ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH VERIFIED SOLUTIONS/A+ GRADE SCORE (UPDATED)

ATI Pediatric
4.
A nurse is assisting with the care of a child who is postoperative and received a transfusion
during a surgical procedure. Which of the following findings indicates the child is havig a
hemolytic reaction?
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
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a) Chills and flank pain (Chills and flank pain are findings that indicate an incompatibility
of the transfused blood product with the client's blood. The nurse should identify this
finding as an indication that the child is having a hemolytic reaction.)
b) Pruritus and flushing
c) Rales and cyanosis
d) Bradycardia and diarrhea
5. A guardian calls the clinic nurse after his child has developed symptoms of varicella and
asks when his child will no longer be contagious. Which of the following responses should
the nurse make?
a) “When your child no longer has a fever.”
b) “Three days after the rash started.”
c) “Six days after lesions appear if they are crusted.” (The nurse should inform the guardian
that a child will stop being contagious around 6 days after the lesions appeared, as long as
they are crusted over.)
d) “When your child’s lesions disappear.”
6. A nurse is collecting date from a child during a well-child visit. The nurse should recognize
that which of the following findings places the child at a higher risk for abuse?
a) The child is 6 years old.
b) The child is male.
c) The child was born at 30 weeks of gestation. (The nurse should identify that children
who are born prematurely are at greater risk for abuse because of the potential for
impaired bonding during early infancy.)
d) The child was born via cesarean birth.
7. A nurse is reinforcing teaching with the guardian of a child who has a new diagnosis of
rheumatic fever. Which of the following statements by the guardian indicates an
understanding of the teaching?
a) “I should not give my child aspirin for pain or fever.”
b) “My child will take antibiotic for 6 months.”
c) “My child might have a period of irregular movement of the extremities.” (The nurse
should instruct the guardian that the child might experience chorea weeks or months
after the initial diagnosis. Chorea is a temporary lack of coordination and the presence of
sudden, irregular movements or periods of clumsiness.)
d) “I should expect there to be blood in my child’s urine.”
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
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8. A nurse is collecting data from an infant during a well-child visit. Which of the following
sites should the nurse use when obtaining the infant’s heart rate?
a) Apical (The nurse should use the apical pulse to obtain the infant's heart rate and count it
for a full minute, because it gives a reliable rate and rhythm and provides accurate
baseline assessment data. In an infant, the apical heart rate is auscultated at the fourth
intercostal space lateral to the midclavicular line.)
b) Radial
c) Carotid
d) Femoral
9. A nurse is preparing a toddler for suturing of a minor facial laceration. The nurse should
place the toddler in which of the following restraints?
a) Mummy restraint (The nurse should use a mummy wrap when a short-term restraint is
needed for treatment of the toddler that involves the head and neck. The nurse should
always use the least amount of restraint necessary.)
b) Jacket restraint
c) Elbow restraint
d) Wrist restraint
10. A nurse is reinforcing dietary teaching with the parent of a 2-year-old toddler. Which of the
following should the nurse include in the teaching?
a) "It is recommended that the toddler consumes no more than 12 ounces of fruit juice each
day."
b) "An appropriate serving size is 1 tablespoon of food per year of age." (The nurse should
include that an appropriate serving size for a 2-year-old toddler is 1 tbsp of food per year
of age.)
c) "Introduce healthy finger foods like carrots and celery sticks."
d) "Encourage 5 cups of low-fat milk each day."
11. During a well-child visit, the parent of a toddler expresses concern to the nurse that the
toddler takes several hours to fall asleep at night. Which of the following recommendations
should the nurse make?
a) Vary the time the toddler goes to bed each night
b) Allow the toddler to watch television before bedtime
c) Provide the toddler with a favorite toy at bedtime. (The nurse should recommend to the
parent that providing the toddler with a favorite toy at bedtime will help the toddler to
feel more secure and facilitate sleep.)
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
VERIFIED SOLUTIONS/A+ GRADE SCORE (UPDATED)
d) Increase the toddler's activity prior to bedtime
12. A nurse is assisting with the care for a 7-month-old infant who has a cleft palate. Which of
the following actions should the nurse take to decrease the infant’s risk for aspiration?
a) Feed the infant in supine position.
b) Encourage the mother to breastfeed the infant exclusively.
c) Burp the infant frequently during feedings. (Infants with a cleft palate have difficulty
creating a seal around a bottle. Burping the infant frequently, following every ounce of
fluid consumed, dissipates swallowed air and helps to prevent aspiration.)
d) Perform nasotracheal suctioning if coughing occurs
13. A nurse is reviewing the laboratory values of a school-age child who has iron deficiency
anemia. Which of the following findings should the nurse expect?
a) Hgb 9.0 g/dL (The nurse should expect a child who has iron deficiency anemia to have an
Hgb level below the expected reference range of 9.5 to 15.5 g/dL. An Hgb of 9.0 g/dL is
below the expected reference range.)
b) Hct 37%
c) Iron 100 mcg/dL
d) Total iron binding capacity 325 mcg/dL
14. A nurse is reinforcing teaching about vital signs with the guardian of a 1-year-old toddler.
Which of the following statements by the guardian indicates an understanding of the
teaching?
a) "My child's pulse could increase to 150 beats a minute with activity.” (A pulse rateof
150/min is within the expected reference range for a toddler during physical activity.)
b) "My child's temperature should be 96.8 degrees Fahrenheit."
c) "My child should take 40 breaths a minute."
d) "My child's pulse could get as low as 60 beats a minute while asleep."
