (DKA), the initial intravenous (IV) fluid of choice is normal saline infusion. Normal saline helps to correct dehydration and electrolyte imbalances commonly seen in DKA patients. It does not contain glucose to prevent worsening hyperglycemia or ketoacidosis. NPH insulin infusion is not the initial treatment for DKA; it is typically used after fluid resuscitation. Potassium infusion may be required in DKA to address electrolyte imbalances, but normal saline is the priority for fluid resuscitation.
4. How should the nurse prepare the sibling of a near-drowning accident victim who wants to see his brother in the pediatric intensive care unit, considering the child was present during the accident?
- A. Have the parents explain to the child why the sibling is so sick and inform the child that this could be the last time he sees his brother.
- B. Reassure the sibling not to cry in the child's room to avoid upsetting the ill child.
- C. If death is imminent, avoid informing the child about it and minimize involvement in care to protect the child from further trauma.
- D. Cover tubes and wires with a sheet, wash off any existing blood, and prepare him for what he will see.
Correct answer: D
Rationale: When preparing a sibling to see their brother in the pediatric intensive care unit after a near-drowning accident, it is essential to cover tubes and wires with a sheet, wash off any existing blood, and explain what the sibling will see. This approach helps the sibling understand the situation better and prepares them emotionally for the encounter, reducing potential distress and trauma. By providing information and visual preparation, the sibling can have a more controlled and less overwhelming experience when visiting their brother in the intensive care unit. Choice A is incorrect as informing the child that this could be the last time he sees his sibling may cause unnecessary distress and anxiety. Choice B is incorrect as it dismisses the sibling's emotional response, which is essential to address in a supportive manner. Choice C is incorrect as honesty and appropriate information sharing are crucial, even in difficult situations, to help the child cope effectively with the circumstances.
5. Which of the following findings is abnormal?
- A. Rapid, irregular breathing in a newly born infant
- B. Heart rate of 80 beats/min in a 3-month-old infant
- C. Respiratory rate of 26 breaths/min in a 2-year-old child
- D. Systolic BP of 100 mm Hg in a 10-year-old child
Correct answer: B
Rationale: A heart rate of 80 beats per minute in a 3-month-old infant is abnormally low for that age group and could indicate underlying health issues. The normal heart rate for a 3-month-old infant is typically higher, around 100-150 beats per minute. Therefore, this finding stands out as abnormal and warrants further evaluation. Choice A is not necessarily abnormal in a newly born infant as irregular breathing patterns can be common during the neonatal period. Choice C falls within the normal respiratory rate range for a 2-year-old child, which is around 20-30 breaths per minute. Choice D reflects a systolic blood pressure value within the normal range for a 10-year-old child, which is typically around 90-110 mm Hg.
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