2023 ATI Paediatrics Proctored Exam With Answers (190 Solved Questions)

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2023 ATI Paediatrics Proctored Exam With Answers (190 Solved Questions) - Page 1 preview image

NGN ATI PEDS PROCTORED EXAM LATEST 2023 / PEDS ATI PROCTORED ACTUAL EXAM ALL300+QUESTIONS AND CORRECT DETAILEDANSWERS1/451.A nurse is teaching themother of a 5-year-oldchild who has cystic fi-brosis about pancreat-ic enzymes.The nurseshould understand thatfurther teaching is nec-essarywhenthemotherstateswhichofthefollow-ing?2.. A nurse is admitting aninfantwhohasseverede-hydrationfromacutegas-troenteritis.Which of thefollowingfindingsshouldthe nurse expect?3.2. A nurse is teach-ingaclientaboutposi-tive signs of pregnancy.Which of the followingfindingsshouldthenurseinclude?4.. Anurse is caring for achildwhoisexperiencingaseizure.Whichofthefol-lowingactionsshouldthenurse take?5.. A nurse is assessingan8-month-oldinfantforcerebral palsy.Which ofthefollowingfindingsisamanifestation of the con-dition?"Iwillgivemysontheenzymesbetweenmeals."Rationale:Theparentshouldgivethechildpan-creatic enzymes with every meal and snack.13%weightlossRationale:A weight loss greater than 10% is amanifestationofseveredehydrationinaninfant.FetalhearttonesdetectedbyultrasoundRationale:Fetal heart tones are a positive signof pregnancy because the presence of fetalhearttonescanonlybeexplainedbypregnancyPositionthechildlaterallySitswithpillowpropsRationale:Infantswhohavecerebralpalsyre-quire support when sitting upright.6.

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2/45Anurseiscaringfora toddler who is havingdifficulty sleeping dur-inghospitalization.Whichof the following actionsshould the nurse take topromote sleep?7.A nurse is caring for achildwhoisexperiencingaseizure.Whichofthefol-lowingactionsshouldthenurse take?8.. A nurse is caring foraninfantwhohasgas-troesophagealreflux.Thenurseshouldplacethein-fant in which of thefol-lowing positions follow-ing feedings?9.A nurse is caring for achild who is having atonic-clonicseizureandvomiting.Which of thefollowing actions is thenurse's priority?10.A nurse is preparing toteach about communi-cable diseases. Duringwhichof the followingstages is the period inwhichadiseaseisconta-gious?11.Anurseisassessinga3-month-oldinfant.Whichof the following findingsProvidebedtimerituals.Rationale:Establishing a bedtime routine is im-portant.Reading a familiarbook or providing afavoritestuffedtoyorblanketwillhelpdecreasethe child's insecurity and fears.Positionthechildlaterally.Rationale:Positioningthechildlaterallyfacili-tates airway patencyPlacetheinfantinaninfantseat.Rationale:Aninfantseatprovideselevationanddecreases the risk of aspiration.Positionthechildside-lying.Rationale:Thisistheprioritynursingaction.Toprevent aspiration due to vomiting, the nurseshould place the child in a side-lying position.CommunicabilityperiodRationale:The communicability period is thetimewhenadiseaseiscontagiousandcanbetransmitted to others.Inability to raise head when in prone positionRationale:A3-month-oldinfantshouldbeable

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3/45shouldthenursereporttothe provider?12.A nurse receives a callfrom a parent of a childwhohasvonWillebranddiseaseandhashavinga nosebleed.Which ofthefollowinginstructionsshould the nurse give tothe parent?13.A nurse is assessing apreschooler.Whichofthefollowingfindingsshouldindicate to the nurse aneedforspeechtherapy?(Select all that apply.)14.A nurse is caring for anadolescent who was ad-mitted with anorexia ner-vosa.Which of the fol-lowingfindingshouldthenurseexpect?15.A nurse is caring for achildwhohasbeenphys-ically abused by a familymember.Whichofthefol-lowingstatementsshouldthe nurse to say to thechild?16.A nurse is caringforachildwhohasLegg-Calve-Perthes dis-easeandisinBuckexten-siontraction.Whichoftheto raise her head and shoulders from proneposition;therefore,thenurseshouldreportthisfinding to the provider"Haveyourchildsitwithherheadtiltedforwardandholdpressureonhernosefor10minutes."The preschooler mispronounceswords.E.The preschooler speaks in a nasallytoneBloatingRationale:Bloatingisafindingassociatedwithanorexia nervosa."Itisnotyourfaultthatthishappened."Rationale:Thenurseshouldreinforcetothechildthat the abuse is not his faultRepositionthechildevery2hr.Rationale:Thenurseshouldrepositionthechildshouldberepositionedevery2hrtopreventskinbreakdown

