ATI RN
Pediatric Clinical Nurse Specialist Exam Questions Questions
Question 1 of 5
Munchausen syndrome by proxy (MBP) is a form of factitious disorder by proxy, where a parent (usually mother) mimics symptoms in his or her child. Of the following, the symptom that is LEAST likely presented is
Correct Answer: D
Rationale: In this scenario, the correct answer is D) failure to thrive. Munchausen syndrome by proxy (MBP) involves a caregiver, typically a parent, fabricating or inducing illness in another person, often their child, to gain attention or sympathy. Failure to thrive is a more chronic and subtle condition that may not immediately attract the attention-seeking behavior typical of MBP. Option A) diarrhea, Option B) respiratory arrest, and Option C) seizures are all acute and dramatic symptoms that would likely garner immediate attention and potentially fulfill the caregiver's need for validation or sympathy. These symptoms are more likely to be fabricated or induced in a case of MBP compared to failure to thrive, which is a slower and less overt presentation. In an educational context, understanding MBP is crucial for healthcare providers, especially pediatric nurses, as they are often at the forefront of recognizing and reporting suspected cases. By knowing the typical presentation of MBP, nurses can be vigilant in identifying potential cases and ensuring the safety and well-being of their pediatric patients. Recognizing the least likely symptom, such as failure to thrive in this case, helps in differentiating it from other common pediatric conditions and can guide appropriate interventions and reporting procedures.
Question 2 of 5
The earliest studies of autism suggested a relatively poor prognosis, with only a small number of individuals being able to function independently as adults. Of the following, the factor that carry POOR outcome is
Correct Answer: D
Rationale: The correct answer is D) good communication. In the context of autism, individuals with better communication skills may be more likely to receive support and accommodations, which can lead to improved outcomes. Good communication abilities can help individuals express their needs, understand information, and navigate social interactions, all of which are important for functioning independently. Option A) early onset is not necessarily a factor that guarantees a poor outcome. Early identification and intervention can actually lead to better outcomes for individuals with autism by providing timely support and therapies. Option B) higher IQ is also not a definitive factor for poor outcomes in autism. While individuals with higher IQ may face different challenges, it does not necessarily mean they will have a poor prognosis. Intelligence level does not determine the potential for growth and development in individuals with autism. Option C) better language skills are typically associated with better outcomes in individuals with autism. Language skills are crucial for communication and social interactions, which are important aspects of functioning independently. Therefore, better language skills would not carry a poor outcome. In an educational context, understanding the factors that can influence outcomes in individuals with autism is essential for healthcare providers, educators, and families. By recognizing the importance of communication skills and providing appropriate support, we can help individuals with autism reach their full potential and lead fulfilling lives.
Question 3 of 5
An -year-old child has excellent ideas in a class discussion, but what she records on paper is primitive and unsophisticated. She can spell well in isolation and understands rules of punctuation and capitalization, but in her own writing she makes multiple errors and mistakes in punctuation and capitalization. Her handwriting is legible, but writing is painfully slow. This girl most likely is having problems with
Correct Answer: B
Rationale: In this scenario, the correct answer is option B) graphomotor production. Graphomotor production refers to the ability to translate cognitive processes into legible written language. The child in the question demonstrates a discrepancy between her verbal expression and written output, indicating a graphomotor issue. Option A) expressive language is incorrect as the child's ideas in verbal communication are excellent; it is the translation to written form that is challenging. Option C) ideation is not the issue as the child's thoughts are sophisticated, but the execution in writing is the problem. Option D) attention is also not the primary concern as the child's slow writing speed and errors are more indicative of a fine motor skill challenge. From an educational perspective, understanding the nuances of different developmental domains like graphomotor skills is crucial for educators and healthcare professionals working with children. Recognizing and addressing these challenges can help support the child's overall academic success and self-esteem. Teachers can implement strategies like occupational therapy interventions, assistive technology, and modifications to support the child in improving their graphomotor skills and written expression.
Question 4 of 5
Nocturnal enuresis is described by all of the following EXCEPT
Correct Answer: D
Rationale: Nocturnal enuresis, or bedwetting, is a common pediatric issue that can have various causes. In this case, option D is the correct answer because primary nocturnal enuresis is typically not associated with emotional disorders. Primary enuresis refers to bedwetting in a child who has never been consistently dry at night, while secondary enuresis occurs after a period of dryness. Option A is incorrect because enuresis can be primary (never been dry at night) or secondary (previously dry at night). Option B is incorrect as while genetics can play a role in enuresis, it is not solely determined by genetic factors. Option C is incorrect because nocturnal enuresis typically occurs during specific stages of sleep, particularly during deep sleep stages. In an educational context, understanding the different types of enuresis, their possible causes, and associated factors is crucial for pediatric clinical nurse specialists to provide effective care and support to children and their families dealing with this issue. By recognizing the distinctions between primary and secondary enuresis and debunking common misconceptions, nurses can offer appropriate interventions and support to help children overcome bedwetting.
Question 5 of 5
The treatment of choice for childhood onset of major depression is
Correct Answer: C
Rationale: The correct answer is C) serotonin reuptake inhibitors for the treatment of childhood onset major depression. Serotonin reuptake inhibitors, such as fluoxetine, are considered the first-line treatment for pediatric depression due to their efficacy and safety profile in children and adolescents. They work by increasing the levels of serotonin in the brain, which helps regulate mood. Option A) monoamine oxidase inhibitors (MAOIs) are not typically used as a first-line treatment for pediatric depression due to their potential for serious side effects and dietary restrictions. Tricyclic antidepressants (Option B) are also not recommended as the first choice due to their higher risk of adverse effects, especially in children. Benzodiazepines (Option D) are not indicated for the treatment of major depression in children, as they are primarily used for anxiety disorders. In an educational context, it is crucial for pediatric clinical nurse specialists to be familiar with evidence-based treatment guidelines for pediatric depression to provide safe and effective care to their young patients. Understanding the rationale behind the choice of medication can help nurses advocate for appropriate treatment and monitor for potential side effects or improvements in the child's condition.