ATI RN
RN ATI Pediatric Proctored Exam 2023 with NGN Questions
Extract:
Question 1 of 5
Your patient has just returned from the OR following an arterial septal defect repair. You are reviewing your orders and question the fluid rate ordered. Your patient is 6 years old and weighs 50 pounds. Select the appropriate hourly maintenance fluid rate for your patient.
Correct Answer: A
Rationale: The appropriate hourly maintenance fluid rate for a 6-year-old patient weighing 50 pounds can be calculated using the Holliday-Segar method, which recommends 100 ml/kg/day for the first 10 kg of body weight, 50 ml/kg/day for the next 10 kg, and 20 ml/kg/day for each additional kg. Converting the patient's weight from pounds to kg (50 lbs / 2.2 = 22.73 kg), the calculation would be:
100 ml x 10 kg + 50 ml x 10 kg + 20 ml x 2.73 kg = 1000 ml + 500 ml + 54.6 ml = 1554.6 ml/day
To convert this to an hourly rate, divide by 24 hours: 1554.6 ml/day / 24 hours = 64.775 ml/hr, which rounds down to 63 ml/hr (Option
A).
The other choices are incorrect because
Question 2 of 5
Which is the correct positioning of a child experiencing epistaxis:
Correct Answer: D
Rationale: The correct positioning for a child experiencing epistaxis (nosebleed) is option D: the child should sit up and lean forward. This position helps prevent blood from flowing down the throat, reducing the risk of choking or aspiration. Sitting up also helps to reduce blood pressure in the vessels of the nose, aiding in the clotting process. Placing the child in a prone position (option
A) can lead to blood flowing down the throat, causing potential airway obstruction. Placing the child in a supine position (option
B) can also lead to blood going down the throat and may increase the risk of aspiration. Sitting with the head tilted back (option
C) is not recommended as it can lead to blood running down the back of the throat and potentially into the airway.
Therefore, option D is the correct choice for managing epistaxis in a child.
Question 3 of 5
A 15-year-old with type 1 diabetes mellitus presents with a fever and 48-hour history of vomiting. As the nurse, you note the child's breath has a fruity odour, his breathing is deep and rapid, and mom states he has become less arousable. You recognize these are the signs of:
Correct Answer: B
Rationale: The correct answer is B: Diabetic Ketoacidosis (DK
A). The fruity odor of breath, deep and rapid breathing (Kussmaul breathing), and altered mental status are classic signs of DKA. In DKA, the body produces excess ketones due to lack of insulin, leading to metabolic acidosis. Acute Hypoglycemia (
A) presents with low blood sugar levels, not high as in DKA. Hyperglycemia (
C) is a general term for high blood sugar without the specific ketone production seen in DKA. Polydipsia (
D) refers to excessive thirst, not the symptoms described in the scenario.
Question 4 of 5
The nurse is providing education to the parents of an infant with cradle cap. Which of the following statements by the parents indicates their understanding?
Correct Answer: C
Rationale: The correct answer is C: "We should brush the loosened crusts out of the hair after shampooing." This statement indicates understanding as brushing the loosened crusts helps to remove the scales and prevent further build-up. Hydrogen peroxide (
A) is not recommended for cradle cap as it can irritate the skin. Asthma and allergies (
B) are not directly related to cradle cap. Decreasing hair wash frequency to once a week (
D) can worsen cradle cap by allowing build-up of oils and dead skin cells.
Question 5 of 5
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
Correct Answer: B
Rationale:
Correct
Answer: B
Rationale: Manifestations of ADHD affect all aspects of the child's life but are most obvious in the classroom. ADHD symptoms impact academic performance, social interactions, and behavior in various settings. Children with ADHD often struggle with impulse control, hyperactivity, and inattention, leading to challenges in the classroom environment. This choice acknowledges the pervasive nature of ADHD symptoms while highlighting the prominent impact on the child's educational experience.
Summary of other choices:
A: Incorrect - Manifestations of ADHD are not necessarily bizarre, and the diagnosis is often complex due to overlapping symptoms with other conditions.
C: Incorrect - Learning disabilities and ADHD are separate conditions, and ADHD symptoms may persist into adulthood without necessarily disappearing.
D: Incorrect - While consistent manifestations are a key diagnostic criterion, ADHD symptoms can fluctuate in intensity and may still be present without being constant.