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4/45followingactionsshouldthe nurse take?17.Anurseisprovidingcareto children on a gener-al pediatric unit.Whichof the following childrenshould the nurse identi-fyasapotentialvictimofabuse?AchildwhoseparentsanswerquestionsforthechildRationale:Oftentheperpetratorofabuseiscon-trollingandwilltalkforthechildtoavoidtheriskofthechildsayingsomethingthatcouldexposetheabuse.Aschool-agechildshouldbeabletoanswermostquestions.Thenurseshouldgath-erinformationwhentheparentsareabsentandto determineif the child interacts differently18.Anurseiscaringforatod-instructtheparenttoavoidpressingontheab-dler whose parent stateswhile bathing the childshenoticedamassinhisabdominal area and thathis urine is a pink color.Whichofthefollowingac-tionsisthenurse'spriori-ty?19..A nurse is providingteaching to the parentsof a child who has irondeficiencyanemiaandistakingironsupplements.Which of the followingdominalarea.Rationale:The priority action is to instruct theparenttoavoidpressingonthechild'sabdomen.ThesesymptomsareassociatedwithWilms'tu-mor,andtraumatothemassshouldbeavoidedto prevent movement of cancer cells into othersites."Ourchild'sbloodcountwillneedtobemoni-tored routinely for several weeks."Rationale:Thechild'sresponsetotreatmentwillbe determined by monitoring hemoglobin andhematocrit levels through routine blood tests.statementsbytheparentsTreatmentcantakeupto3monthstobeeffec-indicatesanunderstand-ing of the teaching?20..A nurse is planning carefora4-year-oldchildwhorequiresairborneprecau-tions.Whichofthefollow-ing activities shouldthenurse plan for child?tive.Putting a large-piece puzzletogetherRationale:A child who requires airborne pre-cautionsmustremaininherroom.Appropriateactivities for a 4-year old child include puttingtogetherlarge-piecepuzzles,usingpaintsand

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5/4521.A nurse is preparing toadminister a vaccine intothe deltoid muscle of apreschooler.Whichofthefollowing actions shouldthe nurse take?22..A nurse is providingteaching to a parentof a preschooler whohaseczema.Whichofthefollowinginstructionsshould the nurse includein the teaching?23.A nurse is providingteaching to a school-agechildwhohasanewdiag-nosis of type 1 diabetesmellitus.Whichofthefol-lowing statements by thechild indicates an under-standingoftheteaching?24.Anurseiscaringfora pre-school age childwhohasepiglottitiswitha barking cough.Whichof the following actionsshould the nurse take?25..A nurse is caring forachildontheoncolo-gy unit.The child's par-entsareaskingthenurseabout the cancerdiagno-crayons, playing ball, riding tricycles, playingpretendanddressup,sewingcardsandbeads,and reading books.Applyatopicalcorticosteroidointmenttotheaffected area.Rationale:Thechildmightrequireatopicalcor-ticosteroid ointment to use during flare-ups todecrease inflammation"Ishouldeatasnackhalfanhourbeforeplayingsoccer."Rationale:Exerciselowersbloodglucoselevels.Thechildshouldeatasnackhalfanhourpriortophysicalactivity.Iftheexerciseisprolonged,thechild might require a snack during the activity.Monitoroxygensaturation.Rationale:Thenurse should monitor the child'soxygensaturationlevelstocheckforindicationsofrespiratorydistressoradeclinechild'scondi-tion.Wilms'tumorRationale:Wilms' tumor, or nephroblastoma, isthemostcommonmalignantrenalandintra-ab-dominaltumorofchildhood.28.Anurseiscaring

