ATI RN
Pediatric Clinical Nurse Specialist Exam Questions Questions
Question 1 of 5
One of the following is not a screening test for a child with bleeding tendency:
Correct Answer: C
Rationale: In the context of screening for a child with a bleeding tendency, the correct answer is C) Thrombin time. Thrombin time is not typically used as a screening test for bleeding disorders in children. A) Clotting time assesses the overall clotting ability of blood, which can help identify clotting disorders. B) Bleeding time measures how long it takes for bleeding to stop after a standardized skin incision, providing information on platelet function. D) Partial thromboplastin time (PTT) evaluates the intrinsic and common coagulation pathways and can detect deficiencies in factors VIII, IX, XI, and XII. Educationally, it is important to understand the rationale behind each screening test for bleeding disorders in children to make informed clinical decisions. Knowing which tests are appropriate for specific situations can help healthcare providers accurately diagnose and manage pediatric patients with bleeding tendencies.
Question 2 of 5
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as which of the following?
Correct Answer: A
Rationale: In this scenario, the correct interpretation is option A) Normal finding. The closure of the anterior fontanel at 14 months is within the expected range of normal development in infants. The anterior fontanel typically closes between 12 to 18 months of age as the bones of the skull fuse together. This closure is a normal physiological process and indicates that the infant's cranial sutures are maturing appropriately. Option B) Questionable finding—indicates infant should be rechecked in 1 month is incorrect because the closure of the anterior fontanel at 14 months is not a cause for concern or a reason for immediate reevaluation. It falls within the normal range of development. Option C) Abnormal finding—indicates need for immediate referral to practitioner is incorrect as the closed anterior fontanel at this age is not indicative of any urgent medical condition or pathology that would require immediate referral. Option D) Abnormal finding—indicates need for developmental assessment is also incorrect as the closure of the anterior fontanel is a physical developmental milestone and does not specifically warrant a developmental assessment. In an educational context, it is crucial for pediatric clinical nurse specialists to have a comprehensive understanding of normal pediatric growth and development. Recognizing normal variations from abnormal findings is essential in providing appropriate care and guidance to infants and their families. Understanding the timing of fontanel closure is a key aspect of pediatric assessment, and interpreting this finding correctly can help prevent unnecessary parental anxiety and medical interventions.
Question 3 of 5
Sara, age 4 months, was born at 35 weeks of gestation. She seems to be developing normally, but her parents are concerned because she is a more difficult baby than their other child, who was term. The nurse should explain that:
Correct Answer: A
Rationale: The correct answer is A) infants' temperaments are part of their unique characteristics. This response is correct because infants, just like adults, have individual temperaments that are innate and not necessarily influenced by external factors. It is essential for parents to understand that babies can have different temperaments, and being a more difficult baby does not necessarily indicate a problem. Option B) stating that infants become less difficult if they are not kept on scheduled feedings and structured routines is incorrect. Infants actually thrive on routine and structure, and deviating from scheduled feedings can disrupt their development and overall well-being. Option C) suggesting that Sara's behavior is suggestive of failure to bond completely with her parents is incorrect. Bonding is a complex process that is not solely determined by an infant's temperament. Sara's behavior is likely not a reflection of bonding issues. Option D) claiming that Sara's difficult temperament is the result of painful experiences in the neonatal period is also incorrect in this scenario. While past experiences can impact a child's behavior, it is unlikely that this is the cause of Sara's temperament at 4 months of age. Educationally, this question highlights the importance of understanding infant development and temperament variability. It is crucial for healthcare providers, like pediatric clinical nurse specialists, to educate parents about normal variations in infant behavior and reassure them that differences in temperament are common and natural. This knowledge helps parents better respond to and care for their children, fostering a healthy parent-child relationship.
Question 4 of 5
A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given:
Correct Answer: C
Rationale: The correct answer is C. For infants younger than 1 year, the American Academy of Pediatrics recommends the use of breast milk or iron-fortified formula. If breastfeeding is discontinued before 1 year, it is important to switch to a commercial iron-fortified formula to ensure the infant is receiving all the necessary nutrients for growth and development.
Question 5 of 5
Menses typically begins 2.5 years after the onset of puberty at an average age of
Correct Answer: D
Rationale: Understanding the timing of menarche (the onset of menstruation) is crucial for pediatric clinical nurse specialists as it helps in assessing normal development in adolescent girls. The correct answer is D) 12.5 years. Menstruation typically begins around 2.5 years after the onset of puberty, which usually occurs around the age of 10-14 years. This aligns with the average age of 12.5 years for the start of menses. Option A) 9.5 years is too early for the average onset of menarche, as girls typically do not reach this milestone until they are closer to their teenage years. Option B) 10.5 years is also premature for the onset of menstruation, falling below the typical age range for menarche. Option C) 11.5 years is closer to the average but still slightly younger than the usual age when girls start menstruating. Educationally, this question emphasizes the importance of recognizing normal variations in puberty and menstrual patterns among adolescent girls. By understanding the typical age range for menarche, pediatric clinical nurse specialists can better assess and support the reproductive health and development of their young patients. It also highlights the need for healthcare providers to be knowledgeable about normal growth and development to provide appropriate care and guidance to adolescents and their families.