Past Exams
2019 ATI Pediatrics Proctored Exam with Answers (61 Solved Questions)
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ATI PEDIATRICS PROCTORED 2019 B EXAM COMPLETEQUESTIONS AND ANSWERS WITH RATIONALES.LATESTUPDATE 2023•Anurseisassessingthepainlevelofa3yearoldtoddler.Whichofthefollowingassessment scalesshouldthenurse use?•FACES•Numeric•CRIES•Visual analog✔✔✔A. The nurse should use the FACES painrating scaleforpediatricclientswhoare3yearsoldandolder.Thisscaleallowsthetoddlertopointto the face that depicts theircurrent level of pain. The nurse can then determinetheneed forpain management.•Anurseisplanninganeducationalprogramtoteachparentsaboutpro-tecting their children from sunburns.Whichof the following instructionsshouldthe nurse plantoinclude?Page 2

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•"allowyourchildtoplayoutsideduringthehoursbetween10:00amand2:00pm."•"chooseawaterproofsunscreenwithaminimumSPFof15."•"dressyouchildinlooseweavepolyesterfabricpriortosunexposure."•"reapply sunscreen every4hours."✔✔✔B. The nurseshould instruct parents toapplyawaterproofsunscreenwithaminimumSPFof15forchildren.Theparentsshouldapply thesunscreen prior to sun exposure to reduce the risk of sunburn.•Anurseisperforminghearingscreeningsforchildrenatacommunityhealth fair. Which of the followingchildren should the nurse referto aproviderforamoreextensivehearingevaluation?•an18montholdtoddlerwhohasunintelligiblespeech•a3 monthold infant whohas exaggeratedstartleresponse•a4yearoldpreschoolerwhoprefersplayingwithothersratherthanalone•an8montholdinfantwhoisnotyetmakingbabblingsounds✔✔✔D.Thenurseshould refer an infant who is notPage 4
making babbling sounds by the age of 7 monthstoaproviderforamoreextensiveevaluationofhearing.•A nurse in an emergency department is assessing a 3month old infantwhohasrotavirusandisexperiencingacutevomitinganddiarrhea.Whichofthe followingmanifestations should the nurse identify as an indicationthattheinfant has moderate tosevere dehydration?•HR 124•increasedtearproduction•sunkenanteriorfontanel•capillaryrefill2seconds✔✔✔C.Thenurseshouldrecognizethatasunkenanteriorfontanel is an indication of moderate tosevere dehydration due to the acute lossof fluid.•Anurseisprovidingteachingtothefamilyofaschool-agechildwhohasjuvenile idiopathicarthrisis. Which of thefollowing instructions should thenurseinclude in theteaching?•"limitmovementofthechild'slargejoints"•"encouragethechildtoperformindependent self-care."Page 5
•"providethechildwithasoftmattressforsleeping."•"schedulea2hourdailynapforthe child in theafternoon."✔✔✔B.The nurse should teach the family theimportance of encouraging the child to performindependentself-care.Thiswillminimizethechild'spainwhilemaximizingmobility.Encouraging and praising the child's efforts forindependence will also increasetheir self-esteem.•Anurseisplanningcareforaschoolagechildwhohasatunneledcentralvenousaccessdevice.Whichofthefollowinginterventionsshouldthenurseincludein the plan?•usesterilescissorstoremovethedressingfromthesite•irrigateeachlumenweeklywith10mlof0.9%sodiumchloridesolutionwhen not in use•access the site suing a noncoring angle needle•useasemipermeabletransparentdepressingtocoverthesite✔✔✔D.Thenurseshouldcoverthesitewithasemipermeabletransparentdressingtoreducetheriskofinfection.Page 6
•Anurseisprovidinganticipatoryguidancetotheparentofatoddler.Whichof the following expected behaviorcharacteristics of toddlers should thenurseinclude?•controlsimpulsivefeelings•understandsrightfromwrong•easilyseparatesfromparentsforlongperiodsoftime•expresseslikesanddislikes✔✔✔D.Thenurseshouldincludethatexpressinglikesand dislikes is an expected behaviorof toddlers.This is the time in life when atoddlerisdevelopingautonomyandself-concept.Theywilltrytoassertthemselvesandfrequentlyrefusetocomply.Theparentshouldallowthechildtohave somecontrol,butalsosetlimitsforthemsotheylearnfromtheirbehaviorandlearntocontroltheir actions.•Anurseisprovidingdischargeteachingtotheparentofaschoolagechildwho has moderate persistentasthma.Which of the following instructionsshouldthe nurseinclude?Page 7
•"youshouldgiveyourchildtheirsalmeterolinhalerevery4hourswhentheyare having an acute episodeofwheezing."•"youshouldmonitoryourchild'sweightweeklywhiletheyarereceivinginhaledcorticosteroids therapy."•"pulmonaryfunctiontestswillbeperformedevery12-24monthstoevalu-atehowyourchildisresponding totherapy."•"when using the peak expiratory flow meter, record yourchild's averageof three readings."✔✔✔C. The nurse shouldinform the parent that their child willneedpulmonaryfunctiontestsevery12to24monthstoevaluatethepresenceoflungdisease and how the child is responding to the current treatmentregimen.As children grow, sometimes their manifestations canimprove or decline, andtreatmentneeds tochange accordingly.•A nurse is assessing an adolescent who received asodium polystyrenesulfonateenema.Whichofthefollowingfindingsindicates effectiveness ofthemedication?•reportsanabsence ofnausea andvomitingPage 8