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6/45sis.Which of the follow-ing information shouldthenurseprovidethepar-entsaboutthemostcom-mon malignant renal andintra-abdominal tumor ofchildhood?26.A nurse is caring for aschool-agechildwhohasmild persistent asthma.Which of the following isanexpectedfinding?(Se-lect all that apply.27.Aschoolnurseisassess-inganadolescentwhore-ports feeling shaky andishavingdifficultyspeak-ing and concentrating onthequestionsthenurseisasking.Thenursechecksthe adolescent's bloodglucose level and identi-fies a value of 55 mg/dL.Which of the followingfindingsshouldthenurseexpect?28.Anurseisprovidingteachingtoaparentof a child who hasacutegroupAß-hemolyt-ic streptococci.Which ofthe following informationshould the nurse includein the teaching?foraschool-agechildwhohasmildpersistentasthma.Which of the following is an expecteDaytimesymptomsoccurmorethantwiceaweek.MinorlimitationsoccurwithnormalactivityPeakexpiratoryflow(PEF)isgreaterthanorequal to 80% of the predicted value.TachycardiaRationale:A blood glucose level of 55 mg/dLisbelowtheexpectedreferencerangeandanadolescentwiththisbloodglucoselevelislikelytohavetachycardiaduetoincreasedcirculatingcatecholaminesandincreasedadrenergicactiv-ity.Replacethechild'stoothbrushafter24hronantibiotics.Rationale:Thechild'stoothbrushshouldbere-placed after 24 hr on antibiotics to prevent thespread of infection or re-infection.29.

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7/45Anurseiscaringforatod-Administeropioidsforpain.dler who is 24 hrpost-operativefollowingacleftpalaterepair.Whichofthefollowing actions shouldthe nurse take?30.A nurse is caring foraninfantwhohasgas-troesophagealreflux.Thenurse should recognizethat which of the follow-ing findings are associ-ated with this condition?(Select all that apply.31.A nurse is preparing toassist with applying acast to a preschooler'sarm.Whichofthefollow-ing actions should thenurse take?32.A nurse is caring for aschool-agechildwhohasacute glomerulonephritiswith peripheral edemaandisproducing35mLofurine per hour.The nurseshouldplacetheclientonRationale:Administering opioids for pain is anappropriateactionbythenurse.Opioidscontrolpain in the immediate postoperative period arefollowed by administration of acetaminophenPRN.VomitingWeightlossWheezing.Wrapthearmofthechild'sdollortoypriortothe procedure.Rationale:The nurse shouldconsider the de-velopmental age before the cast is applied.Apreschooler might fear bodily harm and fanta-size about the loss of an extremity.Usinga dollorstuffedanimalhelpstoexplaintheprocedure.During this stage of development, the child isa "magical thinker" and might believe stuffedanimals are alive.This action shows the childthatitdoesnothurtthedollorstuffedanimal,and, in turn, will not hurt the childLow-sodium,fluid-restrictedRationale:Alow-sodium,fluid-restricteddietwillprevent complications.

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8/45whichofthefollowingdi-ets?33.A nurse is assessing aschool-age child whoseblood glucose level is280 mg/dL.Which of thefollowingfindingsshouldthe nurse expect?34..Anurseiscaringforachildwhohastineapedis.Thechild'sparentasksthenursewhatthisinfection is commonlycalled.Thenurseshouldrespond with which ofthe following commonnames?35..A nurse in a clinic is as-sessinga9-month-oldin-fant.Which of the follow-ingfindings requires fur-ther intervention?36.A nurse is caring for achildwhohasasuspect-eddiagnosisofbacterialmeningitis.Which of thefollowing actions is thenurse's priority?37.A nurse in an emergencydepartment is assessinganinfantwhoisdehydrat-LethargyRationale:A blood glucose of 280 mg/dL isabove the expected reference range indicatinghyperglycemia.The nurse should expect thechildtoappearlethargic,leadingtoadecreasedlevel of consciousness and confusionAthlete'sfootRationale:Athlete'sfootisthecommonnamefortinea pedisPositiveMororeflexRationale:The Moro reflex disappears at ap-proximately 3 to 4 months of age.Therefore, a9-month-oldwhohasapositiveMororeflexisafinding that requires further interventionAdminister antibiotics whenavailable.Rationale:The priority nursing action is toadminister antibiotics when available. Bacteri-al meningitis is an acute inflammation of themeninges and the CNS.Antibiotic therapy hasamarkedeffectonthecourseandprognosisofthe illnessIrritability

