ATI RN
ATI Pediatric Proctored Exam Questions
Question 1 of 5
A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy. Which medical prescription should the nurse question?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Rectal temperatures every 4 hours. The nurse should question this prescription because taking rectal temperatures in a toddler who is scheduled for a colostomy closure can introduce the risk of infection due to the proximity of the surgical site to the rectum. Option A) Clear liquids today. NPO tomorrow is appropriate as it follows the standard preoperative fasting guidelines to prevent aspiration during surgery. Option B) Type and cross-match for 1 unit of packed red blood cells is also a valid prescription as it is essential for preparedness in case the toddler requires a blood transfusion during or after the surgery. Option D) Start an intravenous line with D5NS at 20 mL per hour is a common preoperative order to maintain hydration and provide glucose support during the perioperative period. In an educational context, it is vital for pediatric nurses to understand the rationale behind each medical prescription to ensure the safety and well-being of their young patients. Questioning orders that may pose risks or are not in the best interest of the child is a crucial aspect of advocating for pediatric patients' health and safety.
Question 2 of 5
The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?
Correct Answer: A
Rationale: In pediatric nursing, understanding fluid and electrolyte balance is crucial for providing safe and effective care. For a child with severe isotonic dehydration, the appropriate intravenous fluid prescription would be 0.9% normal saline (NS), which is isotonic and helps to expand the intravascular volume without causing a shift in fluid balance across the compartments. Option A is correct because 0.9% NS closely resembles the electrolyte composition of extracellular fluid, making it the most suitable choice for isotonic dehydration. This solution helps to restore fluid volume without causing significant changes in electrolyte concentrations. Options B and C are incorrect. D5 0.2% (¼) normal saline and D5W are hypotonic solutions, which could worsen the child's condition by causing fluid to shift into the cells, leading to potential complications like cerebral edema. Option D, Albumin, is a colloid solution that is typically used for specific situations like severe hypoalbuminemia or certain cases of shock. It is not the first-line treatment for isotonic dehydration in children. Educationally, this question highlights the importance of understanding the principles of fluid and electrolyte balance in pediatric patients. It emphasizes the need for nurses to select the appropriate intravenous fluids based on the child's clinical condition to prevent adverse effects and promote optimal outcomes.
Question 3 of 5
As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?
Correct Answer: A
Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood.
Question 4 of 5
The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?
Correct Answer: A
Rationale: In pediatric nursing, administering medications like digoxin requires a thorough understanding of the drug's effects on the body, especially the cardiovascular system. The priority nursing intervention before administering digoxin is to analyze the heart rate and rhythm. This is crucial because digoxin is a cardiac glycoside that primarily affects the heart, and a change in heart rate or rhythm could indicate toxicity, which requires immediate intervention. Assessing for Homan's sign (option B) is not relevant in the context of administering digoxin as it is a sign of deep vein thrombosis, unrelated to this medication. Checking blood pressure (option C) and palpating pedal pulses (option D) are important assessments but are not the priority before administering digoxin to a pediatric patient. Educationally, understanding the rationale behind prioritizing assessments before administering specific medications enhances a nurse's clinical judgment and ensures safe and effective care for pediatric patients. It emphasizes the importance of focusing on assessments directly related to the medication's potential effects, thereby preventing adverse outcomes.
Question 5 of 5
What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?
Correct Answer: C
Rationale: When a patient is prescribed verapamil and digoxin, it is crucial to monitor for signs of digoxin toxicity due to the potential interaction between these medications. Verapamil can elevate digoxin blood serum levels, increasing the risk of toxicity. Symptoms of digoxin toxicity include nausea, vomiting, and visual changes. Restricting intake of oral fluids and high-fiber foods is not a specific consideration related to this medication combination. Before administering digoxin, it is essential to take an apical pulse for a full minute, not just 30 seconds. Additionally, holding the medications if the heart rate exceeds 110 bpm is not a typical response to the combination of verapamil and digoxin, which can cause bradycardia rather than tachycardia.