15. A nurse is caring for an adolescent who has acne and anew prescription for isotretinoin. For
which of the following adverse effects should the nurse monitor?
a) Hypersalivation
b) Depression (Clients taking isotretinoin can experience mental status changes, such as
suicidal thoughts, aggression, emotional lability, and depression. The nurse should
monitor the adolescent's mental status while taking isotretinoin.)
c) Bradycardia
d) Hyperreflexia
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
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16. A nurse is reinforcing teaching about interventions for mild hypoglycemia with the parent
of a child who has diabetes mellitus. Which of the following statements by the parent
indicates that the teaching has been effective?
a) "I should administer a glucagon injection to my child."
b) "I should give my child 5 grams of a simple carbohydrate."
c) "I should give my child 4 ounces of orange juice followed by cheese and crackers." (The
parent should treat mild hypoglycemia with 10 to 15 g of a simple carbohydrate, such as
4 oz. of orange juice, and follow it with a starch-protein snack.)
d) "I should give my child a snack that is 10 percent of his daily caloric intake."
17. A nurse is collecting data from a 10-month-old infant. Which of the following findings
should the nurse report to the provider?
a) Pulls self to standing position
b) Moves by creeping on hands and knees
c) Takes intentional steps when standing
d) Sits with support by leaning on hands (The nurse should identify that sitting with support
can indicate a developmental delay, because an infant should be able to sit unsupported
by 8 months of age. Therefore, the nurse should report this finding to the provider.)
18. A nurse is preparing to administer phenobarbital to a toddler who has a seizure disorder
and weights 10 kg (22 lb). The prescription reads phenobarbital sodium 2.5 mg/kg PO BID.
Available is phenobarbital 20 mg/5 mL. How many mL should the nurse administer with
each dose? (Round to the nearest hundredth. Use a leading zero if it applies. Do not use a
trailing zero
Ratio and Proportion
6.26 mL
Step 1: What is the unit of measurement the nurse should calculate? mL
Step 2: What is the dose the nurse should administer? Dose to administer = Desired 2.5 mg/kg =
2.5 x 10 = 25 mg
Step 3: What is the dose available? Dose available = Have 20 mg
Step 4: Should the nurse convert the units of measurement? No
Step 5: What is the quantity of the dose available? 5 mL
Step 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
20 mg/5 mL = 25 mg/X mL
X = 6.25
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
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19. A nurse is caring for a child who has type 1 diabetes mellitus and has been receiving insulin
via subcutaneous infusion pump. Which of the following laboratory tests would verify the
average blood glucose level over the past 2 months?
a) Postprandial blood glucose
b) Fasting blood glucose
c) Glycosylated hemoglobin (Glycosylated hemoglobin provides an accurate average of the
client's blood glucose level over the past 120 days. This test can be used to determine the
effectiveness of, or compliance with, a treatment plan. It can also be used to diagnose
diabetes mellitus.)
d) Mean corpuscular hemoglobin
20. A nurse is reinforcing teaching with the guardian of a child who has a new prescription for
levalbuterol solution for use in a nebulizer. Which of the following statements by the
guardian indicates an understanding of the teaching?
a) "I should store the unused medication in the freezer."
b) "I should make sure I use the vial within 3 weeks of opening it from the foil package."
c) "My child might be drowsy while taking this medication."
d) "My child might experience palpitations after taking this medication." (Palpitations are
an adverse effect of levalbuterol. If this occurs, the guardian should discontinue the
medication and notify the provider.
21. A nurse is collecting data from a 12-month-old infant during a well-child visit. At birth, the
infant’s weight was 3.6 kg (8 lb.) and his length was 50.8 cm (20 in). Based on this data,
whichof the following findings should the nurse expect?
a) The infant weighs 6.4 kg (14 lb)
b) The infant is 101.6 cm (40 in) long
c) The infant is 76.2 cm (30 in) long (The nurse should expect a length of 76.2 cm (30 in),
because the infant's length should increase by about 50% by 12 months of age.)
d) The infant weighs 14.5 kg (32 lb)
22. A nurse is reinforcing teaching about home care with the guardian of a 14-month-old
toddler who has spastic cerebral palsy. Which of the following statements by the guardian
indicates an understanding of the teaching?
a) "I will perform daily stretching exercises to my toddler's affected muscles." (The nurse
should reinforce that performing stretching exercises of the toddler's affected muscles
will prevent muscle contractures.)
b) "I will ensure my toddler avoids activities that involve repetitive joint movements."
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c) "I will place my toddler on his stomach to nap after meals."
d) "I will give my toddler pain medication just after he performs strenuous activities."