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9/45ed.Whichofthefollowingfindingsshouldthenurseexpect?38.A nurse is providing dis-chargeinstructionstotheparent of a 10-year-oldchild following a cardiaccatheterization.Which ofthefollowinginstructionsshouldthenurseinclude?39.A nurse is assessing achild who is in sickle cellcrisis.Whichofthefollow-ing findings should thenurse expect?40..Anurseiscaringfora school-age child whohas asystemic disor-der and is receivingantibiotics,immunosup-pressants,andcorticos-teroids.Bothofthechild'sparents have a smokinghistory.The child reportssoreness in his mouthand refuses to eat. In-spection of his mouthreveals a white, milkyplaque that does notcome off with rubbing.The nurse should sus-pectwhichofthefollow-ing conditions?41.Anurseisreviewingdatafor four children.Whichof the following childrenRationale:Aninfantwhoisdehydratedwillexhib-it irritabilityGivethechildacetaminophenfordiscomfort.Rationale:The child might have minor discom-fortatthepuncturesite.Theparentshouldoffereither acetaminophen or ibuprofen due the riskofReyesyndromeassociatedwithtakingaspirinPainRationale:Aclientwhoisinsicklecellcrisishassevere pain resulting from tissue hypoxia andnecrosis.CandidiasisRationale:Manifestationsoforalcandidiasisin-clude white patches that adhere to the innercheeks,tongue,andpalatethatarepainfulandcan cause the child to refuse to eat.A10-year-oldchildwhohassicklecellanemiawho reports severe chest pain

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10/45shouldthenurseassessfirst42.Anurseiscaringfora6-week-oldinfantwhohas a pyloric steno-sis.Which of the fol-lowingclinicalmanifesta-tionsshouldthenurseex-pect?43.A nurse is assess-ingatoddlerwhohasacute nephrotic syn-drome.Whichofthefol-lowing findings shouldthe nurse report to theprovider?44.A nurse is caring for a6-month-oldinfantwhohas a prescription forclearliquidsbymouthaf-terarepairofanintussus-ception.Which of the fol-lowing fluids should thenurse select for the in-fant?45..Anurseisplanningcarefor a 5-month-old infantwho is scheduledfora lumbar puncturetoRationale:Whenusingtheurgentvs.nonurgentapproachtoclientcare,thenurseshoulddeter-mine that the 10-year-old child who has sick-le cell anemia and reports severe chest painshouldbeassessedfirst.Thisfindingisamed-icalemergencybecauseitisamanifestationofacute chest syndromeProjectilevomitingRationale:Pyloric stenosis is a narrowing of thepylorus,theoutletfromthestomachtothesmallintestine.Thenarrowingdoesnotallowforemp-tyingofthestomachcontents.Vomiting,whichisusuallymildatfirst,becomesmoreforcefulandprogresses to projectile vomiting.A.YellownasaldischargeRationale:Yelloworgreennasaldischargeisanindicationofanupperrespiratoryinfection.Chil-dren whohave nephrotic syndrome are at con-stant risk for infection.The nurse should reportthismanifestationtotheprovidersothechildcanreceive appropriate and prompt treatment.OralelectrolytesolutionRationale:After gastrointestinal surgery, infantsshouldreceiveclearliquidsthatcontainglucoseand electrolytes, such as an oral electrolyte orrehydrationsolution.Theyshouldthenadvanceto formula or breast milk as they demonstratetolerance.Holdtheinfant'schintohischestandkneestohisabdomen during the procedure.Rationale:Duringtheprocedure,theinfantis

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11/45ruleoutmeningitis.Whichof the following actionsshould the nurse includein the plan of care46.A nurse is caring for a10-month-old infant whois ina cast for de-velopmentaldysplasiaofthe hip (DDH).Which ofthe following strategiesshould the nurse imple-ment to promote the in-fant's growth and devel-opment?47.Anurseisreviewingthe laboratory results ofan adolescent who haschronicglomerulonephri-tis.Whichofthefollowingfindingsshouldthenurseexpect?48..A nurse is caring for achild who is postoper-ativefollowingventricu-loperitoneal (VP) shuntplacement. In which ofthe following positionsshould the nurse placethe client?49.Aschoolnurseisassess-ing a child for pediculo-sis capitis.Which of thefollowing manifestationsshould the nurse recog-nize as an indication ofthis condition?positionedonhersideinafetalposition(kneescurledtoabdomenandchintuckedtochest)toopen up the subarachnoid space.Allowtheinfanttostandinthecrib.Rationale:Allowingthechildtoparticipateinnor-mal developmental activities promotes growthand development.The infant can be held andallowed to walk in a cast ororthotic device.BUN50mg/dLRationale:Thenurseshouldexpecttheadoles-cent to have a BUN above the expected refer-encerangeduetokidneyinjuryandtheinabilitytofilterandexcreteureanitrogenfromtheblood.OntheunoperatedsideRationale:The nurse should position the childflat on the unoperated side to prevent a rapidreductionofintracranialfluidandtoprotectthechild for injuring the operative site.FirmlyattachedwhiteparticlesonthehairRationale:Pediculuscapitis,orheadlice,aretinyparasiticinsectsthatliveonthescalpandcanbespreadbyclosecontactwithotherpeople.Theireggs (nits) appear much like flakes of dandruff

