ATI RN
ATI Pediatrics Test Bank Questions
Question 1 of 5
A 34 year old male client is diagnosed with encephalitis. Medication has been started for him and he is receiving nursing care. Which of the ff nursing interventions are the most critical for such a client? Choose all that apply
Correct Answer: B
Rationale: B. Evaluating the client's ventilation capacity and lung sounds frequently is crucial in encephalitis because the inflammation of the brain can affect the respiratory center, leading to respiratory compromise. Any changes in ventilation capacity or abnormal lung sounds should be addressed immediately to prevent respiratory distress.
Question 2 of 5
When assessing the external ear, the nurse palpates a small protrusion of the helix called a Darwin tubercle. The nurse would document this finding as which of the following?
Correct Answer: A
Rationale: A Darwin tubercle is a small, painless, hereditary nodule located on the helix of the ear. It is a normal anatomical variation and is present in varying degrees in the general population, regardless of age. Therefore, it would be documented as a normal finding during the assessment of the external ear.
Question 3 of 5
The following would be a symptom the nurse would expect to find during assessment of a patient with macular degeneration, EXCEPT:
Correct Answer: D
Rationale: Macular degeneration primarily affects the macula, which is responsible for central vision. Therefore, symptoms typically include loss of central vision, decreased ability to distinguish colors, and loss of near vision. Loss of peripheral vision is not a common symptom associated with macular degeneration. Instead, it is more commonly seen in conditions affecting the peripheral retina, such as retinitis pigmentosa.
Question 4 of 5
A 62-year old client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past 2 years. She's fatigued from lack of sleep; urinates frequently, even during the night, and has lost weight recently. Tests reveal the following: sodium level 152mEq/L, osmolarity 340mOsm/L, glucose level 125mg/dl, and potassium level of 3.8mEq/L. Which of the following nursing diagnoses is most appropriate for this client?
Correct Answer: C
Rationale: The client's elevated sodium level of 152 mEq/L indicates hypernatremia, which can lead to osmotic diuresis, causing excessive urination and subsequent fluid loss. This fluid loss can result in deficient fluid volume. The client's symptoms of frequent urination, fatigue from lack of sleep, and weight loss are indicative of dehydration due to the osmotic diuresis. Therefore, the most appropriate nursing diagnosis for this client is Deficient fluid volume related to osmotic diuresis induced by hypernatremia.
Question 5 of 5
When caring for a client with diabetes insipidus, the nurse expects to administer:
Correct Answer: A
Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to conserve water due to reduced secretion of antidiuretic hormone (ADH), also known as vasopressin. Therefore, the treatment for diabetes insipidus typically involves administering synthetic vasopressin, such as desmopressin (DDAVP) or vasopressin (Pitressin Synthetic), to replace the deficient hormone and help the kidneys reabsorb more water. Vasopressin helps regulate water balance in the body by increasing water reabsorption in the kidneys, reducing urine output, and preventing dehydration. Therefore, the nurse would expect to administer vasopressin to a client with diabetes insipidus to help manage the condition effectively.