23. A nurse is assisting with the development of a health promotion program for the guardians
of adolescents. Which of the following information about adolescents should the nurse
recommend to include in the program?
a) The sleep patterns of adolescents are well established.
b) The percentage of adolescents that consider suicide is higher for males than for females.
c) The leading cause of death in adolescents is physical injury. (The nurse should
recommend including this information, because injuries from motor-vehicle crashes are
the leading cause of death in the adolescent population.)
d) The caloric intake needs of adolescents are less than that of school-age children.
24. A nurse in a pediatric clinic is caring for an infant who has heart failure and a prescription
for digoxin. Which of the following statements by the parent indicates the desired
therapeutic effect of the medication?
a) "My baby is breathing easier than she used to." (The nurse should identify that the
desired effect of digoxin is to increase cardiac output and decrease venous pressure and
pulmonary edema, which will reduce respiratory demands.)
b) "My baby is taking longer naps."
c) "My baby is having fewer wet diapers."
d) "My baby's heart rate is faster than it used to be."
25. A nurse is contributing to the plan of care for a 10-month-old infant who is postoperative
following cleft palate repair. Which of the following actions should the nurse include in the
plan of care?
a) Place the infant in side-lying position. (The nurse should place the infant in side-lying
position to promote healing and prevent injury to the surgical site.)
b) Offer the infant liquids with a straw.
c) Prohibit the guardian from holding the infant for 8 hr.
d) Cleanse the suture line with a lemon glycerin swab.
26. A nurse is caring for a toddler following a tonsillectomy. Which of the following is the
priority finding that the nurse should report to the provider?
a) Drowsiness
b) Throat pain
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
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c) Continuous swallowing (When using the urgent vs. nonurgent approach to client care, the
nurse should identify that continuous swallowing is a manifestation of hemorrhage.
Therefore, this is the priority finding for the nurse to report to the provider.)
d) Dark brown emesis
27. A nurse is reinforcing teaching with the guardian of a school age-age child who has acute
bacterial conjunctivitis and a new prescription for sulfacetamide. Which of the following
instructions should the nurse include?
a) Remove dried drainage with a cold washcloth.
b) Instill medication immediately after cleansing the eye. (The nurse should instruct the
guardian to place the medication in the eye immediately after cleansing.)
c) Apply an occlusive gauze over the child's eye.
d) Cleanse the eye by gently wiping from the outer aspect of the eye inward toward the
nose.
28. A nurse is preparing to leave the room after performing nasal suctioning for an infant who
has respiratory syncytial virus (RSV). Identify the sequence in which the nurse should
remove the following personal protective equipment (PPE). (Move the steps into the box on
the right, placing them in the order of performance. Use all the steps.)
Mask Gloves
Gloves Goggle
Gown Gown
Goggle Mask
The infant is on droplet and contact precautions due to the RSV. First, the nurse should remove
his gloves, because these are the most contaminated. Second, the nurse should remove goggles, so
they do not interfere with removing the other PPE. The nurse should then remove the gown, and
finally the mask, to decrease exposure to the disease.
29. A nurse in a provider’s office is caring for a preschooler who has findings of croup.Which
of the following statements by the parent requires immediate intervention by the nurse?
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ATI RN PEDIATRIC PROCTORED EXAM 2020 WITH
VERIFIED SOLUTIONS/A+ GRADE SCORE (UPDATED)
a) "My child has refused to drink any fluids for the past 8 hours." (An inadequate fluid
intake indicates the child is at greatest risk for dehydration and electrolyte imbalance.
Therefore, this statement by the parent requires immediate intervention by the nurse.)
b) "My child has been coughing throughout the night."
c) "My child is very hoarse and has a fever of 100.4 degrees Fahrenheit."
d) "My child recently had the flu."
30. A nurse is administering an injection of epinephrine to a child who is experiencing
manifestations of anaphylaxis. The nurse should monitor for which of the following adverse
effects?
a) Pinpoint pupils
b) Decreased heart rate
c) Increased systolic blood pressure (Epinephrine is an adrenergic agonist used to treat
anaphylaxis by activating the sympathetic nervous system. The nurse should expect the
child to have an increased systolic blood pressure following administration of
epinephrine.)
d) Dry skin
31. A nurse is reinforcing anticipatory guidance to the parents of an adolescent. Which of the
following recommendations should the nurse include?
a) Compare the adolescent's behavior to older siblings.
b) Be open to the adolescent's point of view. (During this stage of development, adolescents
are developing autonomy and self-identity. The nurse should recommend that the parents
actively listen and be open to the adolescent's point of view, even if the parents disagree
with his viewpoint.)
c) Select school activities for the adolescent.
d) Provide the adolescent with flexible rules.
32. A nurse is preparing to administer furosemide to a toddler who has a heart defect. Which of
the following should the nurse take to identify the toddler?
a) Ask the child to state her name.
b) Ask the pharmacy for the child's room number.
c) Ask the child to state her birthday.
d) Ask the guardian to verify the child's name. (Prior to administration of any medication,
the nurse must correctly identify the toddler using two identifiers. The nurse shouldask
the guardian to verify the identity of the child and use the identification band as the
second identifier.