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12/4550.A nurse is caring for achild who is having aseizure.Which of the fol-lowingactionsshouldthenurse take? (Select allthat apply.51.A nurse is providingteachingtotheparentsofa child who has strepto-coccal pharyngitis aboutways to prevent diseasetransmission.Which ofthe following responsesby the parents indicatesan understanding of theteaching?52.A home health nurseis teaching a child'sparentsaboutendotra-cheal suctioning.Whichofthefollowinginforma-tionshouldthenursein-clude in the teaching53.Anurse is providing careto a child who has an al-lergy to eggs.The nurseshould question a pre-scription for which of thefollowingimmunizations?54.A nurse is preparing toadminister a vaccine toa 4-year-old child.Whichofthefollowingvaccinesbutstickfirmlytothehairshaftinsteadofflakingoff of the scalpAssess the client's airway patency.Remove objects from the client's bed.Place the client in a side-lyingpositionWe'll discard his toothbrush and buy another."Rationale:Childrenwhohavepositivethroatcul-tures for streptococcal infection should replacetheirtoothbrushaftertheyhavebeentakingan-tibiotics for 24 hr.Using a contaminated tooth-brushcanre-introducethebacteriaandspreadit to others if others handle the toothbrush.Applysuctionforlessthan10seconds.Rationale:Prolongedsuctioningcancausedam-agetotissuesandinducehypoxia.Hypoxiacaninterfere with stages of respiration, cellular ab-sorption, and blood transportInfluenza,liveattenuated(LAIV)Rationale:AneggallergyisacontraindicationforreceivingtheLAIVvaccine.Severeanaphylacticreactions can occur and pose life-threateningconditions for the child.Varicella(VAR)Rationale:Thechildshouldhavereceivedthefirst dose between 12 to 15 months of age.

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13/45shouldthenurseadminis-ter?55.A nurse is providing nu-tritional teaching to themother of a preschool-er and is recommendingfoodoptionstoprovide1ozofgrains.Whichofthefollowing foods shouldthe nurse recommend56..Anurseisobtainingthelength and weight of a6-month-oldinfant.Whichof the following actionsshould the nurse take?(Select all that apply.)57.Anurseiscaringfora4-year-old child who hascroup and wet thebedovernight.When the par-ents visit the next day,thenurseexplainsthesit-uation and one of theparents says, "She nev-er wets the bed at home.I am so embarrassed."Whichofthefollowingre-sponsesshouldthenursemake58..Anurseisobtainingvitalsigns from 2-month-oldinfant.The infant's heartrate is 190/min and hisThechildshouldthenreceiveaseconddosebetween 4 and 6 years of age.1 cup ready-to-eat cereal flakesRationale:Thechildshouldeat1cupofready-to-eatcerealflakestoconsume1ozofgrains.Placeadisposablecoveringonthescale..Measuretheinfantfromcrownoftheheadtotheheels of feet.Balancethescale to0 priortouse."Itisexpectedforchildrenwhoarehospitalizedto regress.The toiletingskills will return whenyour child is feeling better."Rationale:A recently learned skill, such as toi-let training, is often temporarily lost due to thestressofhospitalization.Thenurseshouldreas-suretheparentsthatregressionisanexpectedbehavior in children who are hospitalized andthat her child will regain bladder control whenshe is feeling betterThefeveriscausinganincreaseinyourbaby'sheart rate."Rationale:Theexpectedreferencerangeforthetemperatureis40°C(104°temperatureofan infantfrombirth to1yearisF).Thefatherasksthenursewhytheinfant's36.5°C(97.7°F)to37.2°C(98.9°F).Thisinfanthasafeverthatiscausingtheinfant'sheart

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