•reportsexperiencinganonsetofloosestoolswithin15minutesofadmin-istration•serumpotassiumlevel4.1mEq/L•blood pressure 86/52 mmHg✔✔✔C. The nurse shouldmonitor the adolescent'sserum potassium level following theadministration of sodium polystyrene sul-fonate. Thismedication is used to treat hyperkalemiaby exchanging sodiumionsforpotassiumionsintheintestine.Therefore,apotassiumlevelwithintheexpectedreferencerangeof3.4to4.7mEq/Lindicatestheeffectivenessofthemedication.•Anurseisassessing aninfantwhohaspneumonia.Whichofthefollow-ingfindingsisthe priorityforthenursetoreporttheprovider?•nasal flaring•WBC count 11,300/mm^3•diarrhea•abdominaldistension✔✔✔A.Whenusingtheairway,breathing,and circulationPage 9
approachtoclientcare,thenurseshoulddeterminethatthepriorityfindingtoreportto the provider is nasal flaring. Nasal flaringindicates the infant is experiencingacute respiratory distress.•A nurse is providing discharge teaching to the guardianof a school agechildwhohasundergoneatonsillectomy.Whichofthefollowingstatementsbytheguardian indicatesanunderstanding theteaching?•"mychildcanresumeusualactivitiessincethisyearjustanoutpatientsurgery."•"mychildwillbeabletodrinkthechocolatemilkshakeIpromisedtogetforthem tonight."•"IwillnotifythedoctorifInoticethatmychildisswallowingfrequently."•"I will have my child gargle with warm salt water torelieve their sorethroat."✔✔✔C.Thenurseshouldinstructtheparentthatfrequentswallowingis anindicationofbleedingand,ifitisobserved,tonotifytheproviderimmediately.•Anurseisdiscussingorgandonationwiththeparentsofaschoolagechild who has sustainedbrain death due toa bicycle crash. Which of thefollowingactions shouldthenursetake first?Page 10
•informtheparentsthatwrittenconsentisrequiredpriortoorgandonation•providewritteninformationtotheparentsaboutorgandonation•asktheprovidertoexplainmisconceptionsoforgandonationtotheparents.•exploretheparentsfeelingsandwishesregardingorgandonation✔✔✔D.Thefirst action the nurse should take whenusing the nursing process is assessment.The nurse should firstexplore the parents' feelings and wishes regarding organdonationtoassistindeterminingiforgandonationistherightchoiceforthefamily.•Anurseiscaringforanewlyadmittedschoolagechildwhohashypopi-tuitarism. Which of the followingmedicationsshould the nurse expect theprovidertoprescribe?•Desmopressin•Luteinizing hormone-releasing hormone•Recombinantgrowthhormone•Levothyroxine✔✔✔C. Recombinant growthhormoneinjections are used to treathypopituitarism,whichinhibitscellPage 11
growthandresultsingrowthfailure.The nurseshouldexpect theprovider toprescribe this treatment.•Anurseisprovidingdischargeteachingtoheparentsofa3montholdinfant following a cheiloplasty. Which ofthe following instructionsshouldthenurse include?•"cleanyourbaby'ssuturesdailywithamixtureofchlorhexidineandwater."•"expectyourbabytoswallowmorethanusualoverthenextfewdays."•"inspectyourbaby'stongueforwhitepatchesusingatonguedepressorevery8 hours."•"apply a thin layer of antibiotic ointment on your baby'ssuture line dailyforthenext3days."✔✔✔D.Thenurseshouldinstructtheparentstoapplyathinlayerof antibiotic ointment onthe infant's suture line daily for 3 days and then continuetoapplypetroleumjellytotheareaforseveralweekstopromotehealing.•Anurseiscaringforaschoolagechildwhohasperipheral edema.Thenurse should identify that which ofthe following assessments should beperformedtoconfirm peripheral edema?Page 12
•palpatethedorsumofthechild'sfeet•weighthechilddailyusingthesamescale•assessthechild'sskinturgor•observethechildforperiorbitalswelling✔✔✔A.Thenurseshouldpalpatethedorsum of the feet by pressing thefingertip against a bony prominence for 5secondsto assessfor peripheral edema.•A nurseis caring for a 10 year old child following ahead injury. Whichofthefollowingfindingsshouldthenurseidentifyasanindicationthatthechildis developingdiabetes incipidus?•urinespecificgravity1.045•sodium 155 mEq/L•bloodglucose45mg/dL•urine output 35 mL/hr✔✔✔B•A school nurse is providing an in service for facultyabout improvingeducationforstudentswhohaveADHD.Whichofthefollowingstatementsbyafaculty memberindicatesan understandingofthe teaching?•"IwillplantoincreasetheamountofhomeworkIassigntostudentswhohaveADHD."
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