you arrive at the scene shortly after a 3 year old female experienced a seizure the child who is being held by her mother is conscious and crying the

ATI LPN

ATI Pediatrics Proctored Test

1. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Correct answer: D

Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.

2. The instructor is teaching a group of new mothers about infant care. Which statement indicates that further teaching is needed?

A. I should put my baby to sleep on their back.
B. I can give my baby water if they seem thirsty.
C. Breastfeeding provides all the nutrients my baby needs.
D. I should burp my baby after each feeding.

Correct answer: B

Rationale: The correct answer is B. Newborns do not need additional water as breast milk or formula provides all the necessary hydration. Giving water to infants can be harmful and is not recommended as it can interfere with the balance of electrolytes in their bodies. Choice A is correct as placing babies on their back for sleep is the recommended safe sleeping position. Choice C is also correct as breastfeeding does provide all the essential nutrients for babies. Choice D is correct as burping the baby after each feeding helps prevent discomfort from trapped air.

3. How can the nurse best assess that the parents demonstrate understanding of the dressing change procedure prior to discharge for their child with burns?

A. The parents explaining the importance of using sterile technique to the nurse.
B. The nurse observing the parents changing the dressing using appropriate technique.
C. The parents observing the nurse changing the dressing and confirming their understanding of the procedure.
D. The nurse allowing the parents to explain the dressing change procedure and perform it in private to boost their confidence.

Correct answer: B

Rationale: The most effective way for the nurse to assess the parents' understanding of the dressing change procedure is by observing them as they change the dressing using the correct technique. This direct observation ensures that the parents are able to perform the task correctly and confidently before discharge. Merely verbalizing or explaining the procedure may not accurately reflect the parents' competency in performing the actual task. Choice A involves the parents explaining to the nurse, which does not directly assess their practical skills. Choice C suggests the parents observing the nurse, which does not evaluate the parents' ability to perform the task independently. Choice D focuses on boosting the parents' confidence but does not directly assess their understanding and competency in performing the dressing change.

4. The nurse is assessing a postpartum client's fundus. Where should the nurse expect to find the fundus 24 hours after delivery?

A. At the level of the umbilicus
B. 1 cm above the symphysis pubis
C. At the level of the xiphoid process
D. 2 cm below the umbilicus

Correct answer: A

Rationale: After delivery, the fundus is expected to be at the level of the umbilicus 24 hours postpartum. This position indicates that the uterus is involuting properly. Assessing the fundal height helps monitor the progress of uterine involution and can identify any potential complications like postpartum hemorrhage.

5. How will a ventricular septal defect affect blood flow?

A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
C. No shunting occurs due to high pressure in the left ventricle.
D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.

Correct answer: A

Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.